National Rx Drug Abuse Summit, a Kentucky product, seeks to make the nation face up to its problem

The second annual National Rx Drug Abuse Summit, organized by Eastern Kentucky's Operation UNITE, called for a national commitment to combating the country's drug-abuse problem

U.S. Rep. Hal Rogers, R-5th District

"People of great passion and perspective are here wanting to make an impact in their communities," said U.S. Rep. Hal Rogers, who first funded Operation UNITE. "The first step is we have to admit there is a problem. I don't think the country is there yet. We've got to face up to it. We've got to make this known ... and that we're not going to hide from it." Rogers was quoted in a news release.

UNITE (Unlawful Narcotics Investigations, Treatment and Education) serves 32 counties in Eastern Kentucky. It was created to fight illegal drug use through a comprehensive approach that includes educating youth and the public and coordinating substance abuse treatment while providing support for families affected by abuse.

In Kentucky, drug overdose is the leading cause of death and is more fatal than motor vehicle accidents, and the number of Kentucky drug-overdose deaths nearly quadrupling from 2000 to 2010. The nation has seen a similar trend, with the number of overdose deaths more than tripling over the decade.

“We can stop this epidemic,” Dr. Thomas Frieden, director of the Centers for Disease Control and Prevention, said at the summit. “But we need everyone working together in an all-hands-on-deck approach.”

Themes highlighted at the summit included the need to provide better education about drug abuse, the need for greater use and seamless integration of state prescription-monitoring programs, the need to facilitate effective treatment and recovery programs, and the need for abuse-deterrent narcotic formulations.

“We were extremely pleased that so many individuals representing such a broad cross-section of interests shared their knowledge and expertise,” said Karen Kelly, who is leaving Operation UNITE to become district director on the Rogers congressional staff. To read more about the summit, click here.

Drive? Is Low Libido Really The Problem?

By John Smith

I've been coming across a lot of articles lately that all talk about the huge need of Viagra for men. You see, the world and even the internet is stocked full with what is mostly just really good ad campaigns. Don't get me wrong. As a guy, I think the idea of Viagra 500mg pills is great, but is it really necessary? Advertising isn't just on the TV any more. It's all over the place, in your morning coffee, in your breakfast cereal, in your house cleaning items, on your facebook, on your phone calls-basically it's everywhere. When you are making a decision on what is good for your body and what is not, don't always go by what you read. Make a careful decision and council with the right people. I have the hardest time researching health issues on the internet because I know that most the time what folks have to say is basically just promoting a product and a lot of fluff to go with it.

Take the subject of Viagra for men, for example. Yes, there are times and situations when it's required, and under these circumstances it is no joke, but most the time you will hear people talking about viagra so casually, that I think we miss the purpose behind it all together. What started out as a pill to help those with ED, has now become crass joke or a quick-pop-solution for a date gone bad. You just can't expect to base your entire life on what you read because most of the information that we have has been pumped up to not only make you want to buy the product but to make a lifestyle out of it.

After some of the stuff that I read about Viagra 500mg pills, I decided to research the matter a bit. Some articles say that the pill should be used for men who have a low libido, and others say that it is only for ED. On the subject of low libido, some health experts write that 1 out of 4 men have it, other say that 1 out of 5 have it, and yet others say that 1 out of 7 have it. Who is right? We really can't say. What I would say, however, is be careful before you buy. Viagra should not be used as the pass time pill for a quick recreation that most people and internet articles put it out to be.

This is a pill popping world and we have a prescribed pill for just about every problem. Whether it's a common cold, a mild headache, and slight or severe depression everything comes with a prescription and is followed by a pill-sex is now in the same boat. There's a large number of young men who use Viagra more times than those over 40, just because they've heard it's a great rush. But they don't realise that there are adverse repercussions to such self-medication. What happened to the days of us working through our problems instead of looking for pills to do the work for us? A momentary infilling of Viagra might boost sexual performance for a hour or so, but is it really benefiting the body in the long run?

The use of Viagra for young men is not advised, because, let's face it-it's just not made for that. It's rare that young men have problems with genuine ED at all. If you have been examined by a doctor and have ED, then by all means, I give you the green on the blue pill. But if you're just experiencing a low in your sex life and the doc has said that it really has nothing to do with ED, then don't go rushing for the blue pill. There are other reasons for a lack of sexual drive, and the best part about these other reasons is that you can do something about it. You can feel strong enough to change your life with your own hands instead of relying a pill. Some of these other reasons are:

• Alcohol, smoking, or drug abuse
• Guilt of an extramarital relationship or pressure to perform with an extramarital partner
• Overwork
• Anxiety and tension
• Lack of exercise

Problems in your sex life could also be related to the side-effects of an illness or disorder. In these cases, it would definitely be best to not go the way of the crowd and depend on ED drugs, because doing so could make things worse. It's very common that people who complain of having problems with sex actually have underlying cardiac problems or diabetes. So while I'm not saying to throw Viagra and it's kin out the door all together, I will say this-don't go by everything you read. Play it safe and keep in control of your own life without having to rely on doctors and medications to do it for you.

5 Side Effects of Drugs

Drugs are not to be messed around with and can be genuinely damaging to your health if not used as prescribed. The indiscriminate usage of medicines or substance abuse possesses its own negative effects, and some are either because of incorrect application, not taking the preventative measures or over using the medicines. A few of the recognized side effects of substance abuse as a result consist of:

1. Over dosage: although the individual does not have any inclination to increase the dose of the medication to be able to create a preferred effect, he might unintentionally take more than the required dosage either because he fails to realize what dosage he should take or due to the fact he thinks that the greater the dosage he takes the quicker the drug heals his ailment. Some over dose produce slight symptoms while some could be deadly.

2. Under dosage: another side-effect of substance abuse is under dosing. The individual might want to take the medication to be able to deal with or get rid of his condition however eventually ends up using a dosage insufficient to manage the condition or the offending organism. This means that the condition may advance unchecked because the medication taken is not really sufficient to prevent its improvement, and at the final resources and time period are lost. Death might at the same time result should the rate of acceleration of the illness is quick.

3. Drug resistance: One significant problem associated with drug under dosage is the organism that the person looks for to eliminate gets subjected to a low dosage of the medication and finally builds up resistance to it so even the usage of a greater dose of the identical medication later on will not take care of the disorder. This is actually the same reason treating malaria is becoming difficult since the plasmodium keeps building resistance to brand new suitable medicines because of under dosage. This over time means that many people wind up losing their lives to some illness that could have been healed by basic adherence to the correct medication dosage.

4. Potentiating illness: a few micro-organisms are normally safe to people even while they habit several areas of the body. These types of microorganisms that are referred to as commensal organisms can be possibly pathogenic or trigger illnesses when their organic state is changed by the indiscriminate usage of antibiotics specifically for a very extensive period of time. Because of this, antibiotics must not be mistreated or used without having a physician's prescription.

5. Drug reaction: a number of drugs can trigger serious toxic responses when used without the guidance of a doctor who must make sure that specific medicines are given at the same time with them or just before their administration to reduce their responses. However with substance abuse these types of preventive steps might not be taken prior to giving the drugs therefore increasing the likelihood of serious reactions. A few of the serious reactions are anaphylactic response, asthmatic attack, serious diarrhea, ringing in the ears, deafness, severe hypotensive response, wheal, vomiting, and so on.

John is a professional blogger writes interesting articles about Health and Rehabilitation and this article was researched and written with the help of Utah Drug Rehabilitation

Women's continued meth use

Women are more likely to use meth than other drugs and often have a harder time getting free of the drug than men.

Why Women Continue to Use Meth

Methamphetamine is a highly addictive drug that forms a quick, strong dependency, even with limited use. Once a methamphetamine addiction has begun, it is a very difficult dependency to break, and women face unique challenges in this area. Many women in turn to meth to help them lose weight and have more energy to keep up with the demands of life, including child care, work, and home care.

Many women are unwilling to seek treatment for their meth addiction because they are afraid of having their children taken away from them when their problem is revealed. Many female meth addicts are single moms with no constant father figure in the lives of their children. Addiction is an isolating disease and these women have no one to care for their children while they're in treatment, leaving them with only the option of turning their kids over to the state until they can get clean. Many women feel that it would be better to try to get clean on their own in order to stay with their children.

For those women who do manage to enter a treatment program to address their addiction, the road to recovery is a particularly difficult one. Many women who are being treated for meth leave treatment early because they are worried about their kids. Even those who do finish have a very hard time staying clean at home. The demands of raising children, attending treatment, going to work, and caring for their home cause a level of exhaustion that they feel they can only relieve by returning to meth use. Out of all of the Utah women who have managed to get clean after a meth addiction, most have failed at treatment at least once and returned to using the drug. Many of these women have lost custody of their children and even been to jail, but they still continue to use the drug.

One of the answers to the increasing meth problem in Utah is to make treatment more available to those suffering from addiction, especially women. Treatment programs tailored specifically to meet the needs and address the concerns of women can encourage moms to complete their program. Sober houses where women can live with their children during recovery have been shown to increase the success rate of staying clean after inpatient treatment is completed. Making support groups for women dealing with addiction more available and visible in our communities may also help decrease the rate of relapse.

John is a professional blogger writes interesting articles about Rehabilitation and this article was researched and written with the help of Las Vegas alcohol rehab

Most Kentucky adults don't know that drug overdose is the leading cause of death in the state, but those in the east do

Drug overdoses, driven largely by prescription drug abuse, overtook motor vehicle accidents as the leading cause of unintentional deaths in Kentucky back in 2010 and remain the state's leading cause of death. From 2000 to 2010, the number of drug-overdose deaths in Kentucky rose a staggering 296 percent, highlighting the state's drug abuse epidemic that now kills more than 1,000 Kentuckians a year. But a recent poll suggests many Kentuckians are not fully aware of the state's drug problem.

In an effort to gauge awareness of the problem, the Kentucky Health Issues Poll asked Kentucky adults whether traffic accidents, falls, firearms or unintentional drug overdoses resulted in the highest dumber of deaths in the state each year. Only 44 percent of Kentucky adults correctly indicated that drug overdose is the leading cause of unintentional Kentucky deaths; 43 percent incorrectly identified traffic accidents as the leading cause.

Respondents from Eastern Kentucky, where the problem is most prevalent  were more likely to correctly identify it as the leading cause of death, at 69 percent. However, only 29 percent of Louisville-area respondents did.

“Experts have reported significant prescription pain reliever abuse in eastern Kentucky,” said Susan Zepeda, presient of the Foundation for a Healthy Kentucky, which co-sponsored the poll.  “It is no surprise that the Kentuckians most aware of this issue are those who are living in this region.  Awareness is the first step towards curbing this trend – it is up to all of us to get involved and take action to reduce the toll of this health crisis.”

The poll was conducted for the foundation and The Health Foundation of Greater Cincinnati from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by land line and cell telephones, and the poll's margin of error is plus or minus 2.5 percentage points.

Conway, other AGs ask FDA to require generic prescription pain pills to be abuse-resistant, tamper-resistant

Generic versions of popular pain relievers must be made harder to abuse, in order to curb prescription drug abuse that is epidemic in many states, Attorney General Jack Conway and 47 other attorneys general said in a letter sent to federal officials Monday.

The National Association of Attorneys General letter encourages the Food and Drug Administration to adopt standards requiring manufacturers and marketers of generic prescription painkillers to develop tamper- and abuse-resistant versions of their products, because the attorneys general are concerned that non-medical users are shifting to non-tamper-resistant formulations of generic opioids.

“Prescription drug abuse is an epidemic that kills more than 1,000 Kentuckians each year,” Conway, who co-chairs NAAG’s Substance Committee, said in a news release. “The development of tamper-resistant and abuse-deterrent opioid drug products is a valuable aid to the law enforcement, legislative and public awareness initiatives many of us have implemented in our states to combat prescription drug abuse.”

Prescription drugs can be deadly when abused, and fatal drug overdoses are now the leading cause of death due to unintentional injury in the United States and Kentucky, exceeding even motor vehicle deaths, according to the Centers for Disease Control and Prevention. Federal data show that U.S. drug overdose deaths totaled 38,329 in 2010, rising for the 11th straight year, and accidental deaths involving addictive prescription drugs overshadow deaths from illicit narcotics.

In Kentucky, the number of drug-overdose deaths in Kentucky rose a staggering 296 percent from 2000 to 2010, according to the Kentucky Injury Prevention and Research Center. Kentucky is one of the most medicated states in the country, and has the sixth highest overdose rate. Last year, 220 million doses of the highly addictive painkiller hydrocodone were dispensed in the state -- that’s 51 doses for every man, woman and child in the state, says the AG release.

The news release from Conway's office said he led the effort to reach out to the FDA, along with Attorneys General Luther Strange of Alabama, Pam Bondi of Florida and Roy Cooper of North Carolina. Click here to read the letter; for a news release, click here.

Legislature sends fix of last year's pill-mill bill to Beshear

"After more than a year of debate, a bill that would revamp Kentucky’s prescription-drug law to more strictly focus on pill abuse and ease requirements on patients is heading to the governor’s desk," Mike Wynn reports for The Courier-Journal. On a 36-0 vote, the Senate sent House Bill 217 to Gov. Steve Beshear, who said he will sign it tomorrow.

The chief lobbyist for the Kentucky Medical Association said the physicians' group did not get all the changes it requested in last year's law but is satisfied with the bill. It "would exempt hospitals and long-term care facilities from many of the requirements that doctors must follow before prescribing drugs," Wynn writes. "It also creates a 14-day exemption for surgery patients and gives doctors more discretion in examining patients before a prescription is given." (Read more)

House panel approves bill easing rules of 2012's pill-mill bill

They could call it the pill they're taking to fix the pill-mill bill.

A state House committee approved a bill Tuesday that would tweak last year's legislation aimed at cracking down on prescription drug abuse through doctor shopping and "pill mills" where painkiller prescriptions are easily available for a fee.

House Speaker Greg Stumbo told the House Judiciary Committee that House Bill 217 would fix “unintended consequences” of 2012's House Bill 1 while still requiring that health-care providers use the Kentucky All Schedule Prescription Electronic Reporting system to track painkiller prescriptions.

The bill "would exempt hospitals and long-term care facilities from HB 1’s per-unit patient dosing restrictions and ensure that physicians decide when physicals are needed," the Kentucky Press News Service reported. "It would limit restricted access to narcotic pain medication for surgery patients, end-of-life patients, cancer patients and a few other categories of patients who may need increased pain management, Stumbo said." (Read more)

Deaths by overdose, mainly of prescription drugs, hit a new record in U.S. in 2011; a huge problem in Kentucky

Drug overdose deaths in the U.S. rose for the 11th straight year and accidental deaths involving addictive prescription drugs overshadow deaths from illicit narcotics, new federal data show.

In 2010, there were 38,329 drug overdose deaths nationwide, and prescription drugs were the cause of nearly 60 percent of them.  As in recent years, opioid drugs such as OxyContin and Vicodin were the biggest problem, contributing to three-fourths of medication-overdose deaths, report Lindsey Tanner and Mike Stoppe of The Associated Press.

Anti-anxiety drugs including Valium were involved in almost 30 percent of medication-related deaths.  Most were unintentional overdoses; 17 percent were rules suicides. The data were reported Tuesday in the Journal of the American Medical Association.

In Kentucky, drug abuse is epidemic and more than 1,000 Kentuckians a year die from prescription-drug overdoses, more than the number who die in car accidents, according to a 2012 Kentucky Justice & Public Safety Cabinet report. About 85 percent of Kentucky's drug-related deaths were accidental and approximately 2 percent were suicides, according to federal Centers for Disease Control and Prevention data.

The number of drug-overdose deaths in Kentucky rose a staggering 296 percent from 2000 to 2010. In 2010, the record number of deaths reflected the national trend and also involved opioid painkillers, according to a study by the Kentucky Injury Prevention and Research Center. The highest rates of overdose deaths during the study period were concentrated in Eastern Kentucky and among men, reports Bill Estep of the Lexington Herald-Leader.

Many doctors and patients don't realize how addictive these prescription drugs can be, and that they're too often prescribed for pain that can be managed with less risky drugs, said Dr. Thomas Frieden, head of the CDC. He said the data show a need for more prescription drug monitoring programs at the state level, and more laws shutting down "pill mills" -- doctor offices and pharmacies that over-prescribe addictive medicines, AP reports.

That was the aim of House Bill 1, passed in last year's legislative session. The Kentucky All-Schedule Prescription Electronic Reporting  (KASPER) system has undergone several changes since the bill's passage to help crack down on so-called pill mills.

Last month, a federal panel of drug safety specialists recommended that Vicodin and dozens of other medicines be placed in a more restrictive drug category, which would make them harder to prescribe. Refills wouldn't be allowed without a new prescription, and faxed or called-in prescriptions wouldn't be accepted; only a handwritten prescription from a doctor would be allowed.

Beshear calls for action to improve state's health, but says only that 'It's time for us to begin looking seriously' at a smoking ban

By Al Cross
Kentucky Health News

His priorities were education and tax reform, but Gov. Steve Beshear mentioned several health issues in his State of the Commonwealth speech tonight to a joint session of the General Assembly.

Beshear called for action to correct the state's "fundamental weaknesses," including "a population whose health ranks among the worst in the nation." Near the end of his speech, he said, "We need to continue improving the health of our people," but after about a minute of discussing tobacco and smoking he stopped short of endorsing a statewide ban on smoking in the workplace. (KET photo)

"It's time for us to begin looking seriously at doing this on a statewide level," he said to some applause, after noting that nearly half of Kentuckians live in jurisdictions where smoking is legally restricted, that the state has the highest or next-to-highest smoking rate overall and among teens and pregnant women, and that "Our smoking-related mortality rate is the worst in the nation. . . . Our addiction hurts productivity, jacks up health care costs and kills our people."

Beshear called for improving prenatal care and newborn screening, and for minor improvements in last year's bill to fight prescription drug abuse. He said the bill has caused a precipitous drop in abuse of prescription painkillers. "Kentucky at one time had the sixth highest rate in the nation, but . . . we improved 24 spots," he said. "Nearly half of the state's known pain management clinics have closed rather than submit to new rules that protect patients." He said use of the Kentucky All Schedule Prescription Electronic Reporting system "has increased nearly seven-fold . . . and prescriptions for some of the most abused drugs have dropped up to 14 percent from a year ago."

However, the problem of babies becoming addicted to drugs in their addicted mothers' wombs has skyrocketed in the last decade or so, Beshear said: "In 2000, reports showed 29 babies in Kentucky born addicted to drugs. But in 2011, there were 730 babies – more than 25 times as many. And that figure is thought to be under-reported." He did not say how he wants to improve screening.

Beshear did not mention perhaps the biggest health policy question facing the commonwealth, whether to use federal subsidies to expand the Medicaid program to people in households earning up to 138 percent of the federal poverty threshold. Now the program covers people in households earning up to 70 percent of the poverty line. The federal government would pay all the cost of the additional enrollees through 2016, when the state would start picking up part of the tab, up to 20 percent in 2020.

Some Republicans say the state can't afford the expansion, while some Democrats say it would be a good long-term investment in the state's health and economy. Beshear has said he wants to do it if the commonwealth can afford it, and expects to get cost estimates around the end of March -- about the time the legislature must adjourn.

For a PDF of the speech text, click here. For an audio recording, go here. For video from KET, here.

Big papers' Page 1 stories spotlight recovery center for pill addicts, lack of state program for problem gamblers

Gripping stories from recovering addicts, on the front pages of Kentucky's two largest newspapers this morning, highlight Kentuckians' fights against all types of addiction, from gambling to drugs.

Hope of recovery emerges from Laura Ungar's story in The Courier-Journal that focuses on the Isaiah House recovery center in Willisburg. A gymnasium at the site has been transformed into a factory of sorts, where a pill addict who has been clean three weeks polishes car parts, while a morphine addict with 103 days’ sobriety hammers nails into wood to make pallets, Ungar reports.

Work is an essential part of recovery at the Isaiah House, giving structure to chaotic lives, teaching job skills and building confidence. “It gives them a sense of purpose, of accomplishment,” Executive Director Mark LaPalme told Ungar. “They get their dignity back — that’s what work does.”

LaPalme, a Connecticut native and recovering cocaine addict, said he started Isaiah House in his basement in 1999, after a spiritual experience moved him to set aside seven bedrooms for other addicts. Today, the house helps to rebuild the lives of drug and alcohol addicts, while promoting worth ethic and responsibility throughout the recovery process (Read more).

Jack Brammer of the Lexington Herald-Leader writes about Kentucky's lack of a state program to treat problem gamblers. It is one of 13 states without such a program.

Billy Stephens, 66, Hawesville Mayor Rita Stephens' husband, said he lived a "a life of lies" with his gambling addiction, but with professional treatment, has not gambled since 2010. When he finally sought treatment, he could find no affordable treatment in Kentucky. The family had to borrow money to pay for his $6,000 treatment in a 36-day program in Louisiana, which is free to residents of the Bayou State.

"My addiction almost destroyed me," he told Brammer. "My insurance in Kentucky would have helped with my treatment if it were alcohol. But it was gambling." (Read more)

Prescription-painkiller epidemic is spurred by societal shift, experts say: People think every problem has a pill for an answer

By Molly Burchett
Kentucky Health News

The prescription-painkiller epidemic stems partly from an evolution of society's views toward pain and how to deal with it, said experts at "The Different Faces of Substance Abuse" conference in Lexington Jan. 23-24.

"The entire society's viewpoint of pain and the management of pain has completed shifted," said Dr. Ryan Stanton, an emergency physician and conference panelist.

Pain is considered the fifth vital sign, after temperature, pulse, blood pressure and respiratory rate, but it is the only sign that is subjective, which complicates the problem, said Stanton, because patient satisfaction is associated with the amount of drugs the provider prescribes. If an emergency-room doctor suggests exercise to combat back pain, he said the patient's reaction might be, "You might as well ask a man to deliver a baby."

The substance-abuse problem shouldn't be laid at the feet of prescribers because patients think there is a pill out there for every problem when sometimes the answer is non-prescription ibubrofen and an ice pack, said Van Ingram, executive director of the state Office of Drug Control Policy.

"This is a complicated issue," Ingram said. "It's easy to be against heroin, and it's easy to be against cocaine. But prescription opioids are things that many people need to live and need to improve their quality of life at the end of life."

Patients need to understand how much a doctor can or should do, said Dr. Helen Davis, conference panelist and chair of the Gov. Steve Beshear's KASPER Advisory Council. "Patients come in to the doctor's office expecting a silver bullet . . . but when looking at pain, the goal isn't to make the patient pain-free," she said. "The goal is to reduce the pain enough that they can have systematic and functional relief to go about their daily living."

Davis said doctors and nurses must change their culture to become more collaborative with the patient to address the non-pharmacological management of pain. There are some things that are the responsibility of the provider and there are some things that are the patients', families' and communities' responsibility, she said, adding that all professionals must look at their interdisciplinary responsibility to the people of the state.

Kentucky Health News is an independent service of the Institute for Rural Journalism and Community Issues in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Poll shows depth of prescription drug abuse in Kentucky

By Molly Burchett and Al Cross
Kentucky Health News

One-third of Kentucky adults have friends or relatives who have experienced problems from abusing prescription pain relievers, and 8 percent have used pain medicine when it wasn't prescribed or for the feeling it caused, according to a statewide poll conducted last fall.

The Kentucky Health Issues Poll found that in Eastern Kentucky, 45 percent reported that prescription drug abuse have caused problems for friends or family members. In the 17-county Bluegrass Area Development District, which includes some Appalachian counties, the figure was 37 percent. It was 32 percent in Northern Kentucky, 31 percent in the seven-county Louisville area and 25 percent in Western Kentucky.

The poll found that young adults are more likely to have the problem. Among those 18 to 29 years old, 13 percent said they had used pain medicine when it wasn't prescribed or for the feeling it caused, and 49 percent said they had a friend or relative who had been affected.

The Foundation for a Healthy Kentucky, which co-sponsored the poll, noted that drug-overdose deaths in Kentucky correspond to a steep increase in the sales of opioid prescription pain relievers, which include OxyContin, Vicodin, Percocet and codeine. More than half of Kentucky adults in the poll reported being prescribed such drugs.

“While these types of medications are important for controlling pain in patients who need them, opioids also carry the potential for abuse,” said Dr. Susan Zepeda, President and CEO of the foundation. “Our state ranks sixth in the nation for prescription pain reliever overdose deaths, and these data provide a window on how many Kentuckians are impacted – directly or indirectly – by prescription misuse.” (Read more)

The poll was conducted for the foundation and The Health Foundation of Greater Cincinnati from Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points.

Kentucky Health News is an independent service of the Institute for Rural Journalism and Community Issues at the University of Kentucky, with support from the Foundation for a Health Kentucky.

FDA could require tamper-resistant painkillers; without such action, prescription-drug abuse problem would worsen

UPDATE, Jan. 14 : Laura Ungar of The Courier-Journal reports, "Addicts by the scores used to get a quick and easy high from snorting or shooting up the powerful narcotic OxyContin — until manufacturer Purdue Pharma developed a new version that’s harder to abuse. But with the company’s patent on its original drug set to expire in April, activists, lawmakers and doctors are worried that cheaper, easily crushable generic versions will flood Kentucky and worsen the state’s already-devastating prescription drug abuse problem."

The Food and Drug Administration will force generic manufacturers of powerful pain pills to switch to a tamper-resistant composition if it finds evidence the composition curbs prescription drug abuse and addiction, Alan Rappeport of The Financial Times reports. Public-health advocates worry that if generic versions of opiate pills are not made tamper-resistant, the prescription drug abuse epidemic may worsen.

If the agency finds tamper-resistance significantly deter abuse, it has legal authority to require generic drug makers to switch their opiate formulas. Just as manufacturers of some pain pills began switching formulas to make the pills harder to crush, easily crushable, generic forms of OxyContin and Opana were released. Purdue Pharma and Endo Pharmaceuticals, which make Opana, have hoped to extend patent life of their drugs by pushing the FDA to prevent generic makers from using old versions of their drugs. Generic makers argue this will keep patients from buying cheaper drugs.

The FDA said it will take a "flexible" approach to determining the effectiveness of tamper-resistant drugs because abusers are constantly finding new ways to avoid deterrents. (Read more)

Pike court will keep lawsuit county and attorney general filed against Purdue Pharma over damage done by its OxyContin

A state court will hear the Kentucky attorney general's 2007 lawsuit against OxyContin manufacturer Purdue Pharma, against the wishes of the company. The U.S. Court of Appeals for the 2nd Circuit affirmed a lower court's order returning the suit to Kentucky from New York's Southern District, where Purdue wanted the case heard. The suit was filed in Pike Circuit Court, in Kentucky's easternmost county.

"After years of delay tactics, Purdue will now answer to a Kentucky court and a Kentucky jury," Attorney General Jack Conway said. Purdue Pharma spokeswoman Libby Holman said the company is disappointed by the decision, but now it is "fully prepared to vigorously defend this action on its merits, and we expect to prevail."

Then-AG Greg Stumbo and Pike County sued Purdue Pharma in October 2007, alleging that the company's "aggressive and deceptive marketing campaign saddled taxpayers with millions of dollars in social, health care and other costs," Laura Ungar of The Courier-Journal in Louisville reports. The suit also alleges the company misled health-care providers, consumers and the government about the highly addictive nature of OxyContin. The suit is largely based on admissions of guilt made by the company and several top-ranking company officials in a May 2007 Virginia federal court settlement. Purdue Pharma, its president, chief legal counsel and former medical director pleaded guilty to misleading doctors, regulators and patients about OxyContin during that case.

The nation's prescription-drug epidemic apparently began in the region, largely because of the introduction and high rate of prescription of OxyContin. Kentucky has nearly 1,000 overdose deaths a year. Conway's office said the suit against Purdue Pharma seeks reimbursement for drug-abuse programs, law-enforcement actions and prescription payments through Medicaid and the Kentucky Pharmaceutical Alliance Program. (Read more)

Legislature likely to tweak, clarify and limit last year's 'pill mill bill'

State lawmakers could narrow the focus of last year's "pill mill bill" during the legislative session that begins tomorrow, to concentrate on adults with long-term prescriptions for frequently abused painkillers, John Cheves of the Lexington Herald-Leader reported yesterday. Doctors, hospitals and patients have complained that HB 1 in its current from "restricts too many drugs in too many clinical settings, needlessly complicating medical care in an effort to shut down storefront pain clinics that recklessly hand out prescriptions," Cheves writes.

Under the law, people with long-term prescriptions for controlled substances must submit to urine drug testing to determine if they are actually taking the drug rather than selling it, and if other unprescribed drugs are in their systems. Some patients complained they were being charges hundreds of dollars for urine tests because their insurance companies denied coverage of such testing. One couple was charged more than $900 for tests to get prescriptions for insomnia and anti-anxiety medication.

The new rules, being drafted by the Kentucky Board of Medical Licensure, would reduce the mandate for drug screening to pain medicine prescriptions of 90 days or more. Other medications would not require testing unless the doctor thinks it's necessary. The new rules will say that other types of testing which would be cheaper, including hair, could be used. The board is also restricting its focus to powerful painkillers, including hydrocodone and oxycodone.

The new regulations are subject to approval by the legislature, which could write its own restrictions into law, but the consensus appears to be that the law needs tweaking, not major changes. for example, House Speaker Greg Stumbo said it should be changed to clarify that hospitals don't have to run a new background check on a patient every time they give another dose of a controlled substance during his stay. (Read more)

Painkiller epidemic was driven in part by drug makers' financial relationships with researchers who discounted the risks

For almost a decade, medical officials and experts claimed OxyContin rarely posed problems of addiction for patients. The drug's label, which was approved by the Food and Drug Administration, said addiction risks were small. Research published in the New England Journal of Medicine also said OxyContin wasn't addictive; so did a study in another journal, which OxyContin manufacturer Purdue Pharma reprinted 10,000 times. Since the drug first hit the market, it has fueled a large-scale swath of prescription pain killer addiction, beginning in Central Appalachia, that has grown into a national epidemic, especially in rural areas.

The epidemic was driven in no small part by doctors' lack of knowledge about OxyContin, which was perpetuated by the drug's manufacturer through false claims that became scientific consensus. But now, "Many in the medical profession have rediscovered the destructive power of opiates," and are calling that consensus into question, Peter Whoriskey of The Washington Post reports. "A closer look at the opioid painkiller binge, in which retail prescriptions have roughly tripled in the past 20 years, shows that the rising sales and addictions were catalyzed by a massive effort by pharmaceutical companies to shape medical opinion and practice."

Doctors were wary of prescribing painkillers to any patient except those with cancer for years. But manufacturers and some pain specialists "helped create a body of scientific research assuaging the long-standing worries about opioids and pushed to expand the use of the drugs in people with chronic pain: bad backs, arthritis, sore knees," Whoriskey reports.

Through an examination of key scientific papers, court documents and FDA records, the Post found that many of the studies claiming OxyContin wasn't addictive were supported by Purdue Pharma. The conclusions those studies reached were sometimes not supported by data, and when the FDA needed to develop an opioid policy, it turned to a panel of doctors who had financial relationships with Purdue Pharma and other drug makers. (Read more)

Generic OxyContin and Opana, headed for market soon, could make fight against pain-pill abuse tougher, McConnell says

With generic versions of the two most commonly-abused painkillers, Opana and OxyContin, coming on the market next year, police, hospitals and health clinics in Kentucky have voiced concern that "these generic crushable drugs lack the tamper-resistant gel coating of the brand-name drugs," says a news release from U.S. Sen. Mitch McConnell.

"Without this technology, addicts crush the pills in order to achieve an immediate heroin-like high from sniffing or injecting the painkillers," the release says. "If these generics come to market without the tamper-resistant coating, much of the work that law enforcement and health care providers have done to stem the tide of pain pill abuse in Kentucky will be lost."

McConnell's news release said he has asked the Food and Drug Administration to keep the crushable drugs off the market "until a workable solution can be found." McConnell, the Senate Republican leader, met Wednesday with the Department for Health and Human Services’ acting general counsel, Bill Schultz, to discuss the issue. (Read more)

U.S. teens' cigarette use drops to a new low, but use of alcohol goes up a bit and more 12th graders are smoking marijuana

Teenagers' cigarette smoking dropped to a record low this year but alcohol use rose slightly after seven years of decline, according to a survey of 45,000 eighth-, 10th- and 12th- graders for the National Institute of Drug Abuse.

The survey also found that the use of illicit drugs dropped slightly among eighth-graders but rose slightly among 12th-graders. Among them, 36.4 percent reported using marijuana in the past year, up from 34.8 percent in 2010, and the share who saw great risk in smoking marijuana occasionally dropped significantly, to 20.6 percent, from 24.5 percent in 2010.

Among all three age groups, only 10.6 percent said they had smoked cigarettes in the past 30 days, down from 11.7 percent in 2010. The University of Michigan researchers who did the survey said the decline was significant, and may have been driven by a big increase in the federal tobacco tax in 2009.

"A 1-percentage-point decline may not sound like a lot, but it represents about a 9 percent reduction in a single year in the number of teens currently smoking," principal researcher Lloyd Johnston said in a news release. Among eighth-graders, the decline was about 20 percent. For other results of the survey, click here; for a PDF version, here. For the full survey report, go here.

"Teen attitudes toward smoking also continued to become more negative. For example, 80 percent of teens said they preferred to date nonsmokers in 2012," Steve Gorman reports for Reuters. "But anti-tobacco advocates said their battle to stamp out teen smoking was far from over, noting that 17 percent of high school seniors still graduate as smokers." And the figure is higher in many rural areas.

Kentucky ranks at or near the top in youth smoking. In 2010, the last year for which state figures are available, 16 percent of Kentucky children aged 12 to 17 (a slightly younger group than the one above) reported smoking a cigarette in the past month. The national rate for that age group was 10 percent, according to the Centers for Disease Control and Prevention.

Managed-care doctor creates process to steer pregnant Medicaid recipients who are using dangerous drugs into treatment

When Dr. Jeremy Corbett of Lexington found that "nearly one in five pregnant women enrolled in the Medicaid managed-care program where he works were using narcotics or other harmful drugs," he tackled the problem. As medical director of the Kentucky Spirit Health Plan, "He designed a new program combining high-tech health information with case management to tackle the problem of addicted babies, which is exploding statewide," reports Laura Ungar of The Courier-Journal. (C-J photo by Tim Webb)

Ungar describes how Corbett's program works: "Employees examine patient records for pregnant Kentucky Spirit members. The pharmacy department uses an analytics report, coupled with the Kentucky All Schedule Prescription Electronic Reporting System, or KASPER, to cross-check for drugs that could be dangerous during pregnancy, including narcotics. Department employees also look at the pattern of prescriptions, which could point toward doctor-shopping for pills. . . . Kentucky Spirit sends letters to the prescribing doctor and the obstetrician the woman is seeing, letting them know she is pregnant and has received a prescription for dangerous drugs. Corbett said sometimes the prescribing doctor doesn’t know the woman is pregnant, and the obstetrician doesn’t know she’s taking narcotics. Corbett said they also send letters outlining the dangers of taking certain drugs during pregnancy, and case managers reach out to women at risk of giving birth to addicted babies."

The program started three weeks ago. Corbett said two women have asked to get substance-abuse treatment, for which Kentucky Spirit pays — "even residential treatment, which is not required by Kentucky law — because it saves money in the long run," Ungar reports. "Kentucky has seen its hospitalizations for addicted newborns climb from 29 in 2000 to 730 last year — a 2,400 percent increase that far outpaces the national increase." Corbett told her, “When these babies wind up in the neonatal intensive care unit, it’s a huge loss, emotionally, and it’s also a huge loss of state dollars.” (Read more)