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)

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)

Oregon may show the way for Kentucky in drug treatment

In facing up to its need for more drug-treatment facilities, Kentucky could learn some lessons from Oregon, Courier-Journal reporter Laura Ungar writes in the third and last part of her package of stories about drug treatment, or lack of it, in our state: "Oregon, like Kentucky, is a largely rural state with about 4 million people — and a substantial prescription-drug abuse problem. But Oregon has acted more quickly and aggressively to tackle treatment." She cites examples:

• Oregon is spending about $51 million annually on substance abuse treatment, $11 million more than six years ago. "Kentucky’s Department of Behavioral Health, Developmental and Intellectual Disabilities spends $29 million a year , and hasn’t increased that amount in more than a decade."

• Medicaid, the federally subsidized health-insurance program for the poor and disabled, covers substance abuse treatment in Oregon, "while Kentucky, with a few exceptions, does not."
• Oregon admits more than twice as many addicts for treatment, and "Oregonians are much more likely to receive intensive treatment: "10 percent of treatment admissions were to long-term, residential facilities, compared with 1.1 percent in Kentucky."
• Kentucky had a much higher rate of deaths from drug overdoses in 2008, the most recent year available — 17.9 per 100,000 compared with 11.7. "Health experts say effective treatment leads to fewer overdoses." (Read more)

In starting its sixth package in series on prescription drug abuse, The Courier-Journal shows treatment programs fall short of need

Brittany Crouch suffers through withdrawal in Frenchburg
before leaving for treatment in Lexington, as daughter
Kaylee Adams, 3, cries. (C-J photo by Alton Strupp)

"In a state plagued by one of the worst prescription-drug abuse problems in the nation . . . treatment options are woefully limited, especially for hard-core addicts in need of the most intense care, Laura Ungar reports for The Courier-Journal in the opening story of its sixth package in the series called "Prescription for Tragedy."

"Only 40 of Kentucky’s 301 treatment and recovery sites offer 24-hour residential care, which experts say may be the only hope for the most severely addicted. And those 40 centers are concentrated in just 19 of the state’s 120 counties, mostly in urban areas, meaning addicts in rural counties often must travel hours for help, Ungar writes, noting that almost 80 percent of the sites "are for outpatients only, typically offering one hour of care a week."

That is the type of care received by two-thirds of Kentuckians admitted for treatment, but by 46 percent nationwide in 2009, the last year for which comparative figures are available. Fewer than 5 percent "entered residential care, compared with 17 percent nationally," Ungar writes. "Treatment shortages are most severe in Appalachian counties with the state’s highest overdose rates. Six Kentucky counties that rank among the 10 highest for overdose deaths have just one outpatient center or no center at all." (Read more)

Today's package includes a map of treatment centers in the state; in the print version, it is overlaid on a county map showing rates of death from prescription drugs, with the highest in Appalachian Kentucky. The dots in green, yellow and red on the Google-based map below indicate centers that provide care more intensive than outpatient.

Veteran journalist sees hope in residential drug recovery program

"Kentucky's struggle to help its citizens who suffer from dependency on drugs and alcohol recently reached an impressive goal when leaders of that struggle who are prominent in different political parties celebrated the official opening of a $5 million treatment center in Western Kentucky," Al Smith wrote in an op-ed piece for the Lexington Herald-Leader.

Smith, left, reports on his trip to the dedication of the Recovery Kentucky residential center in Paducah with "First Lady Jane Beshear, wife of the Democratic governor, and Don Ball, the Lexington developer and Republican fund-raiser," who "left politics behind" to mark the opening of the 10th and last in a series of centers planned at Ball's urging by Gov. Steve Beshear's Republican predecessor, Ernie Fletcher. Smith praises Beshear or "retaining Ball as task force chairman and appointing the first lady as his cochair in a commendable commitment to making the program a bipartisan effort."

Recovery Kentucky uses "a recovery model that includes peer support, daily living skills training, job responsibilities and challenges to practice sober living," writes Smith, who overcame his own alcohol addiction almost 50 years ago while editing the Russellville newspaper. "The memory is so vivid I couldn't resist sharing it with some newcomers to sobriety in Paducah," he wrote, quoting himself: "I've been where you've been. It's a program of hope, it works if you work it." (Read more)

Most Kentuckians want to treat drug offenders, not jail them

Days after a bill was passed that will reduce prison time for the state's low-risk, non-violent drug offenders, the 2010 Kentucky Health Issues Poll shows that seven in 10 Kentuckians favor replacing prison sentences with mandatory drug treatment and probation for people who commit non-violent crimes.

The poll also showed 71 percent of Kentuckians are in favor of doing the same for non-violent offenders who commit crimes under the influence of alcohol.

The results were released today, just days after Gov. Steve Beshear signed House Bill 463, probably the most important piece of legislation passed in the Gereal Assembly's just-ended session. The legislation is, in part, meant to help curb overcrowding in jail and prison populations. Kentucky's prison population has increased by 45 percent since 2000.

About 25 percent of inmates in federal, state and local jails and prison are incarcerated because of drug violations, National Center on Addiction and Substance Abuse data show. Another 4 percent are incarcerated because of alcohol law violations. These violations include drug/alcohol possession or use; substance trafficking; driving under the influence; drunkenness, vagrancy or disorderly conduct; and liquor law violations.

The poll was conducted Dec. 3-22 and Dec. 27-28 by the Institute for Policy Research at the University of Cincinnati. It interviewed a random sample of 1,677 adults, 1,469 by landline phones and 208 via cell phones. The poll was funded by the Foundation for a Healthy Kentucky and The Health Foundation of Greater Cincinnati. In 95 of 100 cases, the estimates are accurate within a 2.4 percent margin of error.

Respondents were asked more than 50 questions that covered a range of health-related topics, including financial stresses related to health care; characteristics of their neighborhood (examples: Is it easy to buy fresh produce or ride a bicycle?); degree of civic engagement, such as donation of blood, work on a community project or attendance at political meeting or rally; using cell phones while driving; health insurance coverage; the new health care law; and smoking policy.

Morehead substance-abuse center gets $250,000 grant

The Morehead Inspiration Center, a substance-abuse rehabilitation facility, has received $250,000 from the state, funds that will be used to expand recovery options for addicts.

MIC is part of Recovery Kentucky, an initiative that improves access to long-term residential treatment for addition, The Morehead News' Noelle Hunter reports. The initiative, established in 2005 under former Gov. Ernie Fletcher and continued under Gov. Steve Beshear, has 10 rehab centers, in Campbellsville, Erlanger, Florence, Harlan, Henderson, Hopkinsville, Morehead, Owensboro, Paducah and Richmond. Each center uses a peer-based recovery model, offers life skills training and provides a therapeutic environment.

The funds for the Morehead center come from a community development block grant, money that comes from the federal government but is administered by the state. (Read more)

Skyrocketing prescription drug abuse is subject for examination by Kentucky's two biggest newspapers

The uphill battle against prescription drug abuse across the state was extensively explored in Kentucky's two largest newspapers this weekend.

In their series titled "Prescription for Tragedy," which continues today, The Courier-Journal's Laura Ungar and Emily Hagedorn examined the effects of drug addiction in Bell County, which has the highest number of drug-related deaths in the state. Yet, as prescription drug abuse continues to rise statewide, funding to fight addiction has been slashed and treatment can be difficult to get, Hagedorn and Ungar report. (C-J photo illustration)

The Lexington Herald-Leader looks at how some counties are fighting back by drawing up ordinances that ban "pill mills," pain management clinics that "churn out large amounts of prescriptions for pain and anti-anxiety pills," Bill Estep and Dori Hjalmarson report.

The C-J reports 978 Kentuckians died in 2009 from prescription drug overdoses, up from 403 in 2000. For more state- and nation-wide numbers, click here. Bell County is the hardest hit in the state, with about 54 prescription drug-related deaths per 100,000 people. The high death rate is attributed to several factors, including "few good jobs, little for young people to do and easy access to nearby states where prescriptions are easier to get," Ungar and Hagedorn report.

While the problem continues to grow, petty crimes, such as theft, have increased with it. Yet, the funds to fight the abuse have decreased in Bell County. That is the case statewide, with funding cut from the state Office of Drug Control Policy and Operation UNITE, which was formed to fight chronic drug abuse. Moreover, Kentucky's family and juvenile drug courts were eliminated last year to save money.

A few Eastern Kentucky counties are fighting back by passing ordinances that ban certain types of pain clinics from opening or continuing to operate, the Herald-Leader reports. Carter, Greenup, Knott and Morgan counties have already approved their bans. Residents of Johnson and Owsley counties are asking for more regulation.

To some degree, the bans are put in place to send a message to doctors who are considering opening up shop in these areas. Carter County did not have any pain clinics when its ban was passed, but one businesses later shied away from opening in the county after learning about the law.

After crackdowns on pill mills in Kentucky in the early 2000s, Kentuckians traveled to Florida, which had no prescription-tracking system, to obtain pills and later sell them. In one raid in South Florida, Estep and Hjalmarson report authorities found more than 1,000 files from patients who lived in Eastern Kentucky.

And pain management clinics still flourish within the state as well. One Johnson County pain management clinic (right) "was so busy Friday — payday — that sheriff's deputies parked outside to spot traffic violations," Estep and Hjalmarson report.

This year, state Sen. Jimmy Higdon, R-Lebanon, has introduced Senate Bill 47, which would more strictly regulate the operation of pain clinics. (Read more)

To read more about The Courier Journal's series "A Prescription for Tragedy," view the following links:

• "Kentucky's Bell County devastated by prescription drug deaths"

• "Bell County cheerleader had good grades — a big drug problem"

• "Drug problems are growing in Louisville but abuse remains below the state average"

• "Funds to fight a drug epidemic cut even as abuse of medicines kills record number of Kentuckians"

• "Treatment is difficult for many to get"

• "Aspiring artist Sarah Shay was getting her life together, and then ..."