By Melissa Patrick
Kentucky Health News
FRANKFORT, Ky. -- "Recovery is possible. Treatment works."
That was the one consistent message of hope for those with an opioid addiction Sept. 20, as a stream of experts told Kentucky lawmakers that opioids have become a "public health catastrophe" in the state, as one put it.
"Today, there is not a lot of good news," Van Ingram, executive director of the Office of Drug Control Policy, told the members of the Interim Joint Committee on Health and Welfare and the Family Services and Medicaid Oversight and Advisory Committee at a joint, all-day meeting.
"When the clock strikes midnight tonight, four Kentuckians will have died of a drug overdose," Ingram said. "When the clock strikes midnight tonight, 140 Americans will have died from a drug overdose. These are all preventable deaths that don't have to happen."
Kentucky saw a 7.4 percent increase in overdose fatalities in 2016, and more than half of the 1,404 deaths involved fentanyl, a synthetic opioid that is up to 50 times more potent than heroin, according to Ingram's office. One-third of the deaths involved heroin. Ingram noted that this trend continues, with fentanyl being present in 53 percent of overdose deaths in the first half of this year.
Throughout the day, more than 20 experts talked about the impact of opioids in the state, including prevention and treatment strategies.
Kentucky Chamber of Commerce President and CEO Dave Adkisson said the epidemic has taken a toll on the state's economic growth and development, especially participation in the labor force.
“The businesses I’ve talked with throughout the state say drug abuse is a key contributor to the problem,” Adkisson said. “Many people actively looking for work cannot pass the drug tests required for employment and many of those who do have jobs are exiting the workforce due to untreated, or undertreated, addictions.”
Dr. Gil Liu, the medical director of the Department for Medicaid Services, said that over the past two years, Kentucky has doubled its behavioral health expenditures and quadrupled its substance use treatment spending.
He warned that Kentucky has the nation's highest rate of newly diagnosed hepatitis C, which is largely spread when intravenous drug users share needles.
He said the state is working to relax some of its "stringent" rules around who can or cannot be treated for the disease, but warned that the treatment, which can cure the disease, is costly. His PowerPoint presentation said it would cost the state $2.4 billion if all hepatitis C diagnosed recipients received treatment. Now, the state pays around $70 million.
"Those who have entered into treatment and that we have information on represent the tip of the iceberg," he said. "We have a large caseload that has yet to enter into treatment."
Dr. Allen Brenzel, clinical director of the Department of Behavioral Health, Development and Intellectual Disabilities, said addressing children's adverse childhood experiences must be part of the solution to "break the cycle" of addiction. He said 50 percent of drug use and 78 percent of intravenous drug use in adults may be attributed to ACEs.
ACEs are potentially traumatic events in a child's life, like physical abuse or substance misuse in the home, that can have negative, lasting effects on their health and well-being. Kentucky's children have "significantly higher" ACE scores than the rest of the nation.
"If we want healthy adults, we've got to screen for ACEs, we've got to idedntify them, we've got to address them," he said.
Brenzel and others talked about the importance of medication-assisted treatment for substance abuse.
“If this is something that the individual requires to lead a healthy lifestyle, to work, to have insurance, to raise their kids, then we have to end this stigma that somehow if you’re not off your medication that you’re not in recovery, and I do think we’re progress in that,” Brenzel said.
“We’ve had a long battle, in my opinion, over the last 10 to 15 years about abstinence-only versus medication-assisted treatment. It’s not versus. It’s that individual assessment that leads to the individual, most appropriate treatment for that person.”
Dr. Molly Rutherford, vice-president of the Kentucky Academy of Family Physicians, talked about the need to move beyond the stigma of addiction and the stigma of treating people with MAT. "Stop arguing over the right treatment, the right treatment is different for every individual and is the treatment that prevents his or her death," she said.
Dr. Lana Davenport, medical director of The Infinity Center in Ashland, said medication-assisted treatment is probably the best treatment for rural people with substance-use disorders, because abstinence-only programs require ancillary services, such as Alcoholics Anonymous or Narcotics Anonymous, and they often don't exist in rural areas.
Several groups shared how their programs help pregnant women with substance-use disorders and their infants, who are often born with neonatal abstinence syndrome. In Kentucky, one out of every 50 newborns has NAS.
Jennifer Hancock, president of the Volunteers of America chapter in Louisville, which runs Freedom House, a program that serves pregnant women with an addiction for up to two years after the child's birth, said the average cost of an NAS case is about $100,000. She said every 10 healthy babies represents a $1 million savings to the state, because most of the cost of these babies falls to the Medicaid program. She called the state's opioid problem "a public-health catastrophe."
Brenzel wrapped up the meeting by noting that Kentucky received $10.5 million from the federal 21st Century CURES Act, and will spend this money on a combination of evidence-based projects that focus on prevention, treatment and harm reduction.
One of the projects will create "bridge clinics" at the University of Kentucky, the University of Louisville and the Saint Elizabeth hospitals in Northern Kentucky that will allow them to become the first point of treatment for people with addictions.
The hospitals' emergency rooms will be staffed with a peer-support specialist who, with permission, will make contact with the patient in the emergency room and then will regularly follow up with them after discharge. Of the patient wants to start treatment immediately, the emergency rooms will have a protocol to assess the patient and do that, if appropriate.
The hope is to increase those getting treatment from 10 percent to upwards of 70 percent, Brenzel said.
Ingram said, "We're going to beat this. It's just going to take time."
Kentucky Health News
FRANKFORT, Ky. -- "Recovery is possible. Treatment works."
That was the one consistent message of hope for those with an opioid addiction Sept. 20, as a stream of experts told Kentucky lawmakers that opioids have become a "public health catastrophe" in the state, as one put it.
"Today, there is not a lot of good news," Van Ingram, executive director of the Office of Drug Control Policy, told the members of the Interim Joint Committee on Health and Welfare and the Family Services and Medicaid Oversight and Advisory Committee at a joint, all-day meeting.
"When the clock strikes midnight tonight, four Kentuckians will have died of a drug overdose," Ingram said. "When the clock strikes midnight tonight, 140 Americans will have died from a drug overdose. These are all preventable deaths that don't have to happen."
Kentucky saw a 7.4 percent increase in overdose fatalities in 2016, and more than half of the 1,404 deaths involved fentanyl, a synthetic opioid that is up to 50 times more potent than heroin, according to Ingram's office. One-third of the deaths involved heroin. Ingram noted that this trend continues, with fentanyl being present in 53 percent of overdose deaths in the first half of this year.
Throughout the day, more than 20 experts talked about the impact of opioids in the state, including prevention and treatment strategies.
Kentucky Chamber of Commerce President and CEO Dave Adkisson said the epidemic has taken a toll on the state's economic growth and development, especially participation in the labor force.
“The businesses I’ve talked with throughout the state say drug abuse is a key contributor to the problem,” Adkisson said. “Many people actively looking for work cannot pass the drug tests required for employment and many of those who do have jobs are exiting the workforce due to untreated, or undertreated, addictions.”
Dr. Gil Liu, the medical director of the Department for Medicaid Services, said that over the past two years, Kentucky has doubled its behavioral health expenditures and quadrupled its substance use treatment spending.
He warned that Kentucky has the nation's highest rate of newly diagnosed hepatitis C, which is largely spread when intravenous drug users share needles.
He said the state is working to relax some of its "stringent" rules around who can or cannot be treated for the disease, but warned that the treatment, which can cure the disease, is costly. His PowerPoint presentation said it would cost the state $2.4 billion if all hepatitis C diagnosed recipients received treatment. Now, the state pays around $70 million.
"Those who have entered into treatment and that we have information on represent the tip of the iceberg," he said. "We have a large caseload that has yet to enter into treatment."
Dr. Allen Brenzel, clinical director of the Department of Behavioral Health, Development and Intellectual Disabilities, said addressing children's adverse childhood experiences must be part of the solution to "break the cycle" of addiction. He said 50 percent of drug use and 78 percent of intravenous drug use in adults may be attributed to ACEs.
ACEs are potentially traumatic events in a child's life, like physical abuse or substance misuse in the home, that can have negative, lasting effects on their health and well-being. Kentucky's children have "significantly higher" ACE scores than the rest of the nation.
"If we want healthy adults, we've got to screen for ACEs, we've got to idedntify them, we've got to address them," he said.
Brenzel and others talked about the importance of medication-assisted treatment for substance abuse.
“If this is something that the individual requires to lead a healthy lifestyle, to work, to have insurance, to raise their kids, then we have to end this stigma that somehow if you’re not off your medication that you’re not in recovery, and I do think we’re progress in that,” Brenzel said.
“We’ve had a long battle, in my opinion, over the last 10 to 15 years about abstinence-only versus medication-assisted treatment. It’s not versus. It’s that individual assessment that leads to the individual, most appropriate treatment for that person.”
Dr. Molly Rutherford, vice-president of the Kentucky Academy of Family Physicians, talked about the need to move beyond the stigma of addiction and the stigma of treating people with MAT. "Stop arguing over the right treatment, the right treatment is different for every individual and is the treatment that prevents his or her death," she said.
Dr. Lana Davenport, medical director of The Infinity Center in Ashland, said medication-assisted treatment is probably the best treatment for rural people with substance-use disorders, because abstinence-only programs require ancillary services, such as Alcoholics Anonymous or Narcotics Anonymous, and they often don't exist in rural areas.
Several groups shared how their programs help pregnant women with substance-use disorders and their infants, who are often born with neonatal abstinence syndrome. In Kentucky, one out of every 50 newborns has NAS.
Jennifer Hancock, president of the Volunteers of America chapter in Louisville, which runs Freedom House, a program that serves pregnant women with an addiction for up to two years after the child's birth, said the average cost of an NAS case is about $100,000. She said every 10 healthy babies represents a $1 million savings to the state, because most of the cost of these babies falls to the Medicaid program. She called the state's opioid problem "a public-health catastrophe."
Brenzel wrapped up the meeting by noting that Kentucky received $10.5 million from the federal 21st Century CURES Act, and will spend this money on a combination of evidence-based projects that focus on prevention, treatment and harm reduction.
One of the projects will create "bridge clinics" at the University of Kentucky, the University of Louisville and the Saint Elizabeth hospitals in Northern Kentucky that will allow them to become the first point of treatment for people with addictions.
The hospitals' emergency rooms will be staffed with a peer-support specialist who, with permission, will make contact with the patient in the emergency room and then will regularly follow up with them after discharge. Of the patient wants to start treatment immediately, the emergency rooms will have a protocol to assess the patient and do that, if appropriate.
The hope is to increase those getting treatment from 10 percent to upwards of 70 percent, Brenzel said.
Ingram said, "We're going to beat this. It's just going to take time."
from Kentucky Health News http://ift.tt/2xxBn66
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