As heroin use increases in Kentucky, new report shows its strong connections to abusers of prescription pain medicines

Kentucky's law-enforcement agences, policymakers and public-health advocates have taken serious measures to curb the state's rampant prescription drug abuse problem, and recent state and national news stories suggest that the reduced supply of these painkillers, at least the ones in a non-crushable form, has driven pill abusers to heroin. Now there's research to support this theory.

Non-medical use of prescription pain medication may raise the risk of heroin use, says a new report by the Substance Abuse and Mental Health Services Administration. SAMHSA says people aged 12 to 49 who previously used prescription pain relievers non-medically were 19 times more likely than non-abusers to have started using heroin over the past year.

Proving the connection, the converse was true: Almost 80 percent of those who started to use heroin over the past year had abused prescription pain relievers. These findings are part of a larger effort to identify some risk factors of heroin use, and also to understand the "dependence and initiation that have occurred in the past few years," says a SAMHSA news release.

Heroin use, which had already become a problem in Northern and Central Kentucky, has been spreading to the Southern and Eastern Kentucky. The drug is becoming more popular throughout the state and nation because it is cheaper and easier to get than prescription painkillers, specifically opioid medications.

The number of U.S. heroin users has increased by about 60 percent from 2007 to 2011, says the 2011 National Survey on Drug Use and Health.  And while some can argue for the benefits of prescription medication, that same risk-benefit analysis doesn't apply to heroin, which has only risk.

The SAMHSA report offers another risk of prescription drugs: “Prescription pain relievers when used properly for their intended purpose can be of enormous benefit to patients, but their nonmedical use can lead to addiction, serious physical harm and even death,” said Dr. Peter Delany, director of SAMHSA’s Center for Behavioral Health Statistics and Quality. “This report shows that it can also greatly increase an individual’s risk of turning to heroin use – thus adding a new dimension of potential harm.”

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Join high schoolers around the state on Sept. 19 in taking the 'It Can Wait' pledge not to text while driving

In preparation for its national day of action, the "It Can Wait" campaign teamed up with state legislators in four schools across Kentucky to increase awareness about the risks of texting while driving. Become an advocate too by taking the pledge not to text and drive on Sept 19. 

State Rep. Rick Nelson of Middlesboro, Sen. Brandon Smith of Hazard and AT&T partnered to provide a simulation for students at Bell County High School to learn about dangers of texting while driving. The simulator subjected the participants to a variety of real-life traffic conditions, like driving alongside a bus, showcasing the real-life dangers of texting.

“As a father to teenagers with driver’s licenses, I am personally devoted to spreading awareness of the dangers of texting while driving, Smith told the Middlesboro Daily News. “Drivers who send text messages while driving are 23 times more likely to be in a crash, so it is critical to spread the word that when it comes to texting and driving — it can wait.”

The tour, which is also sponsored by Verizon, Sprint and T-Mobile, also stopped in Central Kentucky, where about 200 Scott County High School students participated in the simulation, along with Rep. Ryan Quarles and Sen. Damon Thayer, both of Georgetown. Quarles crashed and Thayer was stopped for driving too slow in the “busy thoroughfare,” reports Dan Adkins of the Kentucky Press News Service. Click here to try the simulator.

The “No Texting While Driving” law has been in place in Kentucky for two years and forbids anyone to send text messages while driving a motor vehicle. The law also forbids any use of a cell phone for driving under 18.

Take the pledge not to text and drive by joining the "It Can Wait" campaign. Click here for more information. You can also download the AT&T DriveMode app that automatically sends a customizable reply to incoming messages to let people know that you'll get back to them at another time.

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UK's Gill Heart Institute joins Appalachian Regional Healthcare to advance specialty heart care in Eastern Kentucky

Appalachian Regional Healthcare, the Appalachian Heart Center and UK HealthCare’s Gill Heart Institute announced a new collaboration to deliver cardiovascular care to Eastern Kentuckians, which will extend the UK's sub-specialty care footprint and increase access to cardiovascular expertise in the area.

Cardiologists Dr. Vidya Yalamanchi, Dr. Rao Podapati and Dr. Srini R. Appakondu from Hazard's Appalachian Heart Center will team up with UK to provide advanced treatment options not before available in the eastern part of the state.

“We look forward to the opportunity to work closely with the physicians and health care providers at Gill Heart Institute to enhance cardiology services to patients in Eastern Kentucky,” said Dr. Yalamanchi. “This partnership is an example of teamwork that emphasizes a commitment to providing exemplary patient care.”

In addition to the combined efforts in Hazard, UK and ARH have also agreed to jointly administer and manage cardiovascular services at ARH hospitals in Harlan, Whitesburg, McDowell, Hyden and Williamson, W.Va.

 “The goal of this collaboration is to expand the scope of cardiology services provided within our community,” said Joe Grossman, president of ARH. “By providing a range of comprehensive cardiology services, including inpatient and outpatient services to residents of Eastern Kentucky, we hope to improve lives in a region where patients suffer from some of the highest rates of mortality in the nation from heart disease and stroke.”

UK officials have said their hospital must expand its geographical reach to ensure access to quality care for Kentuckians. This collaboration represents a step towards achieving both this goal and the goal of being the hospital destination for sub-specialty care in the state and region.

“This alliance further expands the UK HealthCare mission to improve access to quality health care delivery for all Kentuckians in a cost effective and responsible manner,” Dr. Michael Karpf, UK executive vice president of health affairs, said in the release. “But the real benefit for many patients and their loved ones will be the ability to stay close to home for complex cardiology care.”

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Judge OKs Medicaid expansion and health insurance exchange

A judge upheld Gov. Steve Beshear's decisions to expand Medicaid and set up the state's health-insurance exchange under federal health reform, but his adversaries say they will continue to fight in court.

Franklin Circuit Judge Phillip Shepherd's two rulings mean that implementation of the Patient Protection and Affordable Care Act, through Medicaid expansion and the health exchange will continue as planned, at least for now.

Circuit Judge Phillip Shepherd

Tea Party activist David Adams filed a lawsuit in April challenging the governor's legal authority to create the insurance exchange, which is called Kynect and begins enrollment Oct 1, without first seeking approval from the General Assembly.

Shepherd said Beshear is simply implementing a section of a federal law that has been upheld by the U.S. Supreme Court, reports Tom Loftus of The Courier-Journal. Adams said he will appeal both the Medicaid expansion and exchange orders directly to the Kentucky Supreme Court, attempting to bypass the Court of Appeals.

Republican Sen. Julie Denton of Louisville, chair of the Senate Health and Welfare Committee, told Loftus she expects major problems to occur if the administration proceeds with Medicaid expansion.

"My overriding concern from the beginning is that Medicaid is not being run well now; they’ve never gotten their hands around managed care,” said Denton. “Do we really want to expand a broken system? And do we want the government to take on another new project like the health-care exchanges?”

Beginning next year, most Americans will be required to have health insurance, and Kynect is designed to help as many as 640,000 uninsured Kentuckians get coverage through private insurance plans. The online service will allow individuals and business to shop for plans, compare benefits and determine eligibility for payment assistance or tax credits.

Beshear announced Medicaid expansion in early May

Adams challenged the constitutionality of a state law mandating that Kentucky use all available federal funds for Medicaid. Shepherd said the legislation was a clear step towards achieving a state objective, to expand health care benefits to "indigent citizens," Loftus reports.

“The Kentucky Supreme Court has held that this legislative power may be delegated to the executive branch of government in these circumstances, so long as there are standards governing the exercise of discretion, and the legislature retains the authority to withdraw the delegation,” Shepherd wrote. “Those conditions are clearly met here.”

The law calls for expansion to cover people under 65 in households up to 138 percent of the federal poverty level -- currently $15,856 for an individual or $32,499 for a family of four. The federal government will pay all the cost of newly eligible Medicaid patients from 2014 to 2017, when Kentucky will increasingly pick up part of the tab, rising to 10 percent by 2020.

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Ensure children's eye safety during fall sports season

Children are back in school, playing sports, and parents can take precautions to ensure their children's eye safety as they compete.

Although many parents are unaware of the risks posed to their child's eye safety, about 40,000 eye injuries take place in the United States during sports or recreational activities each year, says Prevent Blindness America. Some sport-related eye injuries lead to vision loss, with almost one-third of them occurring in children between the ages of 5 and 14, says the Kentucky Optometric Association.

“Eye injuries are the leading cause of blindness in children in America, and most injuries occurring in school-aged children are sports-related,” Benton optometrist Dr. Laurel Van Horn said in a KOA release. “The results of an eye injury can range from temporary to permanent vision loss, so it’s important that parents take the proper steps when their children play sports.”

Almost 90 percent of these injuries are preventable with proper use of eye protection on the playing field, says Van Horn. To prevent such injuries, the KOA provides the following tips for eye and vision safety while playing sports: Always wear protective eyewear, do not rely on street eyewear for protection, and refer to the American Society for Testing and Materials standards when shopping for protective eyewear. Click here to learn more or find an optometrist in your area.

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Just-released figures show uninsured by county, age, income

People in Logan, Magoffin, Casey, Todd, Menifee, Adair, Monroe, Edmonson and McCreary counties are more likely to lack health insurance than residents of other Kentucky counties, according to the data just released from the Bureau of the Census. And children are least likely to be uninsured in Todd, Monroe, Lyon, Edmonson, Webster, Hickman, Logan, Trigg, Woodford and Breckinridge counties.

Example of interactive mapping shows data for Logan County, highest in percentage of uninsured

According to the American Community Survey, a continuing poll by the Census Bureau, 22.3 percent of Logan County residents had no health insurance in 2011. Because of small sample sizes in the poll, the error margin for each county's figure is plus or minus 2 percentage points, approximately. The figures are for people under 65, who do not qualify for Medicare. Other counties with 20 percent or more uninsured, in descending order, are Magoffin, Casey, Todd, Menifee, Adair, Monroe, Edmonson, McCreary, Lewis, Metcalfe, Clinton, Breckinridge, Cumberland, Rowan, Gallatin, Butler, Robertson and Graves.

The maps are especially topical because enrollment in the state health-insurance exchange begins Oct. 1. An interactive tool allows users to map and rank counties by various factors. A little clicking reveals that Todd County, on the western border of Logan, probably has the highest percentage of children without health insurance, 10.3 percent, plus or minus 2.5 percentage points. To show county data, limit the geography to Kentucky and check the Show Counties box.

The data are from 2011, the latest year available. The figures can also be sliced by income levels: less than 138 percent of the federal poverty line, the new eligibility threshold for Medicaid in Kentucky and other states that have expanded it under the federal health-reform law; and less than 400 percent of the poverty line, the threshold for subsidies for insurance policies that the insurance exchange will offer.

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