Tag Archives: overdose deaths

(KY) This Week at the State Capitol


For Immediate Release

February 17, 2017

This Week at the State Capitol

February 13 – 17, 2017

FRANKFORT — Headlines in recent days have made it clear that Kentucky’s problems with heroin, other illegal opioids and prescription drug abuse, continue to take lives and devastate communities at a shocking rate.

In-state newspapers have recently reported the more than 52 drug overdoses occurred over a 32-hour period in Louisville, and nine overdose calls came in over 12 hours in Madison County. A national publication reported that one rural Kentucky county filled enough prescriptions over 12 months to supply 150 doses of painkillers to every person in the county.

The same conversations held across the state about the way the drug crisis is impacting the court system, police, health care workers, treatment facilities, social workers, prison officials and families are also being held in the State Capitol. Those deliberations resulted in a number of bills aimed at addressing the issue, including several bills that took steps forward in the legislative process this week.

On Tuesday, the Senate approved Senate Bill 14, which is aimed at getting drug dealers off the streets by strengthening penalties for trafficking in heroin and fentanyl, a powerful synthetic opioid. Under the legislation, which was approved on a 36-0 vote, trafficking in less than two grams of these substances would be elevated to a Class C felony punishable by five to 10 years in prison.

Later in the week, a pair of bills addressing the drug crises were also approved in the House committees.

House Bill 333 would make it a felony to illegally sell or distribute any amount of fentanyl, carfentanil – a powerful opioid intended for large animals – and related drugs. Trafficking any amount of these drugs could result in up to 10 years in prison under the legislation. The bill would also restrict prescriptions for some painkillers to a three-day supply, though exceptions would be allowed in some circumstances. House Bill 333 was approved by the House Judiciary Committee and now goes to the full House for consideration.

The House Education Committee approved House Bill 145, which would help fight opioid addiction by requiring that public school students be educated about the dangers of prescription pain killers and their connection to addiction to heroin and other drugs.

Bills on other issues that advanced in the General Assembly this week include the following:

· Senate Bill 1 is a sweeping education reform measure that sets the course to change educational standards and accountability for public schools. The more than 100-page-long bill is an omnibus measure aimed at empowering state education officials, locally-elected school board members and teachers to decide the best teaching methods for their communities. It would set up several committees and advisory panels to review educational standards. The bill would change how students are tested, and it would also set up a new way for intervening in low-performing schools by placing more power in the local school district during those interventions. The bill passed the Senate on a 35-0 vote and now goes to the House for consideration.

· House Bill 14 would give police, firefighters, and emergency medical services personnel protection under the state’s hate crime statutes. Under the bill, those who assault, kidnap, or commit certain other violent offenses against first responders could face stricter sentencing in court. Currently only the legally-protected classes of race, color, religion and national origin, as well as sexual orientation, are covered under the state’s hate crime statute. House Bill 14 passed the House on a 77-13-1 vote and has been sent to the Senate.

· Senate Bill 78 would require public schools across Kentucky would to go smoke-free by next school year. The bill would outlaw the use of all tobacco products, including electronic cigarettes, on elementary, middle and high school campuses in addition to buses. The bill was approved by the Senate on a 25-8-2 and has been sent to the House.

· Senate Bill 75 would increase the amount donors can contribute to election campaigns. Under the legislation, individuals and political action committees could donate $2,000 in the primary and general elections in Kentucky– up from the $1,000 limit. The bill passed the Senate on a 27-10 vote and has been delivered to the House.

· House Bill 192 would make it easier for 16- and 17-year-olds in foster care to apply for driver’s permits and driver’s licenses. The bill, which passed 96-0 before being sent to the Senate,  would allow those in foster care to get a driver’s license or permit without requiring them to have a parent’s or other adult’s signature on the permit or license applications.

Members of the General Assembly are eager to receive feedback on the issues under consideration. You can share your thoughts with lawmakers by calling the General Assembly’s toll-free message line at 800-372-7181.

You can also write any legislator by sending a letter with the lawmaker’s name to: Capitol Annex, 702 Capitol Avenue, Frankfort, Kentucky 40601.

–END–

Lawmaker says top issue for constituents is marijuana; oncologist advocates for safe access


02/12/2017 12:39 PM

Far and away the largest number of phone calls from constituents of Rep. Jason Nemes, R-Louisville, are in support of marijuana legalization, and he says he’s heard plenty of other lawmakers also getting the calls.

Nemes recently published online what voters are calling him about, and in a phone interview with Pure Politics he said the calls on marijuana come in three forms: advocating for medical marijuana in pill form, medical marijuana that can be smoked and full-scale state legalization of the federally illegal drug.

“I’m getting contacted on all three of those areas, I don’t know where I am on it, but the Kentucky Medical Association tells me there’s no studies that show that it’s effective,” Nemes said in a phone interview on Wednesday.

Dr. Don Stacy, a board certified radiation oncologist who works in the Kentucky and Indiana areas, said there’s a reason there’s no studies proving effectiveness — studies have not been allowed to take place.

“It’s one of those things where we can’t provide randomized phase three studies in cannabis without making it legal — that is the gold standard for any sort of medicine,” Stacy said. “We have a variety of studies of that nature from other countries of course, but American physicians are very particular about American data. The database we have now is plenty enough to say we shouldn’t be arresting patients for trying to help themselves.”

Stacy said he became interested in marijuana after he noticed some of his patients were doing better with treatment than similar patients. In reviewing their records and through private discussions with the patients, he learned “a significant portion” of those doing better were the patients using marijuana.

“I was surprised by that,” he said. “I’ve always been a skeptic of alternative medicines, but then I began to research the data. I was impressed with the data.”

Dr. Stacy said he’s had some particular patients who showed minor or moderate improvements or side effects, but patients who had to stop treatment because the toxicity of the treatment was so severe. The patients who had to stop treatment tried marijuana, and then they were able to complete their treatments showing “dramatic differences,” Stacy said.

Because of the improvements in patients, Stacy is advocating for safe and legal access to the drug.

Twenty-eight states and the District of Columbia allow access to medical marijuana in different forms. Through those states allowing access, Stacy said several show improvements outside of overall medical care.

In states that have legalized medical marijuana the suicide rate has dropped by 10 percent among males 18 to 40, he said.

“It says when people have serious medical or behavioral issues — if you cannot find the treatment that helps you then some people decide to end their lives, and cannabis apparently prevents a certain portion of people from doing that.”

Stacy said that there is also a 10 percent decrease in physicians prescribing narcotics in medical marijuana states. The effect of that, Stacy said is a 25 percent decrease in overdose deaths linked to narcotics in states with medical cannabis laws. With the level of heroin and opiate abuse in Kentucky, he said there would be positive effects seen here too.

“I think that one-quarter of the people who will overdose and die of narcotics in this state in this year would be alive if we had a medical cannabis law.”

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The price of a life-saving overdose treatment has increased 680% to $4,500 in the last 3 years


An emergency medication often referred to as an “antidote” for opioid overdoses has been skyrocketing in price over the last few years.

The device, the only auto-injector version of naloxone, is called Evzio, and it’s made by Kaleo. 

Naloxone instantly reverses opioid overdoses by blocking the drug from interacting with the brain’s receptors. It has been on the market since 1971.

In 2014, when Evzio was approved in the US, the list price was $575 for a two-pack. Now, it has a list price of $4,500 — an increase of 680%.

Kaleo, a private company based in Richmond, Virginia, also owns Auvi-Q, the emergency epinephrine device that made headlines in October 2016 when the company announced it would come back to the US as competition to the EpiPen after getting recalled a year earlier. The Auvi-Q and Evzio use the same auto-injector technology to deliver their respective emergency medications. 

The list price for a two-pack of the Auvi-Q comes in at $4,500 as well, though the company maintains that the cash price for people without insurance is $360 and that more than 200 million people will be able to get the device with a $0 copay. That list price is roughly 640% higher than the list price of the EpiPen, which was singled out in August 2016 for increasing the price of a two-pack by 500% over the course of seven years.

Now, the list prices of the two drugs is catching the eye of Democratic Senator Amy Klobuchar of Minnesota, who sent a letter Friday to Kaleo asking for more information about the company’s pricing strategy.

List prices don’t often tell the whole story when it comes to a drug’s price. There are other players in the system that each take a piece, which means that what a drugmaker actually receives could be lower even as the list price rises. Kaleo declined to comment on its average net price for Evzio. 

“When setting the ‘list’ price for products, kaléo always starts with the needs of the patient first and then engages with multiple stakeholders in the healthcare system,” Kaleo’s vice president of corporate affairs Mark Herzog said in a statement emailed to Business Insider. “Following these discussions, in order to help ensure our product is available as an option to most patients for $0 out-of-pocket, we set the list price at $4500.”

The rationale of the company’s pricing strategy didn’t seem to satisfy Klobuchar. 

auvi q 

“I understand that Kaleo is trying to mitigate the impact on consumers by providing Evzio for free to cities, first responders, and drug treatment programs, and offering various programs to help ensure that no consumer pays the $4,500 price for Auvi-Q,” Klobuchar wrote. “While these subsidies and programs are noteworthy, I am concerned that they do not address the underlying problem of rising prescription drug costs.”

This isn’t the first time rising naloxone prices have been called out. Until recently, Evzio’s price had been $3,750 per two-pack. And across the board, naloxone prices have been skyrocketing, as Business Insider’s Harrison Jacobs has reported.

However, most other naloxone options — syringes, and a nasal spray — have list prices in the hundreds for sets of 10 vials or two nose sprays. As a proportion of total naloxone market, Evzio made up roughly a third of prescriptions in 2016, according to data from IMS Health.

It remains to be seen how many prescriptions transfer from the EpiPen to the Auvi-Q. Before it was recalled, Auvi-Q only had a small share of the market at a list price of around $500.

But its high list price is already turning off health insurers and pharmacy benefits managers. FiercePharma reports that Cigna, Humana, and the pharmacy benefits manager Express Scripts have come out against the pricing strategy for Auvi-Q, while Aetna is putting it on restricted coverage. The device officially launches in the US on February 14. 

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How police tracked down a suspected heroin dealer after a rash of overdoses in Nicholasville


By Karla Ward

kward1@herald-leader.com

 

When a narcotics detective with the Nicholasville Police Department heard about a surge in heroin overdoses in Jessamine County this week, he got busy.

The detective, also a task force officer with the U.S. Drug Enforcement Administration, notified Nicholasville Emergency Medical Services Tuesday that if there were more suspected heroin overdoses, he wanted to be notified. Within two hours, he got a call about a crash involving a suspected overdose.

Court records show that the police work that followed resulted in a federal charge Thursday against a suspected drug dealer. Jeffrey James Ruggiero was charged in U.S. District Court in Lexington with possession of heroin with intent to distribute. His first court appearance was scheduled for 1 p.m. Friday.

According to an affidavit, the chain of events began when emergency workers arrived on Southbrook Drive in Nicholasville at 7:02 p.m. Tuesday and found a driver, Nathaniel Brezeale, “in obvious distress with agonal breathing and eyes closed.”

Suspecting an overdose, they administered 3 milligrams of Naloxone, and the man revived.

Brezeale’s girlfriend told investigators “that he had a substance abuse problem” and that before the accident, they had been to a double-wide mobile home in Garrard County, where Brezeale went inside alone and stayed for about 10 minutes.

While driving back to Nicholasville, Brezeale began to act strangely, so she asked him to pull over. When he did, the vehicle’s front wheels went over a curb. Passersby called emergency crews.

Two DEA task force officers went to St. Joseph Jessamine and interviewed Brezeale, who told them that he had called Ruggiero that night and asked about buying heroin. He had bought from Ruggiero before, he said.

When Brezeale got to the mobile home, he told investigators, he paid $25 for a tenth of a gram of heroin, which he said Ruggiero took from a larger plastic bag of heroin. Ruggiero placed the heroin onto a piece of paper, and Brezeale snorted it before he left.

A DEA special agent went to Lancaster, found the mobile home and began surveillance about 9:40 p.m., according to the affidavit.

About five minutes later, a Chevrolet Impala left the mobile home heading toward Nicholasville, and the special agent followed. He called Nicholasville police and asked for help. Officers clocked the Impala going 64 mph in a 55 mph zone.

The Impala was stopped, but the driver wouldn’t cooperate. However, “a Nicholasville K-9 was presented to the vehicle and a positive alert was noted. A subsequent search of the vehicle resulted in a quantity of suspected heroin being seized,” the affidavit states.

After that, a search warrant was obtained for the mobile home on Carlotta Drive.

Just before midnight Tuesday, about five hours after Brezeale’s accident, officers from the DEA in Lexington, the Nicholasville police detective bureau and Kentucky State Police went to the mobile home and detained Ruggiero while they searched the home and outbuildings.

Police seized about 1 gram of suspected heroin, plus prescription medication, several sets of digital scales and packaging material, and Ruggiero admitted that he had sold heroin to Nathaniel Brezeale earlier in the day, according to the affidavit.

Emergency crews responded to nine overdoses in Jessamine County in a 24-hour period Monday and Tuesday.

Karla Ward: 859-231-3314, @HLpublicsafety

Read more here: http://www.kentucky.com/news/local/crime/article126283869.html#emlnl=Morning_Newsletter#storylink=cpy

Apparent overdose in Ohio McDonald’s parking lot captured on Facebook live


 

 

 

Alyssa Raymond, WKYC 12:30 PM. CST November 19, 2016

SANDUSKY – A desperate search for help from the man seen in a Facebook Live stream who overdosed in a McDonald’s Parking lot in Sandusky Thursday evening.

The video and the man’s story are a powerful reminder of the heroin and opioid epidemic here in Northeast Ohio. The problem is real and so we want to warn you that we wanted to show you a clear picture, which some of you may find hard to watch. 

But the man on the ground and his family say they are glad this video is out there.

This is real life and people are dying. 

There have been 30 overdoses in 30 days in Sandusky.  Four people died. 

The family of the man you see on the ground wants everyone to share this story and this video.  They want the truth about heroin out there.

In an eleven and a half minute Facebook Live stream, you see a 27-year-old man gasping for air after overdosing on heroin.  That man lying there, seemingly lifeless, is Michael Williams.  Like so many, he watched the video over and over again.

“I was fighting back the tears,” said Michael Williams.  “I got goosebumps and teary eyed.  Like I said, I am a strong individual, and it was hard to watch.”

His older sister, Amber Roesch, found it hard to watch too.

“Watch that video and share it because that is terrifying,” said Roesch.

She hopes users all over the country see what happened to her brother.

“I do not want to have to bury him,” said Roesch.  “He needs help now.”

Amber says a week ago he told her he needed help, and he said it again today.

“I definitely have a problem,” said Williams.  “If I could get the help right now, I would definitely go.  I need it I want it.”

Michael’s family expected the worse when they received that phone call.  But EMS and Narcan saved his life.  Amber says they tried to thank everyone including Eddie Wimbley, the man who recorded it all.

“I hope it is like a wakeup call,” said Wimbley.  “I just do not understand how people can do something knowing that they could possibly die.”

Michael says he started using heroin four months ago.  Before that, he drank a lot and took pain pills.  But when he lost his job, he turned to something cheaper.  Michael will tell you, he never thought it would happen to him, but it did.

You might be wondering why Williams can’t just go out and get the help he needs.  He says he recently lost his job so he does not have insurance and he was told a lot of places would not take Medicaid.  His family told me it costs around $800 a day for him to go to an inpatient facility, which they say that’s what he needs, but cannot afford.

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KY: Bill to outlaw fentanyl trafficking aired in committee


Image result for kentucky legislature

For Immediate Release

October 10, 2016

Bill to outlaw fentanyl trafficking aired in committee

GRAYSON—Jessamine County Sheriff Kevin Corman can think of days when Nicholasville has averaged two to four drug overdoses in 24 hours. Much of the blame for that, he told state lawmakers last week, goes to heroin and the abuse of the pain killer fentanyl.

The combination of the two drugs can increase the potency of heroin by up to 50 times, according to drug enforcement agencies. Hundreds of overdoses in central and northern Kentucky in recent months have been attributed to the mixture. Nationwide, more than 29,000 people died from overdoes of heroin and painkillers including OxyContin, hydrocodone or fentanyl in 2014 alone.

And drug use is only part of the problem, Corman told the Interim Joint Committee on Judiciary on Oct. 7 at Ashland Community and Technical College. The other part is drug trafficking which is extremely lucrative where drugs like fentanyl are involved. A small amount can bring big money on the streets, he explained.

“I read something the other day that you can take $10 of this fentanyl and make $5000 worth on the street,” said Corman.

Nodding in agreement next to Corman was Kentucky Attorney General Andy Beshear who was at the meeting with State Rep. Russ Meyer, D-Nicholasville, and Rep Dennis Keene, D-Wilder, to support a bill proposed by Rep. Meyer that would add fentanyl analogues, or knock-offs, not approved for human consumption to the list of highly-addictive Schedule I drugs under state law. Schedule I drugs, which include heroin and LSD, have no currently accepted medical treatment use in the U.S.

There are at least 800 known fentanyl analogues and could be 1,000 or more, according to committee testimony.

Calling the drug epidemic “Kentucky’s greatest threat in general,” Beshear covered highlights of the bill which would not only classify fentanyl analogues as Schedule I drugs but make trafficking in any amount of fentanyl or its analogues a Class C felony for the first offense and a Class B felony for the second or subsequent offense. The penalty would be pared down if the person had a “substance use disorder” at the time the offense was committed.  Trafficking 10 grams of more of fentanyl, including fentanyl analogues, would be a Class B felony under the proposal.

Judiciary Committee Co-Chair Sen. Whitney Westerfield, R-Hopkinsville, asked Beshear if substance use disorder as defined in the bill would require a diagnosis or just a court finding. Beshear said the determination would just take a court finding under current language, and Meyer said that could be spelled out in the bill.

Sen. John Schickel, R-Union, was admittedly emotional when he spoke about the heroin epidemic and its impact on Boone County where he lives. He cast some of the blame on House Bill 463 passed by the 2011 Kentucky General Assembly. The bill, now law for over five years, reduced some drug penalties while moving defendants into drug treatment.

Schickel said Kentucky was below the national average for heroin overdoses in 2009-2010. After HB 463 was signed, he said, the state’s heroin overdoses spiked. He suggested the drug penalties amended by HB 463 be raised back to the level they were at before 2011.

From his perspective, Corman said the issue isn’t just about drug overdoses. It’s about an increase in crime overall which he linked to the drug culture.

“This is getting to the point that probably 90 percent of all crime is related to this problem,” said Corman.  “You look at burglaries, thefts, robberies, a lot of your domestic violence… Somehow we have to put a lid on this and start winning,” he told the committee.

The committee also received testimony on a proposed Reentry Drug Supervision Pilot Program explained by Rep. Lewis Nicholls, D-Greenup, heard a presentation on an evidence-based drug recovery model from the organization Celebrating Families,  and received an update on gross misdemeanors legislation pre-filed for the 2017 legislative session that is similar to a bill considered last session.

–END–

The Law of Unintended Consequences: Illicit for Licit Narcotic Substitution


Image result for heroin plant

Originally written July 15, 2014 at LINK below

Martin R. Huecker, MD and Hugh W. Shoff, MD, MS

 

The dealers will not use it. Heroin dealers have explicit knowledge of the addictive properties of their product. The heroin addict is no longer the desperate character living under a bridge. She is a 17-year-old high school senior who runs out of her grandmother’s oxycodone. He is the stockbroker who weighs the economics of purchasing one oxymorphone on the street for $100 or ten doses of heroin for $200. Because these people are ingesting and injecting products of unknown composition and unfamiliar potency, they can potentially overdose. If lucky, they end up in the emergency department rather than the morgue.

Kentucky ranks third in the nation in drug overdose mortality rate per 100,000 persons, with opioid pills making up the majority.1 In response to these statistics, the State of Kentucky passed House Bill One (HB1) in April 2012, effective October 2012. Also known as “the pill mill bill,” HB1 contains provisions intended to limit opioid prescriptions by pain management physicians and by other acute care providers such as emergency physicians. To prescribe narcotic pain medications, physicians must perform a full history and physical, prescribe only a short course, educate the patient on risks of controlled substances, and obtain a report from a statewide prescription monitoring program (PMP) (Kentucky All Schedule Prescription Electronic Reporting [KASPER]).2

As a result, the number of registered KASPER users in Kentucky has gone from 7500 to 23,000 from December, 2011 to November, 2012. Reports are up from 3300 to 17000 in the same time frame.3 According to the same press release, Kentucky witnessed a decrease of 10.4% total prescriptions in the first six months since HB1 was enacted.3

Mandating PMP reports, as sixteen states currently do, leads to an increase in reports, but so far no statistical difference in opioid overdose mortality.1,4,5,6 In fact, this legislation may not even lower the rate of opioid consumption, rather may shift which opioids are being prescribed.6

Researchers in Ohio looked at the impact of real time PMP information on opioid prescriptions. With PMP data, providers changed prescriptions in 41% of cases; 61% giving fewer opioids but 39% prescribing more opioids.7

House Bill One was intended to and has reduced opioid prescriptions in Kentucky. Forty-four pain clinics in Kentucky closed overnight.8 Preliminary analysis at a large, metropolitan emergency department has shown a decrease in prescriptions for hydrocodone and oxycodone, along with a decrease in ED administration of these medications. This type of “pill mill” legislation has been passed in Louisiana, Florida, Texas and California with varying results.9

Florida had a sharp decrease in opioid prescriptions after similar legislation. Having 90 of the top 100 physicians on the Drug Enforcement Agency (DEA) 2010 list of top opioid purchasers, Florida saw the number decrease to 13 in 2011, and zero as of April 2013.10 In 2011, Ohio passed a “pill mill bill” to crack down on pain management clinics.11 This legislation led to seizing of 91,000 prescription pills with 38 doctors and 13 pharmacists losing their medical licenses. In the end, 15 medical professionals were convicted on diversion charges.11 With all of this, pill overdose deaths began to decline, but heroin overdoses “skyrocketed.”11

The unintended but foreseeable consequence of such measures has been increase in distribution, abuse, and overdose of heroin. Heroin has gained market share in a similar way in the past. In 2010, Purdue Pharma began manufacturing a reformulated OxyContin after a $600 million fine for misrepresentation.12 Endo Pharmaceuticals Inc. followed in 2011 with an Opana ER reformulation. This resulted in making the pills harder to crush into powder for snorting or injecting.13,14 States such as Florida, Ohio, Minnesota, and Utah have seen patients turn to heroin after crackdown on prescription opioid availability.11,14

The New England Journal of Medicine warned us of what would be a two-fold increase in heroin use after the reformulation of Oxycontin.15 In the 2010 ODLL report, the United States DEA also attempted to warn health care organizations that Oxycontin users might switch to heroin.16,17 The first paper we know of to report this warning was published 3 years later in 2013.16 This paper, a qualitative study of the transition of opioid pill users to heroin users, provides insight into the economic and convenience factors associated with the switch. The researchers interviewed a small sample of heroin users, forty-one in all. All but one of the 19 heroin users aged 20–29 started with pills and progressed to heroin – “termed pill initiates.”16

Numerous popular news reports directly implicate decreased opioid pill availability in the rise of heroin abuse and overdose.16 However, very little discussion of this phenomenon has entered the emergency medicine literature.

The drug cartels have capitalized on the United States opioid appetite and now decreased supply of pills. The route from Mexico to Detroit, then south through Ohio, ends up in northern and central Kentucky. The Kentucky State Police recovered 433 samples of heroin in 2010. In 2012 the number was 1349.13 In Lexington, KY, the eight total heroin arrests in 2011 exploded into 160 in the first 6 months of 2013.18,19 Undercover narcotics officers in Lexington find it easier to buy heroin than marijuana.

Heroin-related overdoses in Kentucky increased from 22 cases in 2011 to 143 cases in 2012, and 170 in the first 9 months of 2013.8,20,21 Kentucky’s percentage of overdose deaths involving heroin went from 3.2 in 2011 to 19.5 in 2012 and up to 26 in 2013.8.21 This phenomenon has occurred in Florida, California, Massachusetts, New York, Oregon, Washington and Ohio.11,2224

The emergency medicine literature has minimal recent discussion of heroin overdose management in the ED; nor have we discussed secondary prevention. Supportive therapy suffices in the ED, with liberal naloxone use and airway protection. State and federal actions to curb heroin deaths can be effective. Good Samaritan laws, present in only one third of states, protect from prosecution those lay individuals attempting to help themselves or companions in overdose situations.

Also present in only one third of states are laws to expand community access to reversal agents such as naloxone. Twenty-two states have laws requiring or recommending education for opioid prescribers. Medicaid expansion to cover substance abuse treatment has occurred thus far in less than half (24) of states.1

As more states enact measures intended to reduce total opioid prescriptions, legislators and healthcare providers alike must be aware of the predictable and devastating rise in heroin sales, abuse, and overdose. Funding for this legislation should include monies allocated toward substance abuse treatment programs and availability of naloxone. Similarly, pill mill bills could universally be coupled with Good Samaritan laws in anticipation of the increase in parenteral opioid overdoses. Funds could be allocated to lay population education via public service announcements. Stricter punishments for drug traffickers could accompany such legislative changes. Many of these measures have been presented as interventions to combat prescription opioid abuse and can now be applied to the subsequent heroin abuse and overdose dilemma.9

At the first line of medical care, emergency physicians must be involved in efforts to minimize collateral damage in this long-term process of curing America’s addiction to opioid drugs and their horrible consequences.

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Gov. Beshear, First Lady Beshear and Attorney Gen. Conway Announce Funding for Heroin Overdose Reversal Kits


Tuesday, 01 06, 2015

Kerri Richardson
Terry Sebastian
502-564-2611

FRANKFORT, Ky. – Gov. Steve Beshear, First Lady Jane Beshear and Attorney General Jack Conway today announced that heroin overdose reversal kits will be purchased for Kentucky hospitals with the highest rates of heroin overdose deaths. Overdose patients will receive a kit free of charge when they leave the hospital, so they or a loved one can prevent another overdose event and possibly save a life. The funding is provided through the Substance Abuse Treatment Advisory Committee (SATAC).

“Heroin has harrowing impacts on people who use it, as well as on their families and their communities. Many hospitals in Kentucky see multiple overdose victims every day,” said Gov. Beshear. “These kits, once in the community, can allow a friend or family member to reverse a heroin overdose almost immediately. It’s a literal lifesaver as families forge a path toward recovery.”

Gov. Steve Beshear created SATAC by executive order to oversee the KY Kids Recovery grant program and distribution of the $32 million in settlement funds that Attorney General Conway secured from two pharmaceutical companies. The judge required the settlement funds be used to expand treatment in Kentucky. Attorney General Conway chairs the committee and First Lady Jane Beshear serves on the committee.

The committee is providing $105,000 to purchase approximately 2,000 Naloxone Rescue kits for the University of Louisville Hospital, the University of Kentucky Hospital in Lexington, and the St. Elizabeth Hospital system in Northern Kentucky. The kits will be provided free of charge to every treated and discharged overdose victim at the pilot project hospitals. SATAC hopes to expand the program to 17 more Kentucky hospitals or hospital systems.

“This project will allow us to get this medicine into the hands and homes of the people who need it most – heroin users and their families,” Attorney General Conway said. “Heroin and opiate abuse is killing Kentuckians, and these kits will save lives and provide a second chance for people to seek treatment for their addictions. I hope the legislature will follow our lead by putting partisan politics aside and passing meaningful heroin legislation that will stiffen penalties for large scale traffickers, increase treatment funding, provide for a Good Samaritan defense, and get Naloxone kits into the hands of first responders and limit the civil liability of those responders.”

Naloxone, which is also known as Narcan, has no potential for abuse and immediately reverses the effects of a heroin overdose by physiologically blocking the effects of opiates. Right now, it is not covered by Medicaid or many private insurance companies, which means even if users currently receive a prescription they likely never fill it because they cannot afford it. Naloxone is available in injectable or nasal mist forms. The nasal mist form must still be approved by the FDA. When it is approved, health experts believe most insurance companies and Medicaid will begin to cover it.

“Narcan kits are critical, lifesaving tools that can help put people on the road to recovery,” said Mrs. Beshear. “As Kentuckians expand access to mental health treatment, including addiction recovery, it’s more important than ever to have community access to tools like Narcan. Often, an overdose experience is what finally drives people suffering from addiction to seek help.”

In 2013, 230 Kentuckians died from heroin overdoses. The final numbers for 2014 are not currently available, but officials do expect an increase in the number of heroin overdose fatalities.

History of SATAC
Gov. Steve Beshear created SATAC to administer $32 million in settlement funds that Attorney General Conway secured from two pharmaceutical companies.

The committee created KY Kids Recovery grants to help expand adolescent treatment in Kentucky. The 19 programs it is funding are located in every region of the state and encompass all aspects of evidence-based, substance abuse services for adolescents, including prevention, outpatient counseling, intensive outpatient and residential services.

For a complete list of the 19 grant recipients, visit KyKidsRecovery.ky.gov.

In addition to the $19 million in KY Kids Recovery grants, the settlement is providing $500,000 to complete construction of a Recovery Kentucky center in Carter County, $2.5 million for almost 900 scholarships to Recovery Kentucky centers, and $560,000 to create 14 drug-free homes for people completing and transitioning out of residential substance abuse treatment programs.

The following entities are also receiving funds from the settlement:

$6 million to administer and upgrade KASPER, Kentucky’s electronic prescription drug monitoring program.
$1 million to support substance abuse treatment for pregnant women by Chrysalis House in Lexington and Independence House in Corbin.
$1.5 million to the University of Kentucky to develop best practices for adolescent substance abuse treatment providers.
$1 million to develop a school-based substance abuse screening tool with the Kentucky Department of Education to intervene with at-risk children before they enter judicial or social services systems.
$250,000 to create a database to evaluate outcomes of adolescent treatment.
For more information about Attorney General Conway’s efforts to fight substance abuse, visit http://www.ag.ky.gov/rxabuse.

Substance Abuse Advisory Committee
In addition to Attorney General Conway and Mrs. Beshear, committee members include Cabinet for Health and Family Services Secretary Audrey Tayse Haynes, Justice and Public Safety Secretary J. Michael Brown, Kentucky Office of Drug Control Policy Director Van Ingram, Kentucky Housing Corporation Executive Director/CEO J. Kathryn Peters and Dr. Allen Brenzel, Clinical Director of the Department for Behavioral Health, Developmental and Intellectual Disabilities.

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Kentucky Senate passes bill that could make heroin traffickers face homicide charges


 

 

SB 5 passed 36-0 Thursday with Sen. Perry Clark, D-Louisville, passing.

By Kevin Wheatley, Published: January 17, 2014 10:19AM

The Senate passed a bill Thursday to combat the state’s growing heroin problem, though not without questions during a committee hearing earlier in the day on certain provisions’ constitutionality.

Senate Bill 5 passed 36-0 with Sen. Perry Clark, D-Louisville, passing.

SB 5 would require those convicted of trafficking more than 4 grams of heroin or methamphetamine to serve at least 50 percent of their prison sentence before becoming eligible for probation, parole or early release. Traffickers could be charged with homicide in cases of overdose deaths, and the bill would require coroners to report overdoses caused by Schedule I drugs, such as heroin.

“The bill targets two different groups: the trafficker, who needs to be run out of Kentucky or locked up; and the addict, who has broken the law but has created their own personal prison of addiction that is worse than any jail this state could design and needs treatment,” the bill’s sponsor, Senate President Pro Tem Katie Stine, said.

The legislation would allow the Department of Medicaid Services to expand treatment options and direct a quarter of savings realized through a corrections reform bill passed in 2011 to supplement the Kentucky Agency for Substance Abuse Policy.

SB 5 would also allow police officers and emergency responders to carry and administer naloxone, a drug used to counter opiate overdoses; grant immunity from drug possession charges for those seeking help for someone overdosing; and grant immunity from paraphernalia charges for those who alert law enforcement of any hypodermic needles or sharp objects in their possession before a search. Some could be given leniency for helping prosecute other drug crimes.

Kentucky Office of Drug Control Police Executive Director Van Ingram said the state has had problems with opioid addiction for years, and the heroin trend has evolved from opiate-based painkillers such as OxyContin and Opana. The numbers of heroin overdoses and confiscations have risen dramatically in recent years, he said.

“Senate Bill 5, I think, takes a broad view and it hits on a number of things, all aimed at reducing the availability of heroin, educating our citizens about heroin and some harm reduction things to try to keep people alive,” Ingram said during testimony before the Senate Judiciary Committee.

“We can’t get people into treatment and we can’t get them leading productive lives if they’re gone.”

Supporters of the bill cross party lines with Stine, R-Southgate, Rep. John Tilley, D-Hopkinsville, and Democratic Attorney General Jack Conway backing the measure.

The heroin issue extends beyond northern Kentucky, which supporters of SB 5 spotlight as an area of the state wracked by heroin addiction because of its close proximity to Cincinnati. Clay Mason, public safety commissioner for Lexington-Fayette Urban County Government, said central Kentucky has seen a rise in heroin abuse in recent years.

“This is not a back alley drug situation from the movies of the late ’60s and early ’70s. This is anybody’s problem,” Mason told the committee. “There are many, many people who, as we’ve already heard, have gone from a pill prescription addiction problem and now rolling into heroin for a multitude of reasons — price and availability.”

Ernie Lewis, a lobbyist for the Kentucky Association of Criminal Defense Lawyers, raised concerns about the constitutionality of certain parts of SB 5, specifically in prosecuting dealers of Schedule I substances whose drugs cause overdose deaths.

Offenders convicted of homicide or fetal homicide where the victim dies from such an overdose would not be eligible for release until serving at least half his or her sentence, under SB 5.

Lewis specifically pointed to a provision eliminating the defense that victims contributed to their deaths by willingly ingesting substances, sometimes more than the Schedule I drugs at the center of SB 5.

“Many overdose deaths occur when a person combines drugs; they combine that cocktail, unfortunately,” he said. “They may take cocaine, they may take Xanax, they may take other benzos (benzodiazepine, a psychoactive drug) or opioids. Sometimes the defendant is not even aware of that because that might have occurred earlier, because when you’re sick, you take whatever’s available to you.

“… Foreseeability has to do with the awareness of a risk. The prosecution has to prove awareness of a risk, and this provision says as a matter of law, the risk is there, we’re going to presume it, and they can’t do that under the due process of laws.”

SB 5 is meant to clarify an issue raised in a 2000 Kentucky Supreme Court decision overturning a reckless homicide conviction in which the victim died of an overdose from a mixture of cocaine and heroin, Stine and Tilley said.

“It seems to me that all that provision is doing is eliminating the ‘blame the victim’ defense, and I think we can all agree that’s not a bad thing.”

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