Aaron Payne | Ohio Valley ReSource

The sound of sirens in Cabell County, West Virginia, has a good chance of indicating an overdose these days.

The county’s Emergency Medical Service had responded to 622 overdose calls this year as of September 24, according to ES Director Gordon Merry. Last year it was more than 900 overdoses, which surpassed the total of the previous three years combined.

The county received national attention in August after responding to 26 ODs in just four hours.

“That many overdoses in that short of time was a challenge,” Merry said. “It just took us off guard there.”

All 26 victims that night survived, thanks in part to the medication naloxone. Naloxone, also known by its brand name NARCAN, is becoming more a part of everyday life due to the epidemic that’s gripped the Ohio Valley. The life-saving drug is a welcome addition for emergency responders but they caution that it is no silver bullet for the addiction crisis.

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Louisville has been chosen for a federal pilot program aimed at attacking the city’s heroin and prescription opioid problem.

The program, led by the U.S. Drug Enforcement Agency, is called the “360 Strategy.” It takes a multi-faceted approach to the problem and will involve law enforcement, medical and public health organizations and service groups.

It will include the formation of a Heroin Investigation Team, made up of Louisville Metro Police detectives and DEA agents.

U.S. Attorney John Kuhn said the team will investigate overdoses as crime scenes. Dealers whose drugs cause overdoses will be prosecuted in federal court and could go to prison for 20 years to life without parole, he said.

“Today, we have a message for heroin dealers,” Kuhn said. “You are killing people in this city, and we cannot allow this to continue.”

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Many people struggling with opioid addiction can't find a doctor to provide medication-assisted treatment, even though it's highly effective. One reason could be that doctors who are qualified to prescribe the medication typically treat just a handful of patients.

Researchers at the RAND Corporation looked at pharmacy records from the seven states with the most doctors approved to prescribe buprenorphine, which helps people manage cravings and avoid withdrawal. They found 3,234 doctors who had prescribed the drug, also known as Suboxone, to new patients from 2010 to 2013. The median number of patients by a doctor treated each month was 13. About half of the doctors treated 4 to 30 patients; 22 percent treated less than 4; 20 percent treated 31 to 75.

"We were really surprised," says Dr. Bradley Stein, a psychiatrist and lead author of the study, which was published Tuesday in JAMA, the journal of the American Medical Association. "We found that only about 10 percent of doctors were what we would call heavy prescribers, with more than 75 patients a month."

Only a fraction of the 4 million people thought to abuse prescription painkillers or heroin in the U.S. are getting medication-assisted treatment.

Ryland Barton

U.S. Attorney General Loretta Lynch warned high school students about the dangers of heroin and opioid abuse at an assembly in Richmond on Tuesday.

The visit was part of an Obama administration initiative to educate people about heroin and prescription painkiller abuse.

Lynch is the nation’s top law enforcement official, but she said the heroin and opioid problem isn’t just a law enforcement crisis, it’s a moral one.

“…A test of whether we here in the United States can protect our children, our friends, our neighbors, our fellow citizens from the scourge of addiction,” Lynch said.

Heroin overdoses have surged recently in Kentucky — reports from Northern Kentucky, Louisville, Lexington and smaller cities like Mt. Sterling have linked the spike to doses of heroin laced with fentanyl, a potent pain killer.

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The nation's opioid problem comes with staggering physical and emotional costs to patients and families. But the financial burden on the health system has been harder to peg.

A report set to be released Tuesday shows a more than thirteenfold increase in spending by health insurers in a four-year period on patients with a diagnosis of opioid dependence or abuse.

From 2011 to 2015, insurers' payments to hospitals, laboratories, treatment centers and other medical providers for these patients grew from $32 million to $446 million.

While the latest figure represents a small portion of the overall spending on medical care in the United States, the rapid rise is cause for concern, says Robin Gelburd, president of Fair Health, a nonprofit databank that provides cost information to the health industry and consumers.

"That really shows the stress on the health system and the impact on the individuals," said Gelburd.

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Kentucky educators will be trained this week on how to administer a heroin antidote.  The drug Naloxone, also known by the brand name Narcan, is being made available to high schools who voluntarily choose to participate. 

Bowling Green Superintendent Gary Fields says he still hasn’t decided if his district will stock Narcan, which can also reverse the effects of prescription drug overdoses.

"I think anytime we ask lay people who aren't health care professionals to administer medicine, that's always a scary moment, but if we feel like it's going to possibly save the life of a student down the road, then I think we're going to have to move in that direction," Fields told WKU Public Radio.

The south central Kentucky region has not seen the rise in heroin experienced by Lexington, Louisville, and northern Kentucky.

Opioid High: Students Face A Different Kind of Test

Sep 11, 2016
Aaron Payne | Ohio Valley ReSource

It’s not just about notebooks and pencil boxes anymore: the opioid epidemic means back-to-school supplies now include things like emergency overdose treatments and drug prevention plans.

Many schools in the Ohio Valley region are using random drug testing despite doubts from addiction treatment experts about whether the tests really work to deter abuse.

A Tragedy, Then Testing

A new testing program takes effect this year in Belpre, Ohio, where students have witnessed the consequences of opioid abuse first hand.

On a recent Friday night, the Belpre High School football team made the trip to face Trimble in the second week of high school football.

Among the team leaders are Logan Racy and Aric Ross, who are both in their senior seasons.

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A powerful drug that's normally used to tranquilize elephants is being blamed for a record spike in drug overdoses in the Midwest. Officials in Ohio have declared a public health emergency and the U.S. Drug Enforcement Administration says communities everywhere should be on alert for carfentanil.

The synthetic opioid is 100 times more potent than fentanyl, the prescription painkiller that led to the death earlier this year of the pop star Prince. Fentanyl itself can be up to 50 times more deadly than heroin.

In the past few years, traffickers in illegal drugs increasingly have substituted fentanyl for heroin and other opioids. Now carfentanil is being sold on American streets, either mixed with heroin or pressed into pills that look like prescription drugs. Many users don't realize that they're buying carfentanil. And that has deadly consequences.

"Instead of having four or five overdoses in a day, you're having these 20, 30, 40, maybe even 50 overdoses in a day," says Tom Synan, who directs the Hamilton County Heroin Coalition Task Force in Southwest Ohio. He's also the police chief in Newtown, Ohio.

Flickr/Creative Commons/Dimitris Kalogeropoylos

Elizabeth Boccieri has been using meth and oxycontin in the past few days, ever since she heard about extra-strength laced heroin that’s been making its way south from Ohio to Louisville.

Law enforcement officials are worried that heroin laced with poison finally reached Louisville this week. Twenty-eight people have been hospitalized with suspected heroin overdoses in Louisville in the past three days, according to local hospitals. One died on Wednesday.

And while it will take weeks to for officials to determine whether the heroin is laced through toxicology testing, it’s what’s on virtually everyone’s mind who encounters the drug in some way.

“My mom is, like, begging me to not use heroin,” the 29-year-old Boccieri said. “There’s bad stuff going around. And so I’m trying to stay away from it.”

Two weeks ago, Boccieri ended her fifth stint in jail this year for heroin-related charges, she said. For 49 days, she detoxed from heroin and other drugs. But after doing hard drugs for almost half of her 29 years, the habit has become her life. She is back to living on friends couches and doing drugs.

24 Heroin Overdoses Reported in One Day in Louisville

Aug 31, 2016
Flickr/Creative Commons/Dimitris Kalogeropoylos

Public health officials in Louisville are warning of a spike in heroin overdoses in the city.

According to WDRB-TV, officials at Norton Hospital say there were at least 24 confirmed overdose cases in Louisville on Tuesday.

Dr. Robert Couch, an emergency physician at Norton, said at a news conference that he saw eight overdose patients within five hours.

He calls it a "public health emergency," saying the heroin on the street seems to be unusually potent. He says patients taking what would usually be a small amount are losing consciousness.

Couch says larger doses of naloxone, a widely available overdose antidote that many first responders carry, are needed to reverse the drug's effect.

The announcement comes after recent overdose spikes in communities in the neighboring states of Indiana, Ohio and West Virginia.

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Indiana’s health commissioner has declared a public health emergency in Southern Indiana’s Clark County that allows local officials to start a needle exchange to curb the spread of hepatitis C and HIV.

Commissioner Dr. Jerome Adams declared the emergency Monday, making the county the sixth in Indiana to win permission for a needle-exchange following an HIV outbreak in Southern Indiana linked to intravenous drug use. The five others are Fayette, Madison, Monroe, Scott and Wayne counties.

Clark County spent eight months trying to work out problems with its initial needle-exchange application. The county submitted a second application after ending talks with the Los Angeles-based AIDS Healthcare Foundation to pay for the program.

County health Commissioner Kevin Burke said state health officials didn’t support how that foundation would have funded the program.

Tommy Farmer/Tennessee Bureau of Investigation/AP

Federal data suggest illegally manufactured fentanyl, a drug that is 50 to 100 times stronger than morphine, is behind an increase in overdose deaths.

A report from the Centers for Disease Control and Prevention says that there was a 426 percent increase in seized drug products that tested positive for fentanyl from 2013 to 2014. And separate data show the number of deaths involving synthetic opioids, a class that includes fentanyl, rose 79 percent during that same period. Among 27 U.S. states analyzed, there was a strong correlation between increases in synthetic opioid deaths and in seized fentanyl products, according to data published Thursday in the Morbidity and Mortality Weekly Report.

That suggests, the authors say, that fentanyl is driving the spike in overdoses. (Deaths attributed specifically to fentanyl aren't reported in national data.)

Fentanyl is available by prescription to treat severe pain. But the fentanyl that's currently on the streets — usually mixed into heroin and often without the user's knowledge — isn't from diverted pharmaceutical products. Instead it's being illicitly manufactured, according to the government.

Bowling Green and Warren County are joining a growing list of communities establishing needle exchange programs. 

In 2015, the Kentucky General Assembly approved a measure allowing local governments to set up the exchanges in response to the state’s heroin epidemic.  The aim is to prevent the spread of disease such as HIV and Hepatitis. 

The Barren River District Health Department serves an eight-county region including Barren, Butler, Edmonson, Hart, Logan, Metcalfe, Simpson, and Warren Counties.  From January 2014 to April of this year, the region saw more than 600 cases of Hepatitis-C. 

Warren County's needle exchange, which begins Thursday, will allow any drug user to come to the health department and anonymously swap dirty needles for clean ones. 

In this interview, Lisa Autry spoke with Dennis Chaney, director of the Barren River District Health Department.

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Kentucky’s leaders are grappling with how to get more of the state’s residents into the labor force. 

In 2015, the commonwealth ranked 46th in the nation for its workforce participation rate, according to Kentucky Education and Workforce Development Cabinet Secretary Hal Heiner.  The rate is determined by the number of adults between the ages of 21 and 65 who are able to work.

Kentucky Labor Secretary Derrick Ramsey says employers are frustrated that too many prospective workers can’t pass drug tests.

"Of the worst 220 counties in America, 54 of those counties are here in the state of Kentucky, where the drug scourge and epidemic is just sucking the life out of us, if you would," Ramsey told WKU Public Radio.

Kentucky has about 130,000 able-bodied residents who choose not to work.

TS Photography/Getty Images

Once people realized that opioid drugs could cause addiction and deadly overdoses, they tried to use newer forms of opioids to treat the addiction to its parent. Morphine, about 10 times the strength of opium, was used to curb opium cravings in the early 19th century. Codeine, too, was touted as a nonaddictive drug for pain relief, as was heroin.

Those attempts were doomed to failure because all opioid drugs interact with the brain in the same way. They dock to a specific neural receptor, the mu-opioid receptor, which controls the effects of pleasure, pain relief and need.

Now scientists are trying to create opioid painkillers that give relief from pain without triggering the euphoria, dependence and life-threatening respiratory suppression that causes deadly overdoses.