Coleman details $12 million in opioid grants, says his opposition to syringe exchanges is greater if they don't have one-to-one rule

Attorney General Russell Coleman talks to DV8 Kitchens
owners Rob and Diane Perez. DV8 Kitchens is getting
one of the prevention grants. (Photo by Melissa Patrick)

This story has been updated. 

By Melissa Patrick
Kentucky Health News

Attorney General Russell Coleman issued details Thursday of more than $12 million in grants from the state's opioid settlements for prevention, enforcement, treatment and recovery.

One of the grants will expand a syringe exchange, and was not supported by Coleman's appointees to the commission. He confirmed at an event Thursday that he opposes the exchanges.

"I'm extremely concerned that needle exchange further perpetuates drug use, and it will not be supported by me or this administration," he said in response to questions at an event he held to highlight the grants.

Coleman said the 51 grant recipients, chosen from 160 applicants, represent "bold ideas" aimed at trying to "save lives and tackle this crisis," with a focus on the three-legged stool of prevention, treatment and enforcement.

“We’re building programs and services that help Kentuckians for the next generation,” he said.

The announcement was made at DV8 Kitchens in Lexington, which employs people in recovery and is getting a $151,730 prevention grant to establish an employee-success mentorship program. 

“By connecting those in recovery with meaningful employment, we can give them a second chance at success,” DV8 owner Rob Perez said in a news release from Coleman's office. 

At the event, Perez stressed that while DV8 is "for people," its success is also good for the community. "Every time one person doesn't return back to addiction, we saved $37,000 as a community," he said.

Coleman's office oversees the Kentucky Opioid Abatement Advisory Commission, which the legislature created in 2021 to distribute the state's portion of the $900 million in settlements with opioid manufacturers and distributors, which are being paid in installments. The commission has awarded $55 million in 110 grants, including $10.5 million the legislature allocated in 2022 for behavioral-health treatment as an option to incarceration in 11 pilot counties. 

Coleman said its important to remember where this settlement money comes from. “This is blood money, purchased by pain and devastation of families across this commonwealth, which is why we must be such stewards of this money,” Coleman said. "We're honoring those we've lost by our stewardship and how we use this money effectively." 

Half of the settlement monies go to the state and the other half goes to cities and counties. The commission is housed in the attorney general's office and is headed by Chris Evans, a former chief operating officer for the U.S. Drug Enforcement Administration.

Syringe exchanges

Evans was one of the Coleman appointees who did not support a grant to the Boyle County Agency for Substance Abuse Prevention at at the June 4 commission meeting. In passing on the vote, he revealed Coleman's position on syringe exchanges.

The grant was approved by a majority vote. Coleman took office in January and has not yet made all of his five appointments; those members serve two-year terms. The other voting members are appointed by the University of Kentucky or serve by virtue of their office, including Coleman, who has designated Evans to hold his seat.

Two of the five positions that are appointed by Coleman were reappointed in June 2023, before he took office, with their terms expiring June 30, 2025. They included Karen Butcher and Von Purdy, both representing citizens at-large. Coleman appointed Darren "Foot" Allen, representing law enforcement, in February and that term will expire June 30, 2025. The other two positions to be appointed by Coleman expire at the end of this month. At this time Van Ingram, representing the drug treatment and prevention community, and Jason Roop, representing victims of the opioid crisis, fill those positions.

Asked if Coleman will make decisions about future appointments to the commission dependent on the person's view of syringe exchange programs, spokesperson Kevin Grout answered "No" in bold letters in an email.

Kentucky Health News asked Coleman if his lack of support for syringe exchanges for intravenous drug users, which are supported by research, could put a chilling effect on future applications for these programs.

He replied, "There's been no grant that has been blocked because of my personal opposition." He went on to say, "I don't support needle exchange. I support very robustly prevention, treatment and enforcement."

Asked if he had research to support his opinion, he said, "I'm a strong proponent of Narcan [an anti-overdose drug] and I'm a strong proponent of prevention. I'm very concerned that particularly when there's not a one-to-one ratio, a one-to-one return on needles that it is an enabler versus the harm reduction that we're actually seeking."

Some syringe exchanges have a one-for-one requirement, but regional health official Scott Lockard said in 2016 that most exchanges at that time used a "patient negotiation model," giving the user as many needles as they need for one week to assure they use a clean needle each time, often up to a capped amount.

"The goal is that they use a clean needle for each time they inject," Lockard said then. He said it is impossible to adhere to a strict one-for-one requirement. For example, he said users don't always keep up with their syringes or sometimes will tell you they are sharing them.

Coleman said he is a very strong advocate for wide distribution of Narcan, "given the nature of the threat we're seeing. . . . Narcan needs to be as ubiquitous as a fire extinguisher given this threat. But it always has to be Narcan plus a pathway to treatment, Narcan plus education. Because Narcan itself can be an enabler in some contexts. We want to make sure it's always coupled with treatment, coupled with prevention." 

Coleman also talked about his plans to build a statewide drug prevention program, with a goal of rolling it out this next school year. 

“We exist in a commonwealth where as little as one pill can and is taking our sons and our daughters,” he said. “But yet we lack a statewide prevention effort in our commonwealth. That will change.”

Coleman's office declined to release details of the grants until Thursday's event. Here's a summary of how the 23 new prevention grants will be used: 

Anderson County Agency for Substance Abuse Prevention, $171,100 for expansion of school-based prevention efforts and law-enforcement training.
Appalachian Research & Defense Fund (Legal Aid), $125,000 for legal support and wraparound services that help stabilize people in recovery by addressing employment barriers and other destabilizing civil legal issues.
Big Brothers Big Sisters of the Bluegrass, $185,301 for a high-school mentoring program, to empower high school students to become positive role models for younger students.
Boys and girls Clubs of Kentuckiana, $200,000 for an innovative program aimed at opioid prevention for youth aged 6-18.
Carter County Public Library, $101,500 to hire resource specialists to prtovide greater access to recovery-oriented programming.
Covington Partners, $225,450 for prevention programming that includes out-of-school-time programs, school-based health services, mentoring, drug and violence prevention and family engagement.
Cumberland Trace Legal Services (Legal Aid), $125,000 for legal support and wraparound services that help stabilize people in recovery by addressing employment barriers and other destabilizing civil legal issues.
DV8 Kitchen Vocational Training Foundation and DV8 Kitchens, $151,730 for the mentorship program, which will focus on removing barriers, supporting career-path development and job readiness while supporting recovery and wellness.
Girl Scouts of Kentucky Wilderness Road Council, $59,052 to launch the Building the Bridge to K-12 Girls Leadership Project, a community-based prevention program that focuses on increasing girls’ positive childhood experiences.
Jewish Family and Career Services, Louisville, $77,207 for enhancement of wraparound services for youth, to include opioid addiction screening and active prevention.
Legal Aid Society, $125,000 for legal support and wraparound services that help stabilize people in recovery by addressing employment barriers and other destabilizing civil legal issues.
Legal Aid of the Bluegrass, $125,000, same as above.
Mercy Health – Lourdes Hospital, $76,552 for a hospital-based, pharmacy-led tapering program, which slowly resudes doses of a drug over time to reduce withdrawal symptoms.
Operation Parent, $87,011 for prevention education of parents of 4th, 6th and 9th grade students in several Kentucky counties.
The Safety Blitz Foundation, $126,335 for a pilot version of The Coaches vs. Overdoses™ program, which addresses youth opioid misuse, the proliferation of synthetic opioids including illicit fentanyl, through prevention, education, awareness and community drug-disposal programming.
Scott County Sheriff’s Office, $91,847 for Drug Abuse Resistance Education in 5th and 9th grades.
Taylor County Schools, $208,824 for a school-based prevention program.
Three Rivers District Health Department, Owenton, $320,803 for a partnership with the Planet Youth program to implement a population-wide primary prevention process designed to take informed actions to increase protective factors, decrease risk factors and ultimately change the environment of children and youth.
University of Kentucky Research Foundation, $380,572 for development of prevention coalitions in Fayette County, educating 4th through 12th grade students and building community capacity and engagement around prevention efforts.
Operation UNITE, $751,850, for continuation and expansion of its Educate. Empower. Prevent. Program, which provides prevention training to students from 4th through 12th grades.
Wanda Joyce Robinson Foundation, Frankfort, $90,472 to start a youth substance intervention and prevention program that prevents substance use and abuse and promotes positive youth development and stronger families. The foundation helps children with incarcerated parents.
WestCare Kentucky, $100,404 for Camp Morilla, a free addiction prevention and mentoring day camp program for youth ages 9-12 and their families who have been impacted by family opioid use.
Young Men’s Christian Association of Greater Louisville, $248,487 for the YNOW Mentoring Program, which focuses on helping youth develop healthy drug-and violence-free lives.

Here is a summary of how the 28 new treatment and recovery grants will be used: 

Appalachia Regional Healthcare, $94,572 for expanding its peer recovery team so peer recovery coaches can be placed in four more hospitals.
Backroads of Appalachia, $167,025 for women in recovery with workforce training and employment opportunities.
Boyle County ASAP, $282,610 for expansion of its harm reduction program (including a syringe exchange), resilient-kids programming and case management efforts.
Celebrate Recovery Fairdale, $30,004 for weekly recovery meetings.
Center for Employment Opportunities, $255,109 for expansion of employment services for justice-impacted individuals in treatment or recovery.
Chrysalis House, Lexington, $227,273 for treatment for pregnant and parenting women.
Comprehend, Inc., $426,087 for opening a buprenorphine clinic in a community mental health center.
Eastern Kentucky Concentrated Employment Program, $450,000 for career and support services for people who are in recovery and comorbid polysubstance use who are interested in entering or re-entering the workforce.
Family Nurturing Center of Kentucky, $221,937 for services to children impacted by their caregiver’s opioid use and provides needed support to parents in recovery.
Family Scholar House, $245,110 for a five-step approach revolving around wrap-around services during and post-treatment to progress individuals from ‘crisis to stability’ targeting single parents, foster alumni, individuals facing reentry and post-secondary students.
Grin Grant, Lexington, $361,251 for expansion of dental restoration scholarships and peer support services and launch of a new recovery program.
Hope Center, $680,280 for in-patient, residential treatment for men.
Hope Springs Church, $50,462,Supports regular recovery support meetings and events.
Horsesensings, Inc., Bagdad, $115,219 for therapeutic job training in the horse industry and housing for those in recovery.
Isaiah House, $250,000 for recovery housing and job training aftercare opportunities for those in long-term recovery.
Kentucky Hospital Research and Education Foundation (Ky. Hospital Assn.), $250,000,Supports expansion of a program that ensures patients have 24/7 access to care.
Lake Cumberland Area Development District, $277,552 for case management and supportive services to individuals in recovery seeking to re-enter the workforce.
Life Learning Center, Covington, $498,500 for "a cutting-edge, technology-enhanced system designed to fill existing gaps in recovery services by providing continuous, real-time data, support and accountability."
Mercy Health-Marcum and Wallace Hospital, Irvine, $179,834 for recovery services for individuals with criminal justice involvement.
Natalie’s Sisters, $88,356 for expansion of services for women who have been sexually exploited or trafficked.
Northeast Kentucky Regional Health Information Organization, $331,997 for the Career Ready Workforce Project, which will focus prevention efforts on high-school students preparing to enter the workforce, individuals struggling with addiction ,and local agency staff members seeking to increase employable skills.
Ramey-Estep Homes, Rush, $222,801 for teen prevention-education programming, expansion of first-responder trauma-treatment programming and expansion of treatment and recovery access.
Recovery Café Lexington, $276,278 for expansion of recovery support model to a third location in Frankfort.
Transitions, Inc., Covington, $156,000 for expansion and enhancement of treatment services, as well as expansion of community education and prevention activities in the African American community.
Voices of Hope-Lexington, $538,021 to increase the quantity and quality of recovery support services for people in or seeking recovery.
Volunteers of America Mid-States, $664,587, for two recovery community centers in Lincoln and Pulaski counties.

Four Rivers Behavioral Health, Paducah, $232,251 for a mobile recovery support vehicle program that provides services to adults.
Young People in Recovery, Louisville, $301,440 for peer-led chapter and life-skills curriculum programs for people seeking recovery and a youth prevention program for middle- and high-school-aged children and their parents in five communities.

In third round of grants from opioid settlements, director passes on one, saying Coleman opposes syringe-exchange programs

Russell Coleman announced Chris Evans's
appointment on Dec. 19. (WKYT image)

By Melissa Patrick
Kentucky Health News
 

The leader of the agency that makes grants from the state's opioid settlements declined to vote for a grant with more money for a syringe-exchange program, saying Attorney General Russell Coleman does not support such programs -- which are considered a key tool for reducing harm to people who inject drugs.

Kentucky Opioid Abatement Advisory Commission Director Chris Evans, who works for Coleman, passed on a June 4 vote that approved a grant to the Boyle County Agency for Substance Abuse Prevention, one of 119 such county agencies.

"This application does increase outreach, which includes educational training, Narcan distribution and referrals to treatment," Evans said. "However, the request does increase the funding of the syringe-service position, which the Office of the Attorney General does not support syringe exchange programs. So I will be passing on the vote of this application."

Asked later why Coleman opposes syringe-exchange programs, Coleman spokesman Kevin Grout said in an email, "Attorney General Coleman is committed to supporting effective prevention, treatment and enforcement efforts. He strongly supports the distribution of Naloxone and other overdose reversal drugs. However, he cannot support syringe-exchange programs, which he believes enable drug use without effectively promoting recovery."

Syringe exchanges are supported by research. The Centers for Disease Control and Prevention says injection drug users who have access to syringe exchanges are five times more likely to get treatment than those who don’t. Another study says the exchanges do not encourage drug use or increase the frequency of drug use among current users.

The exchanges were authorized by the state's 2015 anti-heroin law, in an effort to thwart the spread of HIV and hepatitis C, which are commonly spread by the sharing of needles among intravenous drug users. As of March 14, the state had 80 operational syringe exchange programs in 65 counties.

Later voting against the grant request because of their opposition to syringe exchange programs were commission members State Treasurer Mark Metcalf and retired Master State Trooper Darren "Foot" Allen, whom Coleman appointed to fill a slot representing law enforcement.

Allen said, "There's some people that I trust that tell me this is okay. However, I'm just not in favor of needle exchange. I suspect that this time next year, I won't change my position but I am open to looking at that option," he said. 

Despite the opposition, Boyle County's ASAP grant request for $282,610 passed with a 6-2 majority vote. The commission is comprised of nine voting and two non-voting members from the legislature.

Third round of grants approved

The Boyle County grant was the only one put up for a vote that had any opposition at the commission's June 4 meeting. In all, the commission members approved 51 organizations to receive just over $12 million in grant money. 

The legislature created the commission to distribute the state's portion of the approximately $900 million in settlements with opioid manufacturers and distributors, half of which goes to the state and the other half goes to cities and counties. The commission is housed in the attorney general's office and is headed by Evans, a former chief operating officer for the U.S. Drug Enforcement Administration.

Of the $12 million in this round of grant money, 28 of the awards were given for treatment and recovery, and 23 were given for prevention. This is the third round of state grants, with $32 million awarded to 59 groups in the first round and $13.9 million awarded to 34 groups in the second round.

Asked for brief details of each grant, Grout said they would be announced next Thursday at a press conference at DV8 Kitchen-East End in Lexington, one of the grant recipients.

The 28 new treatment and recovery grants are:

Appalachian Regional Healthcare, $94,572.
Backroads of Appalachia, $167,025.
Boyle County ASAP Board, $282,610.
Celebrate Recovery Fairdale, $30,004.
Center for Employment Opportunities, $255,109.
Chrysalis House, $227,273.
Comprehend Inc., $426,087.
Eastern Kentucky Concentrated Employment Program, $450,000.
Family Nurturing Center of Kentucky, $221,937.
Family Scholar House, $245,110.
Grin Grant, Lexington, $361,251.
Hope Center, Lexington, $680,280.
Hope Springs Church, $50,462.
Horsesensing Inc., $115,219.
Isaiah House, $250,000.
Ky. Hospital Research and Ed. Foundation (Ky. Hospital Assn.), $250,000.
Lake Cumberland Area Development District, $277,552.
Life Learning Center, $498,500.
Mercy Health - Marcum and Wallace Hospital, Irvine, $179,834.
Natalie's Sisters, $88,356.
Northeast Kentucky Regional Health Information Organization, $331,997.
Ramey-Estep Homes, $222,801.
Recovery Café Lexington, $276,278.
Transitions Inc., $156,000.
Voices of Hope - Lexington, Inc., $538,021.
Volunteers of America Mid-States, $664,587.
Four Rivers Behavioral Health, $232,251.
Young People in Recovery, $301,440.

The 23 new prevention grants are:

Anderson County ASAP, $171,100.
Appalachian Research & Defense Fund (Legal Aid), $125,000.
Big Brothers Big Sisters of the Bluegrass, Inc., $185,301.
Boys and Girls Clubs of Kentuckiana, $200,000.
Carter County Public Library, $101,500.
Covington Partners, $225,450.
Cumberland Trace Legal Services (Legal Aid), $125,000.
DV8 Kitchen Vocational Training Foundation and DV8 Kitchens, $151,730.
Girl Scouts of Kentucky Wilderness Road Council, $59,052.
Jewish Family and Career Services, $77,207.
Legal Aid Society, $125,000.
Legal Aid of the Bluegrass, $125,000.
Mercy Health - Lourdes Hospital, $76,552.
Operation Parent, $87,011.
The Safety Blitz Foundation, $126,335.
Scott County Sheriff's Office, $91,847.
Taylor County Schools, $208,824.
Three Rivers District Health Department, Owenton, $320,803.
University of Kentucky Research Foundation, $380,572.
Operation UNITE, $751,850.
Wanda Joyce Robinson Foundation, $90,472.
WestCare Kentucky, $100,404.
Young Men’s Christian Association of Greater Louisville, $248,487.

The grant application portal is closed until the commission opens it for the next round of awards.

Third annual Harlan County Drug Summit looks at ways to address addiction, with a focus on prevention

Dan Mosley, Harlan County judge-executive, speaks to nearly 200 people at the third annual Harlan County Drug Summit at the Harlan Center on Jan. 11. (Photo provided by Operation UNITE) 

Nearly 200 people attended the third annual Harlan County Drug Summit on Thursday, Jan. 11, to hear a message largely focused on prevention, Chandler Wilcox reports for Hazard's WYMT.

“We have a lot of resources around treatment, recovery housing, long-term recovery, programs for people who have been in addiction, but there just hasn’t been enough investment made in prevention,” said Harlan County Judge-Executive Dan Mosley.

Several students from Harlan County High School and Harlan High School who are in clubs sponsored by Operation UNITE, the regional anti-drug group, also took part in the summit, reports Wilcox. 

“It’s really nice for everybody to know, especially in school, about how it can effect not only them, but the people around them,” said Harlan County High School student Morgan Blevins.

The keynote speaker at the drug summit was Julie Hofmans, who was also scheduled to talk to students at both schools the day after the summit. Her son died from a fentanyl overdose in 2020. The fentanyl was in a pill designed to mimic a prescription Xanax tablet, according to a 2022 story by Beth Warren of the Louisville Courier Journal.

Van Ingram, executive director of the Kentucky Office of Drug Control Policy, told the attendees that there is good news and bad news related to drugs and addiction, according to an Operation UNITE press release. 

The bad news, Ingram said in the release, is that “we’re going to lose six more Kentuckians today – preventable deaths.” Five of these deaths, he noted, will be due, at least in part, to fentanyl. 

Further, he said the profits reaped because of the “financial model” of illegal drug trafficking likely means “we will be dealing with this the rest of our lives.”

But, Ingram continued, the positive news is that Kentucky is in the best position it has ever been to address each aspect of addiction , treatment, and recovery.

The release goes on to note that Ingram cited, as an example, the work of Operation UNITE over the past 20 years and the KY HELP Statewide Call Center, which is staffed by the organization. 

He also cited other programs that help remove barriers for people in recovery to obtain meaningful employment, reduce the stigma that surrounds substance use disorders, provide alternative sentencing when appropriate for those in the criminal justice system, and provide funding for individual communities to address local needs, according to the release.

“Every community needs to look at itself” to see if they have the resources they need, said Ingram. “We’re not going to get out of this easily. It is a long-haul fight.”

Mosley agreed, saying, "It requires all of us to do a little to make a huge impact." 

Tom Vicini, president and CEO of Operation UNITE, also stressed the importance of prevention in this day, when “the drugs that are out there are the worst in history," says the release.

In the past, he said, while speaking to a group of students from Harlan Independent, "We’ve been reactive instead of proactive. What about cutting it off at the source? We fight this by reducing the demand.”

Turning to the adults in the room, the release notes that Vicini said it doesn’t matter your age or position, it’s about the passion you bring to the effort. 

“One adult can change the trajectory in the life of a child,” he said, adding those in recovery are the best people to share the prevention message. “They know what it’s like. I want them teaching kids.”

Vicini called on the group to recommit themselves to this prevention effort, saying, "We’re just scratching the surface."

Second round of state grants from settlements with opioid makers and distributors, totaling nearly $14 million, go to 34 organizations

By Melissa Patrick

Kentucky Health News

Attorney General Daniel Cameron announced the latest round of funding from the Kentucky Opioid Abatement Advisory Commission on Monday, with 34 organizations set to receive nearly $14 million. 

Attorney General Daniel Cameron

"I certainly am grateful for all of you all that have committed to fighting this opioid epidemic and there's certainly no debate, the drug epidemic remains the public safety challenge of our lifetime," Cameron said at a news conference. "We can have the finest schools, the lowest taxes and the region's most ambitious economic development plans, but none of that matters if drugs continue to take thousands of Kentucky lives and wreak havoc on thousands of Kentucky families each year." 

The commission was created by the General Assembly to distribute the state's portion of the more than $842 million in settlements with opioid manufacturers and distributors, half of which goes to the state and the other half goes to cities and counties. The commission is housed in the attorney general's office and is headed by Cameron employee Bryan Hubbard.

Of the $13.9 million in this round of grant money, 21 of the awards were given for treatment and recovery, and 13 were given for prevention.

Including the first round of state grants, the commission has awarded more than $32 million of the opioid settlement money to 59 groups. 

Cameron, a Republican, announced the latest grant recipients 10 days after the commission approved the awards by number only at its Sept. 22 meeting, and just over five weeks before voters will decide between him and Democratic Gov. Andy Beshear.

Kentucky Health News was told at the Sept. 22 meeting that there would be a delay in announcing the names of the recipients because the commission needed time to contact them. 

Cameron and Beshear, who preceded Cameron as attorney general, both take credit for the state's share of the opioid settlement money. 

Cameron and Hubbard noted that $800 million in opioid settlements have come to Kentucky during his term. Hubbard said, "No other attorney general in our history has achieved such a momentous breakthrough in the fight against the opioid epidemic."

Beshear has pointed out that when he was attorney general, he sued "more opioid companies than any other attorney general in the country," and has also said that such lawsuits take many years to litigate, and that he filed the lawsuits Cameron has been settling. 

The commission's largest grants in the latest round were $1 million each to Voices of Hope-Lexington for treatment and recovery; to the Kentucky Health Department Association for prevention; and to the Northern Kentucky Office of Drug Control Policy for prevention. 

Twenty other grants are for treatment and recovery: 

• Franklin County Women and Family Shelter, $134,750
• Kentucky River Foothills Development Council, $500,000
• Recovery Cafe Lexington, $657,000
• Feed Louisville, $500,000
• Oxford House, $500,000
• Ramey-Estep Homes, Inc., $578,800
• Stable Recovery, $300,000
• Sterling Health Solutions, Inc. dba Sterling Health, $575,280
• Enrich Corp, $595,213
• Emergency Shelter of Northern Kentucky, $320,098
• Faith Life Ministries, $225,000
• Freedom Management Co. dba SPARC Recovery, $500,000
• Fresh Start Health Centers, $300,000
• Grace Community Health Center, $205,000
• Hope 4 Harrison County Recovery, $123,349
• KVC Behavioral Healthcare Kentucky, $400,000
• AdventHealth Manchester, $250,000
• Serenity Counseling Services, $355,615
• Thrive Community Coalition, $376,050
• The Healing Place, $850,000

The 11 other new grants, for prevention, are: 

• Jeffersontown Police Department, $26,811
• Kentucky Center for Grieving Children and Families, $269,809
• Franklin County Health Department, $300,000
• Morgans Mission, $4,000
• Childrens Law Center, $250,000
• Franklin County ASAP Board, $126,700
• QRT National-O2SL, a division of Homeland Security Solutions, $750,000
• Kentucky Youth Advocates, $93,900
• Shaping Our Appalachian Region, $600,000
• Boyd County Detention Center, $45,200
• Hands Healing Hearts, dba Yes Arts, $200,000

To see the complete list of organizations receiving funding and the counties they serve, click here.

Kentucky Opioid Symposium will be held Oct. 9-10 in Lexington

Kentucky Health News

The Kentucky Opioid Abatement Advisory Commission will host what it calls its inaugural opioid symposium Oct. 9 and 10 in Lexington. 

The two-day conference will feature presentations and workshops by experts in their respective fields "to foster increased awareness of the impact of the opioid epidemic and to bolster a collaborative approach to combatting this scourge," says a news release from the commission.

"Special rate" tickets are available for $99 until Monday, Sept. 11 for the symposium and the welcome  reception, according to the event website. After that date, the cost of the combined ticket increases to $135, with sales ending Oct. 1.

Purchased separately, a ticket to the Oct. 8 welcome reception at Marriott Griffin Gate Resort is $50 and the cost for a ticket to the symposium is $100, with sales ending Oct. 1. 

The symposium will be held at the Central Bank Center, 430 W. Vine St. To register for earlybird tickets visit kentuckyopioidsymposium.com.

The site says, "You can purchase tickets for individual events, or purchase a package for all events."

The agenda addresses s a number of opioid-related topics from the perspectives of prevention and treatment and recovery and reform. U.S. Rep. Hal Rogers will be a speaker, and the keynote speaker will be Sam Quinones, author of Dreamland and The Least of Us: True Tales of America and Hope in the Time of Fentanyl and Meth.  Click here to see the full agenda and here for a list of the presenters. 

The symposium's presenting sponsor is the Kentucky Association of Health Plans, the trade association representing commercial insurers and Medicaid managed care organizations. 

"KAHP is honored to help the Opioid Advisory Commission with convening this important gathering," Tom Stephens, president and CEO of  KAHP, said in a news release. "Managed care organizations continue to show their commitment to fighting the opioid scourge through awareness campaigns, incentivizing alternative therapies, providing Medically Assisted Treatment (MAT), encouraging strong peer supports, and focusing on areas like expungement assistance and recovery housing.”

The Kentucky Opioid Abatement Commission was created by the General Assembly to distribute the state's  portion of the more than $842 million in opioid-settlement money. The funds come from opioid manufacturers and distributors, half of which goes to the state and the other half goes to cities and counties.  The commission is housed in Attorney General Daniel Cameron's office. 

KET panel applauded Kentucky's 5% drop in overdose deaths in 2022, but cited new challenges and remaining difficulties

By Melissa Patrick

Kentucky Health News

A panel of survivors, drug-recovery experts and providers lauded Kentucky's 5 percent reduction in drug-overdose deaths between 2021 and 2022 on a Kentucky Educational Television program, "Disrupting Addiction: A KET Forum," but said there is still more work to do. 

Host Renee Shaw opened the program by sharing data from the state's latest annual Overdose Fatality Report, It shows 2,135 Kentucky residents died from overdoses in 2022, 5% less than in 2021. Fentanyl was identified in more than 1,500 of the deaths, 72% of them. By age group, people 35 to 44 had the most overdoses.  

Van Ingram, executive director of the state Office of Drug Control Policy, said Kentucky was one of only eight states that reported decreases of 100 or more overdose deaths in 2022, compared to 2021. "That's over 100 families that are impacted," he said. "But still, we're losing six Kentuckians every day to preventable disease, preventable death." 

Ingram said another challenge is that in addition to fentanyl, Xylazine, a non-opioid animal tranquilizer that has been approved for veterinary use, is being added to the drug supply.

"It's really going to cause us to redouble our efforts and look for new ways," he said. "There are Xylazine test strips, we'll be looking at those. It's just unbelievable that if fentanyl wasn't deadly enough, now we have to add something else to it." 

Asked why the top five counties with the highest rates of drug overdose deaths in 2022 (Bath, Lee, Floyd, Estill and Knott) were all in Eastern Kentucky, Ingram reminded Shaw that Appalachia was ground-zero for the opioid epidemic.

"It still remains one of the hardest hit areas in the country," he said. "There's just not the resources a lot of times in those communities that others have, and that makes things more difficult." 

Rep. Kim Moser, R-Taylor Mill, chair of the House Health Services Committee, said she attributed the 5% drop in overdose deaths to strong policies that have been passed in the last nine years, a changing conversation around addiction that makes it easier to pass strong policies, and improving resources. However, noting the more than 2,000 overdose deaths in 2022, she added, "We still have a long way to go."  

Despite last year's drop in overdose deaths, Madison County Coroner Jimmy Cornelison said his county is on track to see more than last year. He added that while fentanyl and methamphetamine ae his main two culprits, he is seeing an upswing in cocaine use, which he said, "was gone for some time."  

Asked what can be done to reverse these numbers, Cornelison said he doesn't know if there is an answer. He said Madison County is fortunate to have a strong support system, including its EMS that distributes Narcan, a drug that can reverse the effects of an opioid overdose. He said the drug is expensive and puts a strain on the EMS budget, but without it, overdose numbers would be much higher. 

Cornelison encouraged policymakers to listen to their local people because they see this situation in a different light: "We see what it does to families and friends." 

State Health Secretary Eric Friedlander also talked about the value of Narcan: "Hopefully that Narcan distribution has helped people survive. . . . You can't get to treatment if you're dead, right? You can't turn your life around if you are seeing the coroner."

There are evidence-based, medication-assisted treatments for substance-use disorders, such as methadone, buprenorphine and Suboxone, but nine out of 10 Kentucky drug users go untreated. 

That is largely due to access issues and the stigma that still exists around these treatments, said Dr. Devin Oller,  primary care and addiction medicine physician at the University of Kentucky.

"I don't have any medication for heart failure, for diabetes, that is as effective in terms of reducing death as buprenorphine and methadone -- 50% drop in mortality if I'm able to get folks started on that. But again, the barrier is that access point," Oller said. 

To the criticism that using these drugs is just trading one drug for another, he said, "We would never say to a patient with diabetes that using insulin is trading one drug for another, right? So why do we do that for addiction?" 

Oller said this criticism often stems from mistaken beliefs that addiction is a choice or that there are no genetics or trauma involved. He said addiction is a chronic disease of the brain that has a great prognosis with effective treatment. 

Asked about ibogaine, a psychedelic drug that is illegal in the U.S. but has been anecdotally reported to stop the withdrawal symptoms of opioid dependence, Oller said, "It may be part of of the long-term solution, but Kentuckians are dying right now. And so we need to do whatever we can to get them access to these evidence-based treatments, that again, reduce the risk of death by 50%."

The Kentucky Opioid Abatement Advisory Commission recently held a public forum to learn about ibogaine as it considers using some of the money the state is getting from settlements with drug makers and distributors to help get the drug get approval from the U.S. Food and Drug Administration. 

Bryan Hubbard, executive director and chair of the commission, the main advocate of the idea, said the commission is in the "exploratory phase" when it comes to ibogaine.

"What we can say is that observational data suggest that ibogaine could be added to the existing treatment options that we have, and that it may represent a breakthrough opportunity to pioneer an additional therapeutic that can deliver some fairly dramatic results, at least when it comes to the front end of the long term recovery process that has been mentioned thus far," Hubbard said. 

Asked about the heart risks associated with ibogaine, Hubbard said it's important to remember that the drug is not administered in a medically or clinically controlled setting outide the U.S., and a panel of experts at the public hearing said the risks can be mitigated with proper screening of patients and appropriate monitoring during treatment.

As host, Shaw also highlighted several recovery programs, talked with Nancy Hale of Operation Unite about the importance of early prevention and education, and talked with staffers at the Estill County Health Department about its mobile harm-reduction program, including a syringe exchange. 

The program can be seen at KET.org and will be bebroadcast on various days, times, and channels through Aug. 9. To see the list of dates and times the program will air go to https:// ket.org/program/ket-forums/.

First round of state grants from settlements with opioid makers and distributors, more than $8 million, go to 24 organizations

Operation UNITE was one of 24 organizations to get a grant from the first round of opioid settlement money. It got $1 million to be used for prevention. (Photos by Melissa Patrick)

By Melissa Patrick
Kentucky Health News

Attorney General Daniel Cameron announced the first 24 organizations to receive over $8 million in grant funding from the state Opioid Abatement Advisory Commission on Thursday, with 14 of the grants going toward treatment and recovery and 10 for prevention of opioid abuse. 

Attorney General Daniel Cameron makes the announcement.

"The opioid crisis lingers and won't be defeated merely with these dollars," Cameron said at a news conference to announce the awards. "But for the first time in a long time, meaningful relief is here. For the first time in a long time, we have something to rally around, we have a reason for hope." 

So far, Kentucky is in line to get nearly $900 million in settlements with drug makers, distributors and big retailers. Cameron has implied he should get sole credit, at odds with the account of Gov. Andy Beshear, who preceded him as attorney general and whose job he wants. 

Under state law, half of opioid-settlement money is allocated annually by the commission, which is housed in the attorney general's office, and the other half is allocated by cities and counties, among themselves. Cameron said he has worked closely with local governments and the legislature to manage these funds responsibly because "Not a dime can be wasted; too much is at stake." 

The money is required to be used for reimbursement of prior expenses and the funding of new programs related to the prevention, treatment and recovery of people with opioid-use disorders and co-occurring substance-use disorders or mental-health issues.

Bryan Hubbard, executive director and chairman of the commission, praised the ongoing commitment of commission members, noting that since being appointed in June 2022, they have had 11 town-hall meetings across the state, 10 business meetings and numerous subcommittee meetings. 

Asked what was gleaned from the town halls, Hubbard said thousands of people attended them and that they inevitably became a "collective, cathartic exercise in communal grief" that revealed common needs across the state, including child-centered prevention programs and recovery services that include housing, transportation services, life-skill training, educational opportunities and formalized vocational training. 

"The organizations that are here . . . have all been resourced to meet those acute needs based on the collected feedback that we receive from thousands," Hubbard said. 

He said the commission hopes to make its next grant announcements sometime in "early to mid-fall" after considering about 65 applications that are seeking $130 million, with only $30 million available. 

Commission Chair and Executive Director Bryan Hubbard

Hubbard said they have 200 applications in the pipeline and that the commission is working to provide grant makers who can offer individualized assistance to organizations that are not used to writing grants "to ensure good, full consideration of our grassroots organizations." 

"We will always remember the thousands of lives that paid for the settlement from which these funds come, for it is blood money," said Hubbard. " You are here because you are the front line foot soldiers who will get in the streets and get in the hollers and bring Kentucky some unified victory." 

Cameron said, "I'm proud to say that because of this office's action, with a lot of you all that are here today, Kentucky stands to receive nearly $900 million in settlement from funds from pharmacies, distributors, wholesalers and manufacturers of opioids. This is Kentucky's share of what is a historic settlement, the second largest such agreement in American history."

Cameron claims sole credit; Beshear says he's shocked

Cameron is a candidate in the May 16 Republican primary to pick a nominee to run against Beshear, who has nominal Democratic opposition. Last week on WKYT-TV's Kentucky Newsmakers, Cameron talked about Beshear filing a lot of lawsuits but bringing no settlement money to the state. Asked about that Thursday, Cameron said: "We wanted to quit talking about the epidemic and bring meaningful dollars into the state. And we've been able to do that. We're in the process of bringing nearly $900 million into the state. Andy Beshear, when he was attorney general, didn't bring any money into the state. So this has been about not just talking, again, but taking action so that we can hopefully start to have meaningful change in Kentucky."

Beshear was attorney general four years, and such suits usually take many years to litigate. Cameron said, "The fortunate thing is that the settlements that we entered into were separate and apart from the litigation that he was involved in here in Kentucky. And so we had to make a decision about, you know, whether we want to continue to talk as he did for four years in this office, or do we want to bring money into the state, and we chose to bring money into the state." 

Nicer in 2019: Beshear at Cameron's swearing-in

Asked at his weekly news conference about Cameron's comments, Beshear said, "I'm a little shocked that the attorney general would say I haven't brought any dollars in in opioid settlements. I filed more lawsuits against opioid manufacturers and distributors than any other attorney general in the country. I think he filed one. Every single lawsuit he's settling right now, I not only filed, but I argued personally in court showing up when companies were trying to blame us, for the millions of pills that they sent, hundreds of thousands into really smart communities.

"Listen, as an attorney, you're always supposed to share credit with other lawyers on the suit on a lawsuit or especially the ones who filed it. And if you'll remember, I settled. Actually, Attorney General [Jack] Conway settled the first opioid lawsuit on his way out of office, I was able to award those funds, but we gave credit all the way back to Greg Stumbo, who filed that [suit]. So certainly, first, as attorney general, we did bring in funds to help treatment. Look at Hope in the Mountains in Prestonsburg; it was going to close down without those funds that we provided. Now, they're Medicaid eligible.

"But, I know I filed those lawsuits. I know I did it so that we could have our best shot of getting out of this epidemic. This is blood money that needs to be spent the right way to get people better." 

The list of grants mentioned specific uses in some cases but not in most. Asked for details, Krista Buckell, communications director for the attorney general's office, merely parroted the law: "Each awardee will be pursuing one or more aspects of prevention or treatment and recovery for individuals and communities that have been impacted by the opioid epidemic across the commonwealth."

By far the largest grants were $1 million each to Operation UNITE (Unlawful Narcotics Investigations, Treatment and Education) of London, for prevention, and Volunteers of America Mid-States of Louisville, for treatment and recovery. The Louisville-based organization says it "operates nearly 50 distinct human service programs in Kentucky, Tennessee, West Virginia and Clark and Floyd counties in Indiana." 

The other 13 grants for treatment and recovery are going to:

• Shepherd's House of Lexington, a long-term residential recovery program, $141,450. 
• Appalachian Restoration Project, a residential rehabilitation facility in Barbourville, $250,000. 
• Chrysalis House of Lexington, Kentucky’s oldest and largest residential treatment program that specializes in treating pregnant and parenting women, $250,000. 
• Isaiah House, an addiction treatment center with locations across the state, will get $250,000 to support a "comprehensive, dual diagnosis program to help Kentuckians achieve a lifetime of recovery," the list says.
• Lake Cumberland District Health Department, which serves 10 counties, $250,000. 
• Mountain Comprehensive Care Center of Prestonsburg, $250,000.
• Mountain Comprehensive Health Corp., Whitesburg, $250,000.
• Seven Counties Services, a Louisville-based community mental-health center, $250,000.
• Young People in Recovery of Louisville, which serves youth and young adults recovering from substance use disorder, $308,232. 
• Family Scholar House in Louisville, which helps disadvantaged single parents and children reach their educational and career goals, $316,500.
•  Lake Cumberland Community Action Agency will get $375,268 for "comprehensive programs that help low-income Kentuckians achieve greater economic self-sufficiency."
• Appalachian Research and Defense Fund of Kentucky, offering free civil legal help to low-income people in 37 counties, $250,000. 
• Revive Ministries of Nicholasville will get $500,000 to support its faith-based addiction recovery program in Central Kentucky.

The other nine prevention-service grant recipients are: 

• Kentucky Alliance of Boys & Girls Clubs, $500,000. 
• Kentucky Harm Reduction Coalition of Louisville, $500,000.
• Legal Aid of the Bluegrass, $250,000. It provides legal assistance to vulnerable Kentuckians. 
• Legal Aid Society of Louisville, $250,000 to provide free civil legal help concerning opioid-specific matters to people with incomes at or below federal poverty levels. 
• Cumberland Trace Legal Services, dba Kentucky Legal Aid, Bowling Green, $250,000. It provides free legal counsel to those struggling with addiction.
• YMCA of Greater Louisville, $250,000. 
• Prevent Child Abuse Kentucky, Lexington, $243,050. 
• Taylor County School District, Campbellsville, $100,000. 
• Scott County Sheriff, Georgetown, $92,354.13.

Ky. Opioid Abatement Advisory Commission subcommittees consider five grant applications, with only two getting a yes vote

This story has been updated to reflect that Jason Roop does not serve on the Reform and Compliance Committee. He serves on the Treatment and Recovery Committee.

Commission subcommittees discuss applications. From left: Allen Brenzel, Eric Friedlander, Von Purdy, Scott Hornbuckle, Carlos Cameron, Allison Ball, Lorran Ferguson and Danny Bentley.

Story and photo by Melissa Patrick

Kentucky Health News

Two of the three Kentucky Opioid Abatement Advisory Commission subcommittees reviewed five grant applications asking for funds to fight the opioid epidemic and approved two with caveats, classified two as "maybes" and gave a firm "no" to one on Jan. 24.

The settlement funds come from opioid manufacturers and distributors and are required to be used for reimbursement of prior expenses and the funding of new programs related to the prevention, treatment and recovery of people with opioid-use disorders and co-occurring substance-use disorders, or mental health issues.

So far, Kentucky is getting $842 million from these settlement funds, half of which will be allocated by the state advisory commission, with the other half going to cities and counties. Funds are to be disbursed annually, on various schedules, through 2038.

Members of the Prevention Subcommittee and the Reform and Compliance Subcommittee spent an hour deciding the initial fate of five applications referenced only by an assigned number, to keep them private.

Details from the applications were occasionally and vaguely mentioned during the committee discussion.

However, it was apparent that one of the two applications that got a "yes" vote, both with caveats and adjustments, dealt with harm reduction, while the other was for unnamed program for a small youth cohort. The "maybe" group included a national organization that would partner with existing programs in Kentucky and an elective class to be offered to younger students. The application that got the "no" vote involved a group from New York that proposed something already being done in Kentucky.

Concerns and questions were raised on the "yes" and "maybe" applications that must be answered before they move forward to the full commission.

The main concern with all four applications was money, with a general consensus that they were asking for too much to execute their plans. Other concerns dealt with coverage areas, a need for assurance that the monies would be spent in Kentucky, questions about staffing models and salaries, and a need to know how the programs might overlap with existing programs.

The committee said all of the applications were different from each other and could not be grouped together.

Application criteria

Bryan Hubbard, executive director and chair of the advisory commission, opened the meeting by reading the 12 criteria established in an emergency administrative regulation to guide the assessment of the applications.

The regulation says the commission, in awarding funds, shall consider:

• Compliance with applicable law;
• The entity or agency's record and responsibility in utilizing effectively any funds received previously from the commission or local governments, as described in KRS 15.293;
• The geographic reach of the application;
• Amounts received from the commission or local governments;
• The utility and effectiveness of any part of the application;
• The extent to which Kentucky residents are served by the application;
• The extent to which prior allocations from the commission have served similar purposes;
• The extent to which the application proposes to serve a portion of the population that otherwise would not receive such service;
• The extent to which the application proposes to incorporate relevant partnerships that are likely to increase the efficiency and effectiveness of programming;
• The extent to which the application proposes, among other things, to educate the public about opioid misuse and opioid-use disorder, reduce the occurrence of opioid misuse and opioid-use disorder, promote resistance to opioid misuse and opioid-use disorder, promote the effective treatment of opioid-use disorder, and/or combat the effects of opioid misuse, including co-occurring mental-health issues;
• The extent to which the application activities align with accepted evidence-based practices; and/or
• The sufficiency of records to validate the requested amounts.

Hubbard then instructed the subcommittee to place the reviewed applications into a yes, no or maybe category, adding that the maybes should also include a list of questions and concerns that would be addressed by the applicant so that they could then be placed into a yes or no category.

He said the applications placed in the "yes" category would be assessed for their coverage areas, that like proposals would be grouped together and that unique, stand-alone proposals would remain so.

"That is our process," he said.

Later in the meeting, Scott Hornbuckle, a staffer with the commission, clarified what a yes vote for an application meant: "Yes means it's a good idea, we want them to participate at some level, we need to look into it further. It does not mean, yes, we approve their grants at this price point," but the application would move to the next step in the process.

Hubbard told the legislature's health committees Jan. 19 that the commission had received 32 completed applications and 231 more are in progress. He said the total asked by the completed applications is $63.6 million.

Applications are being accepted on a rolling deadline, and the application date is open-ended, at least for now. The commission plans to make the first awards in the spring, with hopes of making three more later this year.

Members of the subcommittees

Members of the Prevention Subcommittee in attendance were Von Purdy, representing citizens at large and chair of the joint subcommittee; Eric Friedlander, representing the Cabinet for Health and Family Services; and Carlos Cameron, district director for Fifth District U.S. Rep. Hal Rogers, who was appointed by state Senate President Robert Stivers.

Dr. Allen Brenzel, medical director of the Department for Behavioral Health, Developmental and Intellectual Disabilities, who serves if Friedlander is absent, also attended the meeting.

Members of the Reform and Compliance Committee in attendance were state Rep. Danny Bentley, appointed by House Speaker David Osborne; Vic Brown, representing law enforcement, who attended via telephone; and state Treasurer Allison Ball. Jason Roop, representing victims of the opioid crisis, was absent. was not absent. He serves on the Treatment and Recovery Committee. 

Also present was Lorran Ferguson, Ball's chief of staff and deputy treasurer.

Denise Hall awarded Gil Friedell Health Policy Award for her substance-use prevention efforts with youth in Trimble County

Left to right: Foundation for a Healthy Kentucky Board Chair Dr. Clifford Maesaka, Denise Hall, Foundation President and CEO Ben Chandler, and Council President Tim Marcum.

Denise Hall of Trimble County is this year's winner of the Foundation for a Healthy Kentucky's Gil Friedell Health Policy Award for her  substance-use prevention efforts among youth. 

“Drug addiction is something far too many Kentuckians have seen first-hand, and that’s why Denise Hall’s work is so critical,” said Ben Chandler, president and CEO of the foundation. “Her efforts to prevent future addictions and support the overall wellbeing of the youth of her community makes her the perfect person to receive the Friedell Award. At a time when so many young people are struggling with their mental health, Trimble County students can take comfort in knowing what a strong advocate they have on their side.”

Hall began working in the substance-use prevention field in 1998 at Seven Counties Services. In 2003, she became coordinator for the Trimble County Family Resource and Youth Services Center, an organization that connects students and their families to needed services, like utility assistance or clothes and food, as a way to remove nonacademic barriers to learning. 

While with the FRYSC, Hall wrote two Drug Free Communities grants and directed them. In 2017, she gave up her coordinator position to focus on the grant program, which is in its 10th and final year. 

Hall retired Oct. 1, with plans to assist local nonprofits and schools with grant writing and continue attending meetings of the Trimble CARES Coalition, of which she was managing director. CARES stands for Community Assessing Resources and Education on Substance misuse. 

Hall’s work also includes implementing a Drug Education Series and a Sources of Strength group at Trimble County Junior/Senior High School. She made tools such as drug-testing kits and medication-deactivation kits available to parents and she provided one-on-one education for students who violated school drug and alcohol policies. She was also crucial in getting vape detectors installed at the high school. She has written grants for a small kitchen that allows for life-skills lessons in a special-needs classroom and for a washer and dryer at TCJSHS, and was instrumental in finding money to build a new wheelchair ramp after the old one broke. 

“I am so honored to be chosen for this award,” Hall said. “So many wonderful people worked on these projects with me, and we so appreciate the amazing students of this community.”

The Memorial Health Policy Award is named for Gil Friedell, first director of the Markey Cancer Center at the University of Kentucky and cofounder of the Kentucky Cancer Registry. He helped launch a nonprofit advocacy education organization in 2005 that later became the Friedell Committee for Health System Transformation. The Foundation created the award when it united with the Friedell Committee in 2018.

The foundation makes a $5,000 grant to a Kentucky nonprofit working to improve health policy in the commonwealth in honor of the Friedell Award winner. Hall selected Trimble CARES Coalition, which works against the harmful effect of substance abuse and strives to ensure that all youth have support available to make positive, healthy choices.

Hall was selected from the foundation's 2022 Healthy Kentucky Champions, Kentuckians honored for making a difference in the health of their communities or the state. Click here to nominate someone for the 2023 class of Healthy Kentucky Champions. 

State opioid commission opens online portal for grant applications

The state commission handling $239 million in funds from the national opioid settlement has opened its online portal for grant proposals.

The Opioid Abatement Advisory Commission’s portal is at ag.ky.gov/OAAC. "Organizations and individuals dedicated to combatting the opioid epidemic are encouraged to begin a submission. While submissions will be accepted on an ongoing basis, the OAAC recommends that submissions be completed within 30 days of starting the process," said a news release from Attorney General Daniel Cameron, chair of the commission.

“These funds will be used, in part, to support organizations that develop and implement programs to combat the opioid crisis in Kentucky,” Cameron said in the release.  The commission, created by the legislature, is responsible for administering the state's half of the $478 million settlement with opioid companies.

The commission has held three regular meetings to discuss and establish a framework for distributing opioid settlement funds, and three town halls to hear from Kentuckians affected by the opioid epidemic. It has scheduled five more, in Covington, Lexington, Louisville, Bowling Green, and Paducah.

Questions regarding the grant funding process should be directed to Alison Chavies by calling 502-696-5638 or Scott Hornbuckle at 502-234-4194 or by emailing kyoaac@ky.gov.

Ky. has 82 syringe exchange programs in 63 counties, the most of any state, but state drug-control official says 'That's not enough'

Stars show syringe-exchange sites; colors show district departments; white counties are independent. 

By Melissa Patrick
Kentucky Health News

Kentucky still has more syringe service programs than any other state, but 57 counties still don't have one, including 21 of the 54 that the Centers for Disease Control and Prevention considers vulnerable to a rapid outbreak of HIV or hepatitis C among people who inject drugs.

"My God, if you've been identified by the CDC as being a county for a rapid HIV outbreak, you need an SSP. There's no ifs, ands or buts about it," Van Ingram, executive director for the Kentucky Office of Drug Control Policy, said at the annual Kentucky Harm Reduction Summit in August. "So we've got work to do yet."

Syringe exchanges are part of "harm reduction programs," which offer a host of strategies to minimize the negative physical and social impacts of drug use. They are also called syringe service programs or needle exchanges.

Such programs have been legal in Kentucky since 2015, but to have one, a community must have approval from its local board of health, the county fiscal court and the city where the exchange is located. 

As of August, Kentucky had 82 exchange programs operating in 63 of its 120 counties, but Ingram said that despite efforts to expand these service programs, "That's not enough. We need more." 

One program that had been approved is no longer operational.

Estill County (Wikipedia map)

Elizabeth Walling, public health director at the Estill County Health Department, told Kentucky Health News that its program closed in September 2020 because the Irvine City Council took away its approval, citing complaints from the community about an increase of needles in public spaces. 

Walling said the health department has made several attempts to get the council to reinstate the program. "We have patients that call about it weekly," she said. "We're still having to refer them out of the county. . . . We still have a lot of requests for it, which we've expressed to the Irvine City Council."

Syringe exchanges provide a range of services that extend beyond the exchange of clean needles for dirty ones in order to decrease the spread of blood-borne diseases like hepatitis C and HIV. Those services include education on safe use and distribution of wound-care kits and Naloxone, which blocks a drug overdose. Other services are infectious-disease screening, vaccinations, and linking people to housing, food access, insurance, medical care, substance-use treatment and behavioral-health services. 

At the Harm Reduction Summit, Alex Elswick, an assistant extension professor for substance-use prevention and recovery at the University of Kentucky, pointed to the value of the exchanges as a place that connects people who use drugs to care, even if they are not yet seeking treatment.

"This is a population that if syringe-access programs did not exist, would be utterly unengaged," said Elswick, who is in long-term recovery. "Think about that. . . . If you didn't have a syringe-access program in your community, where would these folks be going for any kind of care? Not just for syringes, but for care of any kind, for connection of any kind. They're utterly unengaged when you don't have harm reduction in your community."

Fentanyl test strips in short supply

One service that fewer than 30 of the state's exchanges offer is the distribution of fentanyl test strips, even though the powerful opioid was involved in about 73% of the state's 2,250 overdose deaths in 2021.

According to the CDC, Fentanyl is up to 50 times stronger than heroin and 100 times stronger than morphine. The strips only show if fentanyl is in the drug or not, not the amount of Fentanyl.  

A key reasons some programs have been slow to offer the strips is that they are considered drug paraphernalia under Kentucky law, causing some local officials not to support the use of them. 

Susan Dunlap, spokeswoman for the state Department for Public Health, said in an e-mail that the strips require different levels of approval, depending on how a program has been set up and its local protocols.

Scott Lockard, public health director of the Kentucky River District Health Department, said it is exploring the benefits of offering fentanyl strips in their programs and were working to address any legal concerns.

That said, Lockard noted that such strips may not be as important as they once were because fentanyl has become so prevalent. He said his agency is telling all its harm-reduction participants that they should automatically expect that fentanyl is present in every substance they use right now. 

"We want to make sure that we're using them appropriately, that we have all our legal bases covered and that they're beneficial for those people who are coming into our harm reduction," Lockard said. 

Ingram, asked about this at the summit, said the state was still trying to figure out the best way to respond to this challenge.

"I think fentanyl test strips are important," he said. "I think we've got to make ourselves available of them some way, somehow. It's on our radar and it's something we're trying to figure out." 

Russ Read, CEO of the Kentucky Harm Reduction Coalition, called fentanyl test strips an "essential tool" to help save people's lives and to have an opportunity for another chance to seek treatment and get better. 

"Each one of those test strips represents an opportunity for somebody not to die," he said. "And it's a real opportunity for somebody to make a decision . . . that I don't want to use anymore, or I need some help. It gives them another chance. . . . That's what harm reduction is all about." 

Read said the coalition has distributed more than 120,000 fentanyl test strips across the state. 

To learn more about harm reduction programs in Kentucky, go to the KDPH SSP webpage or the new KDPH Harm Reduction Program page.

Commission that will allocate money from state's settlement with opioid companies will hold its first meeting Tuesday

The first meeting of the commission that will allocate half the money from the state's settlement with opioid companies will be held at 1 p.m. ET Tuesday in Frankfort.
    
The 11-member Kentucky Opioid Abatement Advisory Commission will meet in the attorney general's offices at 1024 Capital Center Dr., Suite 200. The meeting is open to the public, and will be livestreamed here.

Katie Marks, Ph.D.

The meeting agenda is available here. It includes a presentation from commission member Van Ingram, director of the state Office of Drug Control Policy, and Katie Marks of the University of Kentucky, project director of the Kentucky Opioid Response Effort, which oversees federal grants.

The state will get $483 million from the settlement. State government will get half and local governments will get the other half.

Commission named to award grants from state's half of $483 million opioid settlement; local governments will get the other half

By Al Cross

Kentucky Health News

Attorney General Daniel Cameron has appointed the 11 people who will oversee the state's half of the $483 million settlement it made as part of a national agreement with opioid manufacturers and distributors.

The Opioid Abatement Advisory Commission will meet twice a year to approve awards from the settlement fund and will have an executive director, W. Bryan Hubbard, appointed by Cameron from his staff.

Bryan Hubbard

Hubbard, a lawyer, has overseen Cameron's Medicaid fraud unit. In the Matt Bevin administration, he ran the state agency that handles Social Security disability and child-support enforcement.

“Bryan has dedicated his career to the welfare of Kentucky families and children, and he intimately understands the ripple effects of the opioid crisis in the commonwealth,” Cameron said. “I know that he will guide the work of the commission with a steady hand and ensure that the settlement funds are distributed to meaningful opioid abatement initiatives.”

Hubbard will be a member of the commission "representing victims of the opioid crisis," as described in the 2021 law creating the commission. The members mandated by the law are Cameron, who will serve as chair; state Treasurer Allison Ball, and Cabinet for Health and Family Services Secretary Eric Friedlander, who works for Gov. Andy Beshear, a fellow Democrat. The others are Republicans (Cameron is running to unseat Beshear in 2023) and so is Rep. Danny Bentley of Russell, appointed as a non-voting member by House Speaker David Osborne. The other non-voting member, appointed by Senate President Robert Stivers, is Karen Kelly, district director for U.S. Rep. Harold "Hal" Rogers, R-Somerset, and former director of his Operation UNITE anti-drug initiative.

The other members, filling seats specified by the law, are state Office of Drug Control Policy Director Van Ingram, representing the drug treatment and prevention community; Vic Brown of London, deputy director of the Appalachian High Intensity Drug Trafficking Area, representing law enforcement; Jason Roop of Campbellsville University, representing victims of the opioid crisis; Karen Butcher of Georgetown, representing citizens at large; Simmons College of Kentucky Vice President Von Purdy of Louisville, representing citizens at large; and Dr. Sharon Walsh, representing the HEALing Communities Study at the University of Kentucky, which appointed her.

The release said the commission will hold its first meeting "in the coming days" and establish a framework for distributing funds. The other half of the settlement will go to local governments and be distributed "in accordance with an agreement reached among them," the law says. "If no such agreement is reached, the money shall be paid to a trustee appointed jointly by the Kentucky Association of Counties and the Kentucky League of Cities for distribution of the funds."

The $483 million coming to Kentucky is part of a $26 billion settlement states made with Cardinal Health, McKesson Corp., AmerisourceBergen and Johnson & Johnson.