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Northern Kentucky Health Department Continues Efforts to Combat the Opioid Epidemic

Five years ago, public health officials in Northern Kentucky observed a dramatic rise in the rates of residents who contracted Hepatitis C virus from sharing used needles to inject illicit opioids, followed by a surge in heroin overdose-related hospitalizations and use-related crimes. Community leaders in Grant, Kenton, Boone and Campbell Counties soon realized that Northern Kentucky was hardest hit by the lethal opioid epidemic gripping the nation and the state of Kentucky, where the opioid-related death rate had soared to 24.7 per 100,000 residents by 2014, substantially outpacing the average national rate of 14.7 per 100k.

Dr. Lynne Saddler, district director of health at the Northern Kentucky Health Department in the community of Edgewood, argued that many individuals turn to heroin and become addicted to it after having taken a prescription opiate pain reliever for the management of pain following a sports-related injury, tooth extraction or other medical/dental issues. This happens, at least in part, because heroin is a readily available and inexpensive opioid that provides them with a potent high whether they inhale, smoke or inject it. However, individuals suffering from an opioid use disorder, especially younger ones, often are plagued by underlying issues, such as unresolved personal problems or some other issues that involve significant societal changes (i.e. smartphones and social media may have a detrimental effect on face-to-face interactions among young people that help them develop more profound connections to their communities).

The heroin and prescription opiate abuse epidemic has taken a devastating toll on Northern Kentucky's communities over the past five years. St. Elizabeth Healthcare emergency departments have seen the number of heroin overdose patients increase nearly six times, from 253 in 2011 to almost 1,200 in 2015. The disease of heroin addiction which involves sharing used needles can facilitate the spread of blood-borne, co-morbid chronic conditions such as Hepatitis B and C as well as HIV/AIDS. In 2014, Northern Kentucky saw one of the highest rates of Hepatitis C infections in the nation, with a rate of 10.9 per 100k residents, compared to the national rate of 0.55 per 100k. According to Dr. Saddler, while Hepatitis C rates continue to soar in the region, HIV rates have remained relatively stable, thus allowing Northern Kentucky communities and Heath Department to focus their efforts on the prevention of the HIV epidemic in the region.

Dr. Tom Frieden, director of the CDC, warned that in the small community of Austin, Ind., located approx. 40 miles north of Louisville, a group of individuals suffering from opiate use disorders began injecting an opioid called Opana; because one of them was HIV positive, within a few months over 180 people in the southern Indiana community were infected with the HIV virus. Last year, the state granted Austin permission to implement a needle exchange program to reduce the spread of the virus.

The Northern Kentucky Health Department has faced opposition to the needle exchange program from residents claiming that the program encourages heroin use, but Dr. Saddler contended that individuals with a opiate use disorder, which is in fact a chronic disease, are going to use whether they have clean or used needles. Likewise, these programs offer first responders and community members protection against the hazards of used needles left in public places. She added that last month, Grant County launched a needle exchange program that does not require a one-to-one exchange and an exchange has already been approved for Kenton County, but it's not operational yet.

Dr. Lynne Saddler also said that users receive instructions on how to protect themselves and others from spreading the HIV and hepatitis viruses when they visit an exchange. In addition, counselors are able to inform them of various treatment options; statistics show that users who participate in a needle exchange program are 5 times more likely to enter treatment programs.

Dr. Saddler's agency also coordinates a regional coalition of residents, public officials, and medical professionals through Northern Kentucky Heroin Impact Response Task Force as well as explores treatment options for pregnant women with a substance abuse disorder. Many babies born to these mothers may suffer from the neonatal abstinence syndrome and thus they may need special developmental, behavioral and medical services as they age. Highlighting that medication-assisted treatment programs, which combine medications and counseling, maximize the chances of long-term recovery, Dr. Saddler said there is always hope for recovery because all of us as human beings have within us the capacity to change for the better and heal.

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