www.wvgazettemail.com Health http://www.wvgazettemail.com Gazette archive feed en-us Copyright 2016, Charleston Newspapers, Charleston, WV Newspapers 18 'words' reveal drug giant's pain pill shipments to WV http://www.wvgazettemail.com/article/20160525/GZ01/160529703 GZ01 http://www.wvgazettemail.com/article/20160525/GZ01/160529703 Wed, 25 May 2016 17:46:22 -0400 Eric Eyre By Eric Eyre The nation's third-largest prescription drug wholesaler fought to keep secret 18 "words" in a lawsuit filed against the firm in West Virginia.

Turns out that those "words" actually were numbers: The number of pain pills shipped by the company statewide over five years, and the number of pills sold to specific Southern West Virginia pharmacies that filled prescriptions for doctors, some of whom were later indicted on federal charges for running rogue pain clinics.

"AmerisourceBergen and other wholesalers were being disingenuous," said Delegate Don Perdue, D-Wayne, a retired pharmacist. "They knew what they were doing, they knew they were making a lot of money, and they just don't want anybody to know the extent of the issue."

Earlier this week, Judge William Thompson ordered the release of court records that show exactly the 18 numbers drug giant AmerisourceBergen wanted to redact, or black out, in the state's lawsuit against the Pennsylvania-based company.

"The 18 'words' that AmerisourceBergen seeks to redact appear to be actual numbers that represent sales figures," Thompson said in a ruling Monday.

The state's lawsuit - filed by then-West Virginia Attorney General Darrell McGraw and inherited by his successor, Patrick Morrisey - alleges that AmerisourceBergen and other out-of-state drug wholesalers shipped an excessive number of pain pills to West Virginia, failed to report suspicious orders from "pill mill" pharmacies and contributed to the state's ongoing prescription opioid problem.

The unredacted court records show AmerisourceBergen distributed more than 140 million doses of controlled substances to West Virginia pharmacies between 2007 and 2012. About 90 million of those pills were prescription opioids, like Lortab, Vicodin and Oxycontin. The company shipped another 27.3 million tablets of Xanax, an anti-anxiety medication that addicts often take with painkillers.

In a court filing last week, AmerisourceBergen argued that the 18 "words" contained "commercially-sensitive information." The company asked the Boone County judge to hold a closed-door hearing to explain why it wanted to shield those 18 "words" from the public. The drug wholesalers have said they provided the information to the state's lawyers and the U.S. Drug Enforcement Administration with the expectation that it would be kept confidential.

"AmerisourceBergen works closely with regulatory agencies to provide all requested and appropriate data with the expectation and understanding that this information would be maintained as confidential," said Lauren Moyer, a company spokeswoman. "In this litigation, we sought to protect this important precedent to limit the sharing of our and our customer's proprietary information."

The court documents reveal that AmerisourceBergen distributed 149,300 hydrocodone pills - or 12,400 pills a month - to Tug Valley Pharmacy in Mingo County in 2009. The pharmacy filled prescriptions for Drs. Diane Shafer, Katherine Hoover and William Rykman, who operated pain clinics in Williamson.

Federal agents raided the "sham" clinics in 2010, and they never reopened. Rykman and Shafer were convicted on drug charges. Hoover had her assets seized, but she never faced criminal charges after moving to the Bahamas.

In Boone County, AmerisourceBergen shipped 8,000 hydrocodone painkiller tablets to a drive-thru pharmacy over two days in July 2012, according to the unsealed court records. On those same two days, a competing drug wholesaler shipped 8,600 hydrocodone tablets to the same "pill mill" pharmacy. AmerisourceBergen sold another 3,800 oxycodone pills to the Boone County pharmacy that month.

In its lawsuit, the state alleges that AmerisourceBergen violated state laws and ignored drug wholesale industry standards that recommend companies "know your customer."

"This standard was disregarded and violated in thousands of transactions by this defendant," the lawsuit states.

On Monday, Thompson ordered the release of a lawsuit complaint against AmerisourceBergen and other drug wholesalers that had been sealed for more than a year. The Charleston Gazette-Mail filed a motion to unseal the court documents in April.

The complaint includes details about pain pill shipments throughout the state. The court records show the prescription drug distributors shipped large quantities of oxycodone and hydrocodone tablets to some of West Virginia's smallest towns and poorest counties, supplying mom-and-pop pharmacies that filled prescriptions from pain clinics that federal authorities later shut down.

West Virginia has the highest drug overdose death rate in the nation, and those deaths are increasing. Oxycodone and hydrocodone are the most widely abused prescription painkillers, and they contribute to more overdose deaths in the state than any other drug.

Reach Eric Eyre at ericeyre@wvgazettemail.com, 304-348-4869 or follow @ericeyre on Twitter.

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Drug firms fueled 'pill mills' in rural WV http://www.wvgazettemail.com/article/20160523/GZ0115/160529818 GZ0115 http://www.wvgazettemail.com/article/20160523/GZ0115/160529818 Mon, 23 May 2016 19:30:36 -0400 Eric Eyre By Eric Eyre Over five years, the nation's largest drug wholesalers flooded notorious "pill mill" pharmacies in West Virginia's smallest towns and poorest counties with hundreds of thousands of painkillers, according to court records the companies had sought to keep secret for more than a year.

The prescription drug distributors shipped large quantities of oxycodone and hydrocodone tablets to small towns like War, Kermit, Oceana, Van and Crab Orchard, supplying mom-and-pop pharmacies that filled prescriptions from doctors, some of whom were later convicted of federal crimes.

Some examples: H.D. Smith Drug Wholesale Co. sold 39,000 pain pills over two days to two Mingo County "sham" pharmacies located within four blocks of one another, according to allegations in the court records. Another prescription drug distributor, Top Rx, shipped more than 300,000 tablets of hydrocodone - known better under brand names like Lortab and Vicodin - over four years to a McDowell County pharmacy in the town of War, population 808. That amounts to 350 hydrocodone pills per person in War.

"The distribution of vast amounts of narcotic medications to some of the smallest towns and unincorporated rural areas of our state should have set off more red flags than a school of sharks at a crowded beach," said Delegate Don Perdue, D-Wayne. "In this case, perhaps the most unfortunate aspect was that the sharks controlled not only the distribution of the drugs, but the warning flags as well."

On Monday, Boone County Circuit Judge William Thompson ordered the release of previously sealed court documents that include details about the companies' pill shipment records to specific pharmacies in Southern West Virginia.

Thompson's ruling follows a Charleston Gazette-Mail motion to unseal a revised complaint that's part of a state lawsuit. The complaint alleges the firms shipped an excessive number of pain pills to West Virginia between 2007 and 2012, helping to fuel the state's ongoing prescription drug problem.

The drug companies repeated their request to keep the court records under wraps Monday morning. They've been fighting the release of the pain-pill shipment numbers since January 2015.

"Our position is, this is proprietary data," said A.L. Emch, a Charleston lawyer, who represents AmerisourceBergen Drug Corp., one of the companies being sued by the state. "No good reason exists at this point to disclose that information."

The judge disagreed, and two hours later he ordered the release of the court records.

Thompson redacted, or blacked out, pill shipment information for seven drug wholesalers that have reached settlement agreements with the state. Six of those companies agreed to settle with the state over the past two weeks - after the newspaper filed its motion to intervene.

The court records released Monday include pill shipment records supplied by the prescription drug wholesalers and the U.S. Drug Enforcement Administration to lawyers representing the state Attorney General's Office, Department of Health and Human Resources, and the state Department of Military Affairs and Public Safety.

The documents show that over the five-year span:

n AmerisourceBergen, the nation's third largest drug distributor, shipped 60.9 million hydrocodone pills and 26.6 million oxycodone tablets to West Virginia. That's 33 hydrocodone pills and 15.5 oxycodone pills for every man, woman and child in West Virginia.

In 2009 alone, AmerisourceBergen supplied 149,000 hyrocodone pills, or 12,400 tablets a month to a single pharmacy in Williamson, Mingo County, according to the state's lawsuit. Three doctors who wrote prescriptions at that pharmacy were indicted on federal charges the following year.

Over two days in 2012, AmerisourceBergen also shipped 8,000 hydrocodone pills to a "drive-in" pharmacy in Boone County.

The company issued a statement Monday.

"At AmerisourceBergen, we are committed to the safe and efficient delivery of controlled substances to meet the medical needs of patients," said Lauren Moyer, a company spokeswoman. "We work diligently to combat diversion and are working closely with regulatory agencies and other partners in pharmaceutical and healthcare delivery to help find solutions that will support appropriate access while limiting misuse of controlled substances."

n Drug wholesaler H.D. Smith shipped 12.4 million hydrocodone pills and 3.2 million oxycodone tablets to West Virginia.

In January 2008, the company distributed as many as 157,400 hydrocodone tablets to Hurley Pharmacy, a "pill mill" in Williamson, according to the lawsuit complaint released Monday. The complaint characterizes the one-month shipment as "suspicious ... and a gross violation of the [company's] legal duty not to distribute controlled substances being used for non-legitimate purposes."

n Masters Pharmaceuticals supplied 1.5 million hydrocodone pills and 859,000 oxycodone pills to pharmacies in West Virginia.

Between December 2011 and May 2012, Masters distributed 11,400 oxycodone, hydrocodone and morphine pills to a pharmacy in the Boone County town of Van, which has 211 people. That amounts to 63 pills for each Van resident per day.

The lawsuit also spotlights Masters' shipments to pharmacies in rural areas of Raleigh, McDowell, Logan, Putnam and Marshall counties.

"The foregoing distributions were supplied to entities with a population base which could in no legitimate way consume the volume of drugs being distributed," the complaint alleges.

n Top Rx shipped 1.7 million hydrocodone tablets to West Virginia. The lawsuit doesn't list the company's oxycodone numbers.

The bulk of Top Rx's painkiller shipments went to Wayne and McDowell counties, places designated by state and federal authorities as "high-intensity drug-trafficking areas," according to the lawsuit.

The state's complaint - initially filed by former Attorney General Darrell McGraw in 2012 and inherited by his successor Patrick Morrisey the following year - alleges the drug companies turned a blind eye to the suspicious prescription drug orders by West Virginia pharmacies and profited from the state's pain-pill epidemic.

West Virginia has the highest drug overdose death rate in the nation, and the deaths are climbing. Oxycodone and hydrocodone are the most widely abused prescription painkillers, and contribute to more overdose deaths in the state than any other drug.

West Virginia spends more than $430 million a year on problems caused by prescription drug abuse, according to the state's lawsuit.

In previous filings, the drug wholesalers have said raw pill counts can be misleading. The companies argue that their total distribution numbers, and the percentage of sales of controlled substances compared to all drugs, would put the shipping records in better context.

Reach Eric Eyre at ericeyre@wvgazettemail.com, 304-348-4869 or follow @ericeyre on Twitter.

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Charleston native, WVU grad co-authors new autism study http://www.wvgazettemail.com/article/20160522/GZ01/160529866 GZ01 http://www.wvgazettemail.com/article/20160522/GZ01/160529866 Sun, 22 May 2016 21:32:18 -0400 Lydia Nuzum By Lydia Nuzum A Charleston native and West Virginia University graduate has co-authored a study that links the level of pollutants in a child's blood with the severity of their autism.

Dr. Andrew Boggess, who recently earned his doctorate from Duquesne University, and three other researchers led the study, which was recently published in the journal Scientific Reports. The study focused on the levels of common organic pollutants, including ones found things like in automobile exhaust, pesticides, flame retardants and cleaning solvents, and how those levels, as a whole, impacted a child with autism. The researchers evaluated a total of 60 children - 30 with autism, and another 30 "controls" who were neurotypical (not on the autism spectrum) but shared similar socioeconomic backgrounds with the autistic group - and found that, although there was no link between pollutants present in the blood and an increased risk of autism for the control group, children with autism tended to have more severe symptoms relative to the amount of pollutants in their blood.

"For kids already diagnosed with autism, we found that as the amount of these compounds built up in their bloodstream, their neurological performance worsened, and there were very few outliers in the set with autism," Boggess said.

The study also found that the levels of pollutants in the children's blood was "statistically predictive" of their autism, meaning that if the researchers looked at a blood sample without knowing whether the sample belonged to an autistic child, they could tell with relative certainty whether that child had been diagnosed with the most severe form of autism based on the level of pollutants in the sample.

"I don't mean predictive in the medical sense - we're not going to go out tomorrow and start diagnosing people, but it is a statistically predictive way of telling people their odds of being diagnosed with autism," he said.

Boggess said the study differed from other similar autism studies in that, rather than studying the impact of one particular compound or pollutant on the prevalence of autism, the researchers decided to look at whether a host of common pollutants, in a high concentration, contributed to autism severity.

"As some of these compounds start building up in an individual's system, it doesn't necessarily matter the specific identity of the compound; what matters is that they all have very similar biological effects inside the body," Boggess said. "It doesn't matter if the total amount mainly comes from Benzene or if it mainly comes from (polychlorinated biphenyl) - what matters is the total amount."

Boggess and his fellow researchers believe the focus on pinpointing a particular compound as the culprit behind autism severity is what has produced varying results in existing research, and he hopes this study will help steer the direction of future autism research.

"We think one thing that could be going is, if the only thing that matters is the total amount in their blood - and there's good indication that that's true - then some children with autism may have high levels of one compound may not have high levels of another, and other children who may have a similar amount of these totals in their blood may have it from a different compound," Boggess said. "It may explain why different research groups are coming up with such dramatically different results."

Reach Lydia Nuzum at

lydia.nuzum@wvgazettemail.com,

304-348-5189 or follow

@lydianuzum on Twitter.

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Friends share memories of Princeton woman who died after cosmetic surgery http://www.wvgazettemail.com/article/20160521/GZ01/160529895 GZ01 http://www.wvgazettemail.com/article/20160521/GZ01/160529895 Sat, 21 May 2016 20:40:01 -0400 Lydia Nuzum By Lydia Nuzum When Heather Meadows called her friend Suzanna Wilson on the morning of May 12, Wilson did her best to reassure her friend that the surgery she had planned later that day would go smoothly.

"I thought, in my mind, that her fears were like those of any other person going into surgery," Wilson said. "She was scared, yes; I tried to calm her. I told her everything was going to be okay - but yes, she was scared."

Meadows' surgery did not go smoothly, and a few hours later she was dead, after what was meant to be routine cosmetic surgery turned into a medical emergency. According to Darren Caprara, director of operations for the Miami-Dade Medical Examiner's office, the 29-year-old Princeton woman died after fat particles clogged arteries in her lungs and heart. Meadows' death was ruled an accident, the result of a botched "Brazilian butt lift" performed at Encore Plastic Surgery in Hialeah, Florida.

In the days that have followed, details about the doctors and other clinics affiliated with Encore have begun to surface that paint a concerning picture. Last year, a woman fell into a coma for nearly a month after undergoing the same procedure as Meadows from a doctor with ties to Encore, according to the Miami Herald. Patients were discharged from Encore and two other Florida clinics for recovery at private homes, hotels and a even horse farm, according to the Herald.

"They advertise their clinic like they're doctors and they've done these surgeries so many times; we didn't hear any of these other horror stories until after Heather," Wilson said. "If you go on their website, it looks professional. It's misleading ... I don't understand how they're doing this. I don't understand how their clinic is still open after this. I don't understand what doctor in their right mind would want to keep doing procedures there after what happened in this facility."

For her family and friends, Meadows' death has sparked both sorrow and outrage, especially at the negligence that preceded her death.

"Women around the world have this surgery all the time, and Heather was in perfect condition," Wilson said. "She was perfect and happy and her kids were her life; it just doesn't make sense. We want justice, and we want peace."

Jeanifer Rumley, Meadows' cousin, hasn't lived in West Virginia for several years, but kept up with her cousin and said she remembers Meadows as a bright and happy woman who doted on her children.

"Heather is the reason I even have the life I have now; when I was getting ready to move out of West Virginia, I was thinking about moving to Atlanta and she said, 'You should move to Wilmington, North Carolina.' She took me there on a weekend trip. I ended up moving there, I met my oldest daughter's father there, I had her, we moved to Connecticut, I had another child," Rumley said. "I wouldn't even have my kids if it weren't for Heather. One little thing that changes your entire life, and she did that."

Wilson, who had been friends with Meadows for 16 years, describes her as the perfect mother and a dedicated friend. Meadows had been working at Saunders Staffing in Beckley for the last six years, and was set to graduate next year from Bluefield State College with a degree in social science. But it was her two children - Malakhi, 6, and Maliya, who was born in February - that were the center of her world, Wilson said.

"Her kids were her life," Wilson said. "She worked for those kids, she went to school so she could better her life and make sure those kids never went without, that they were never going to go without."

Those kids are living with family members now, Wilson said, and will be well cared for, but Wilson and others want to see that justice is served in their mother's death. A petition on Change.Org that seeks to require Florida doctors be licensed and certified to perform cosmetic surgery has already garnered more than 750 signatures. A Go Fund Me account has also been set up to help cover the costs of Meadows' funeral expenses, and has raised about $1,700 of its $15,000 goal.

"We have lost a best friend, we have lost a mother, we have lost a sister, we have lost a daughter. She was everything to her family and if, by any means necessary, we can open eyes to this problem, that is our goal," she said. "If we can save another life ... it's hard enough that we've lost her, but if we can save another life, her death won't be so in vain."

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

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Pregnant women in US with Zika spikes on new counting method http://www.wvgazettemail.com/article/20160520/GZ01/160529950 GZ01 http://www.wvgazettemail.com/article/20160520/GZ01/160529950 Fri, 20 May 2016 12:57:07 -0400 By Mike Stobbe AP Medical Writer By By Mike Stobbe AP Medical Writer NEW YORK (AP) - The number of pregnant women in the United States infected with Zika virus is suddenly tripling, due to a change in how the government is reporting cases.

Previously, officials had reported how many pregnant women had both Zika symptoms and positive blood tests. In a change announced Friday, the Centers for Disease Control and Prevention's count will include all women who tested positive, regardless of symptoms.

There are now 157 pregnant women infected with Zika in the 50 states, up from the 48 reported last week under the old definition.

Experts emphasized that there does not appear to be any dramatic actual increase of pregnant women with the disease in recent months. There was a spike in diagnoses in February and March, but relatively few new cases since then, according to CDC data that includes women who experienced symptoms and those who didn't.

The Zika virus causes only a mild and brief illness, at worst, in most people. But in the last year, infections in pregnant women have been strongly linked to fetal deaths and to potentially devastating birth defects, mostly in Brazil.

The virus is spread mainly through the bite of a tropical mosquito called Aedes aegypti. It can be found in the southern United States, but there's no evidence that they've been spreading the virus in the U.S. yet. All the 544 total cases in the 50 states so far have been people who had traveled to outbreak areas, or who had sex with someone who did.

Experts think mosquitoes on the U.S. mainland will probably start spreading the virus in the months ahead, when hot weather hits and mosquito populations boom.

The sudden rise in the count of pregnant women with the disease in the U.S. may seem jarring. But Dr. Neil Silverman, a UCLA professor of obstetrics who has been advising the California Department of Public Health on Zika issues, explained the change in method does not indicate a greater risk of infection.

When he gets calls from patients, he said, "About 90 percent of what we're doing is reassuring and calming people."

Only an estimated 1 in 5 people infected with Zika develop symptoms - fever, rash, joint pain, and red eyes - which usually last no more than a week.

Initially, doctors recognized the connection between the virus and birth defects only in women who had suffered symptoms during pregnancy. But reports published this year indicate some pregnant women with laboratory evidence of a recent Zika infection - but who never had symptoms - have delivered infants with these defects.

International health agencies have already been reporting Zika infections in women based solely on lab tests. Some experts have found it surprising that the CDC has been basing its official number on a more conservative case definition.

However, CDC officials had voiced concerns that one kind of blood test is too prone to giving a false positive test result if a woman was infected with a different but similar tropical virus.

CDC officials on Friday said it's possible the new count may include a few false positives, but they say the new count will offer a more complete picture of the effects of Zika in the U.S. states and territories.

CDC says doctors should consider testing pregnant women who have been to an area where Zika is spreading, whether or not they have symptoms. Doctors also are encouraged to ask pregnant women if their sex partner has been infected or traveled to an outbreak area.

The new counting "will give us a better idea of the correlation between a mom's symptoms and the effects on the baby," said Dr. Richard Beigi, an obstetrics expert at the University of Pittsburgh.

The agency also presented new numbers for pregnant women the territories of Puerto Rico, American Samoa and the U.S. Virgin Islands. It rose to 122 cases from 65.

The CDC did not say how many Zika-infected pregnant women were believed to have been infected during travel and how many got it through sex. Officials said the count has includes diagnoses made over several months, and while many of the women in the count still are pregnant, some of the pregnancies have ended since the women were first diagnosed. The agency did not detail the outcomes of the pregnancies.

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Photo: Ambulances of the past and present http://www.wvgazettemail.com/article/20160519/GZ01/160519426 GZ01 http://www.wvgazettemail.com/article/20160519/GZ01/160519426 Thu, 19 May 2016 20:36:01 -0400

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Kanawha health department mulling food-handler cards http://www.wvgazettemail.com/article/20160519/GZ01/160519432 GZ01 http://www.wvgazettemail.com/article/20160519/GZ01/160519432 Thu, 19 May 2016 18:52:38 -0400 Lydia Nuzum By Lydia Nuzum Restaurant workers in Kanawha and Putnam counties would have to get food-handler cards under a proposal put up for public comment by the Kanawha-Charleston Board of Health on Thursday. The move could generate up to $100,000 in yearly revenue for the agency.

According to Lolita Kirk, administrator for the Kanawha-Charleston Health Department, the agency's budget for next fiscal year includes roughly half a million dollars in cutbacks. The KCHD, like other local health departments in West Virginia, faced a potential 25 percent cut in state funds, a loss from threat preparedness grants and uncertainty surrounding reimbursement from Medicaid, Kirk said.

The health department likely won't fill any job openings it has now or in the coming year as a result, with the exception of sanitarians, she said.

"We're going to have to be very careful with what we purchase and watch our overtime - all the things you do when your budget is slim," Kirk said. "Also, increasing some fees to help offset the cuts from the state."

The health department will move forward with a plan to bill Medicaid for HIV and STD testing at the same rates that private providers do, but Kirk said the health department is unlikely to receive the levels of reimbursement it requests from Medicaid. The move to require food-handler cards, which Kanawha County has never required and Putnam County has not required for several years, would generate new revenue without relying on state money.

"There's very little time and effort needed from sanitarians to do this," said Stan Mills, the KCHD's director of environmental health services. "It's well worth it; it's teaching that basic food handler about hand washing and temperatures and things like that that some of them really don't understand."

Dr. Michael Brumage, the health officer for the KCHD, also told board members Thursday that the agency's harm-reduction program has been growing steadily, and its needle exchange saw 75 patients on Wednesday. The program has also successfully referred 15 patients to treatment programs since its launch, Brumage said.

"We don't know what that recidivism rate is going to look like, but we think that's a positive step and that's a good number considering we've only been doing this for the past six months or so," he said.

Brumage said the health department has also placed a police officer on site during the harm reduction clinics to ensure that no illicit drug use or drug dealing occurs on health department property, but said the police presence hasn't discouraged patients from coming.

"Patients even like that they're here; they understand that it is a valuable program for them, and they don't want it jeopardized by [drug dealing]," Brumage said.

Reach Lydia Nuzum at

lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow

@lydianuzum on Twitter.

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Raleigh to pay for hepatitis, HIV testing for heart clinic patients http://www.wvgazettemail.com/article/20160517/GZ01/160519553 GZ01 http://www.wvgazettemail.com/article/20160517/GZ01/160519553 Tue, 17 May 2016 21:40:56 -0400 Lydia Nuzum By Lydia Nuzum The Raleigh County Commission voted Tuesday to pay more than $8,000 to its health department to help cover the cost of hepatitis and HIV testing for former patients of the Raleigh Heart Clinic, and will press the clinic, which is already facing at least two lawsuits, to reimburse the county.

According to County Commission President Dave Tolliver, the commission voted to pay part of the cost of testing patients for the Raleigh County Health Department, which faces the same 25 percent budget cut from the state this year as other local health departments. The state covered part of the cost of testing, but did not pay for the equipment used, Tolliver said.

The commission has already sent a letter to the heart clinic requesting reimbursement, and Tolliver said it will approach the clinic's insurance for payment should the clinic refuse.

"[The health department] had so many people up there that it was stretching their budget, so they asked us to help with the medical supplies and syringes and some overtime, because after this story broke, people were everywhere up there, wanting to be tested," he said. "We agreed to pay for the supplies, and we've already sent Raleigh Heart Clinic a bill, and if they don't pay it, we're going to file against their insurance."

In March, the West Virginia Department of Health and Human Resources sent letters to 2,300 patients who had visited the Raleigh Heart Clinic in Beckley between March 1, 2012, and March 27, 2015 warning them of their potential exposure to Hepatitis B and C and HIV. More than a dozen cases of hepatitis have been linked to the clinic.

Earlier this month, four new cases of hepatitis were reported. Although they were not conclusively linked to the clinic, the DHHR extended its testing recommendation to those who had visited the clinic prior to March 1, 2012. While there hasn't been any evidence of HIV transmission, patients are recommended to get tested because it is transmitted the same way as hepatitis.

According to Tolliver, the state pays for the testing itself, but does not cover the cost of collecting the samples, so the commission decided to step in.

"Obviously, this isn't something that happens every day, and I hope it never happens again," Tolliver said. "There have already been several people who have tested positive ... it's just sad something like this had to happen. It's unreal - it's an expenditure we felt, because they tested so many people and did stretch their budget, that we should help them out."

Anyone who has visited the Raleigh Heart Clinic for a stress test prior to March 27, 2015 who has not been tested for Hepatitis B, C or HIV is encouraged to call the Bureau for Public Health's HIV/STD hotline at 1-800-642-8244 or 304-558-2195.

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

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Behavioral health providers say budget cuts may worsen services http://www.wvgazettemail.com/article/20160517/GZ01/160519559 GZ01 http://www.wvgazettemail.com/article/20160517/GZ01/160519559 Tue, 17 May 2016 20:41:33 -0400 Lydia Nuzum By Lydia Nuzum West Virginia's behavioral health care providers may suffer "a domino effect" of losses and closures if the state doesn't resolve its budget shortfall in time to fund them, and stakeholders are pushing both an increase in the tobacco tax and changes in policy to address the problem.

Members of the West Virginia Behavioral Healthcare Providers Association met with Gazette-Mail editors on Tuesday to talk about how the state's continued budget impasse, and the threat of more budget cuts, could hurt behavioral health providers in the state.

Legislators began a special session Monday to decide how to address a $270 million shortfall in the 2016-2017 budget, with the governor and the Legislature at odds. Gov. Earl Ray Tomblin's proposed 45-cent tobacco tax increase would generate roughly $79 million, and he has proposed a sales tax increase of up to 1 percent, as well as a repeal of the sales tax exemption for telecommunications services.

Republicans in both the House and Senate are overwhelmingly against tax increases of any kind, and Senate President and gubernatorial candidate Bill Cole, R-Mercer, said the gap could be closed through a combination of cuts, money from the state's Rainy Day Fund and sweeping accounts of reappropriated funds.

Tim Morris, the regional director for REM, a home and community-based health services provider, said that although he understands the position the state is in financially, the reality for health providers is also dire - many have also suffered from year-over-year budget cuts, and several smaller providers have been forced to close their doors in the last few months.

"You can't throw in two minimum wage increases, Obamacare, increased regulations and cut rates and think that anybody is going to be left standing," Morris said. "It gets done to this population a lot because they're not the teachers' union and they're not AARP; it happens because it can happen, and the sad part is that if we got the right people in the room and said 'We're going to lock ourselves in here until we figure this out,' we could figure this out."

WVBHPA represents 26 of the more than 100 behavioral health care providers statewide that are already running on razor-thin margins - providers like Highland Hospital, who are treating people with increasingly serious mental illness who, if left alone, are far more likely to end up homeless or unemployed, according to Cynthia Persily, president and CEO of Highland Hospital Association.

"What I hear my staff saying every day is, 'We can't go any further and continue to provide high-quality care to patients who desperately need us,'" Persily said. "It's perpetuating that cycle of not having care services, which fuels all these other problems. Go into the justice system, go into the juvenile justice systems, problems in schools - all of those things are treatable, and we're treating them every day."

Since the state's Medicaid expansion under the Affordable Care Act, the question of how the state will absorb the cost of more than 170,000 new Medicaid patients has become another pressing issue, but one that both Persily and Morris said could be better addressed. Currently, the federal government matches state Medicaid dollars nearly 3 to 1, so that any cuts to the state's Medicaid budget means a three-fold loss in Medicaid dollars. Mark Drennan, executive director of the WVBHPA, noted that while community-based providers receive the Medicaid match, those who are institutionalized are paid for entirely by state dollars.

"We understand that when you don't have money, you don't have money," Morris said. "The problem is, from my viewpoint, that if you get to the point where you're willing to cut from this population - from the most vulnerable population that needs it as much as anybody - and you're willing to do that to the point that you'll give up three times as much as you pay, that sends a message that we're doomed."

Drennan said even a $1 tobacco tax increase, which would generate an estimated $115 million in additional revenue, wouldn't be enough to entirely bridge the budget gap, but other regulatory measures that affect behavioral health providers could be streamlined to help. The state's recent move to unbundle child residential services - forcing providers to bill separately for services that were once bundled together - replaces Medicaid dollars with state dollars and contributes to the state's fiscal issues, Drennan said.

Other changes only require DHHR approval - the Centers for Medicare and Medicaid Services recently changed a rule that will allow freestanding psychiatric facilities with more than 16 beds, like Highland Hospital, to treat Medicaid recipients between the ages of 21 and 64, something the facility is currently barred from doing, Persily said.

"When the ACA was passed, there was a demonstration project that allowed freestanding psychiatric hospitals to be reimbursed for Medicaid; it lasted for three years and ended last May with no changes in policy, so for three years we could take care of Medicaid patients, and now we cannot," she said. "What you have then is beds that are sitting empty and people who need services, and what you also have is people backed up in emergency rooms waiting for a placement, because we can't use the 40 beds we have at Highland, or at River Park [in Huntington] for adults with Medicaid."

According to Morris, another blow to funding for behavioral health could prove disastrous, and has the potential to create a cascade of closures as smaller agencies fold and increase the burden for larger ones like REM.

"We take care of people 24 hours a day - when I first got into this business, for the first six months, every night I went to bed it occurred to me that I had 200 employees making a low wage, and all they'd have to do is get mad and walk out in the middle of the night, leaving a vulnerable person alone, and we could be put out of business," Morris said. "I don't have the money to pay the wages I feel comfortable with, and if we keep taking these hits ... you're seeing it with the smaller providers already, who have folded up, and it's working its way up."

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

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WV attorney general aims to lower prescription drug abuse http://www.wvgazettemail.com/article/20160517/GZ01/160519581 GZ01 http://www.wvgazettemail.com/article/20160517/GZ01/160519581 Tue, 17 May 2016 17:11:07 -0400 CHARLESTON, W.Va. (AP) - West Virginia Attorney General Patrick Morrisey plans to purchase incinerators for the disposal of unwanted and expired prescription medication in a state that leads the nation in the rate of overdose deaths.

Morrisey announced the move Tuesday as part of an initiative to reduce prescription drug use in West Virginia by at least 25 percent.

According to Morrisey's office, the incinerators will cost $6,300 apiece, paid for by the attorney general's Public Health Trust.

Morrisey also urged doctors to regularly monitor patients' use of opioid drugs and asked pharmacists to verify the legitimacy of each prescription, patient and prescriber as well as the proper dispensing of medications. The proposal doesn't involve seriously or terminally ill patients.

Morrisey said West Virginia had nearly 700 drug overdose deaths last year.

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WV sees nation's biggest decline in uninsured rate http://www.wvgazettemail.com/article/20160517/GZ01/160519593 GZ01 http://www.wvgazettemail.com/article/20160517/GZ01/160519593 Tue, 17 May 2016 13:43:59 -0400 David Gutman By David Gutman In 2013, the year that full provisions of the Affordable Care Act began to go into effect, about 29 percent of West Virginia adults did not have health insurance.

Last year, about 9 percent of West Virginia adults did not have health insurance.

The 20 percentage point decline in the uninsured rate (for adults ages 18 to 64) in West Virginia is the largest of any state in the nation, according to new data released Tuesday from the federal Centers for Disease Control and Prevention.

Virtually every state saw significant declines in its uninsured rate, according to the CDC's National Health Interview Survey, an annual study based on more than 100,000 interviews nationwide. West Virginia's decline in the uninsured rate, though, is more than four points greater than the next-largest decline (Kentucky saw its uninsured rate fall by almost 16 percentage points) and more than double the national decline of 7.6 percentage points.

Nationwide, 7.4 million more people had health insurance in 2015 than in 2014, and the rate of uninsured - 9.1 percent for all people, 12.8 percent for adults - was the lowest the annual survey has ever found.

In West Virginia, those numbers also are at record lows - a 6.1 percent uninsured rate overall, and 8.9 percent for adults.

"Today's report is further proof that our country has made undeniable and historic strides, thanks to the Affordable Care Act," said Sylvia Burwell, secretary of the Department of Health and Human Services, and a Hinton native, in a prepared statement.

About 59 percent of West Virginia adults (ages 18 to 64) get health insurance through a private insurance provider, while about 35 percent get it through a public health plan - mostly Medicaid, but also military health insurance and Medicare, for those with disabilities.

West Virginia has the highest rate of adults on public health insurance of any state in the nation.

Other low-income states - Mississippi, Alabama and Louisiana, for instance - have not expanded Medicaid under the ACA and, thus, have much higher uninsured rates than West Virginia.

As of Monday, more than 175,000 West Virginians - nearly 10 percent of the population - were enrolled in the ACA's Medicaid expansion, according to the state Department of Health and Human Resources.

West Virginia's plunging uninsured rate is not solely because of the Medicaid expansion. It is about half attributable to increases in publicly provided health insurance and half attributable to increases in private plan enrollment.

Enrollment in public plans increased by 10 percentage points from 2013 to 2015, from about 25 percent of West Virginia's adult population to 35 percent.

Enrollment in private plans increased by the same 10 percentage points, from 49 percent of the population to 59 percent.

Reach David Gutman at david.gutman@wvgazettemail.com, 304-348-5119 or follow @davidlgutman on Twitter.

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Coroner: Fat clots killed WV woman during Brazilian butt-lift http://www.wvgazettemail.com/article/20160517/GZ01/160519596 GZ01 http://www.wvgazettemail.com/article/20160517/GZ01/160519596 Tue, 17 May 2016 10:47:52 -0400 HIALEAH, Fla. - The Miami-Dade Medical Examiner's Office says fat clots clogged the arteries of a 29-year-old West Virginia woman who died following cosmetic surgery at a Hialeah clinic.

The medical examiner's director of operations Darren Caparara says the fat clots caused Heather Meadows' organs to fail May 12 after undergoing a procedure known as a Brazilian butt-lift at Encore Plastic Surgery.

The mother of two was rushed to an emergency room, where she died.

The Miami Herald reports the medical examiner's report listed complications from lipid transfer as a secondary cause of death, indicating that the fat particles that killed Meadows likely entered her bloodstream through a vein during a fat transfer procedure. During a fat transfer, doctors perform liposuction of the torso, then inject the fat into the buttocks area.

- the associated press

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Oral health checkups during pregnancy are paramount, coalition says http://www.wvgazettemail.com/article/20160517/GZ05/160519622 GZ05 http://www.wvgazettemail.com/article/20160517/GZ05/160519622 Tue, 17 May 2016 00:01:00 -0400 Lydia Nuzum By Lydia Nuzum Pregnant women are told to take care of themselves to ensure their babies get a good start, but many don't realize that advice also applies to their teeth and gums.

Nearly one-third of pregnant women in West Virginia haven't visited the dentist in the last three years, according to the West Virginia Department of Health and Human Resources. That data may be troubling on its own, but with evidence that points to a link between maternal dental health and everything from a child's own dental health to his birth weight, the case for improved dental hygiene for pregnant women is stronger than ever.

"Both for their own health and their newborn's health, pregnant women have a lot of good reasons to take care of their teeth and gums," said Barbara Thaxton, coordinator of the West Virginia Oral Health Coalition.

According to the West Virginia Oral Health Coalition, 38 percent of pregnant women also have some form of tooth decay. The American College of Obstetricians and Gynecologists recommends pregnant women "routinely be counseled" about the safety and importance of dental care, noting that women "often need reassurance" when it comes to the relative safety of visiting a dentist during pregnancy.

Dr. Charles Smith, a Charleston dentist, said that although many women may think a visit to the dentist should wait until after they give birth, seeking out dental care during pregnancy is just as important, if not more important, than regular checkups.

"When I was in dental school, there was a concern about doing dental work on pregnant women, performing radiographs on pregnant women, doing emergency work, and now that's changed," Smith said. "The thought process now is that we're working with OB-GYNs and other family practice physicians to make women aware that the health of their mouth can affect the health of their newborn."

For many, the problem isn't cost - more than half of West Virginia births are covered by Medicaid, and two of the state's largest Medicaid managed care organizations, Coventry and The Health Plan, now cover two dental checkups per year for pregnant women.

"Before, we had nothing like that - if they were over 21, they got no dental coverage other than emergency care. Now they can come in, they can have their teeth cleaned; you can't do any X-rays or restorative work, but at least you can get them in the office and create a dental home for them," Smith said. "You can explain to them the importance of getting their children in for checkups ... if you can get mom to come in, mom will bring the kids. If not, there's a better-than-average chance the kids won't get the care, either."

West Virginia is one of 11 states that will receive a grant from the U.S. Health Resources and Services Administration to increase the number of pregnant women and infants who receive dental care, and the WVOHC plans to use the grant, in part, to raise awareness on the importance of dental care during pregnancy.

"West Virginia is rolling up its sleeves and taking this challenge very seriously," said Meg Booth, executive director of the Children's Dental Health Project, a nonprofit organization based in Washington, D.C. "Their oral health advocates are reaching out to the health providers and other people who are in the best position to let pregnant women know that oral health matters."

Dr. Allen Chamberlain, an OB-GYN in Huntington, said most of the patients he cares for are most willing to change in the face of an immediate problem, but that preventive care is one of the most important things a woman can do to help avoid problems that their insurance may not cover and that may complicate their health during pregnancy - pregnant women with cavities often have a higher concentration of bacteria in their mouths, which can worsen some chronic illnesses such as hypertension and diabetes, according to the WVOHC.

"We know that dental health begins before birth, and that it's a complex story that involves nutrition and science and care," he said. "I think many people feel like it's really hard to get services, and the services they can get aren't ideal from the perspective that you're limited to getting certain services, so that you feel almost like you're caught in red tape. It becomes something that people can't easily do."

In West Virginia, more than half of children will experience tooth decay before they enter third grade. Often, bacteria that isn't present in a child from birth can be passed from sharing food and utensils with adults or other children, according to the WVOHC.

According to Smith, it's important for children to have their first dental appointment by one year of age, not just because their first baby teeth are likely to have come in, but because it gives dentists the opportunity to talk to parents about the importance of nutrition and early dental care habits in ensuring children experience better dental health outcomes later in life.

"It's not so much that we're going to look in the child's mouth - we're also going to have a conversation about nutrition, what to look for, understanding how teeth are going to erupt and at what age, and getting a child used to having a dental home and coming in on a regular basis," Smith said.

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

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Increasing number of WV's organ donations are results of overdoses http://www.wvgazettemail.com/article/20160517/GZ05/160519623 GZ05 http://www.wvgazettemail.com/article/20160517/GZ05/160519623 Tue, 17 May 2016 00:01:00 -0400 Lori Kersey By Lori Kersey Hilda Halstead supports organ donation - she's even registered as a donor herself. She works at Charleston Area Medical Center, though not on the medical side of things.

"I'm a firm believer in research and medicine and trying to help your fellow man," Halstead, of Charleston, said.

But earlier this year when her daughter died of an opioid overdose, she and her family were faced with a difficult decision to make in the midst of their grief: whether to donate the woman's organs.

Nadya Zitek would have been 36 on her birthday in March, had she not suffered a fatal overdose Feb. 10.

Zitek hadn't registered as an organ donor, which was one concern, Halstead said. But more problematic for Halstead was a moral dilemma: Would the drugs that killed her daughter hurt those who received her organs? How could she live with herself if her daughter's organs caused another family to endure the same kind of loss hers was going through?

"It was a very, very hard decision because you're so distraught at the time and still not believing this could possibly happen to you," Halstead said. "And your moral, ethical self sets in: If I knew this person died of overdose, would I want these organs? Those are questions that went through my heart."

Fortunately for Halstead and for those who received Zitek's organs, the doctors who she had worked with and become friends with reassured her.

She recalled one conversation with a longtime friend and physician.

"I put him on the spot," she said. "I said, 'Under the circumstances - you've seen [her] records - if this were your family member would you accept the organs...?' He said yes."

As West Virginia continues to lead the country in the number of opioid overdose deaths each year, more of the state's organ donations are coming from those who have died of overdoses, according to the Center for Organ Recovery and Education. In 2013, 11.9 percent of West Virginia organ donors died of overdoses. That number increased to 13.5 percent in 2014 and to 19.6 percent last year, said Susan Stuart, CORE CEO and president.

West Virginia's rate of organ donors who have overdosed is higher than the national rate of 1 out of every 11 donors, according to a report in the Washington Post.

"Just because an individual has had an overdose doesn't mean they can't donate all eight of their organs," Stuart said. "It's really more involved than just the cause of death."

As far as eligibility, every case is decided individually, Stuart said. She encourages potential donors not to assume that medical conditions would prevent them being donors.

To give organs, a patient must be on a ventilator in the hospital, Stuart said. When a family knows their loved one won't survive and makes the decision to donate organs, a team is called in to do an assessment of the patients' eligibility to donate organs, she said.

There is always a need for organ donors, Stuart said. The waiting list has 121,000 people, and an average of 21 people die everyday while they wait.

"There's no way to keep up with the demand," Stuart said.

Zitek's organs were harvested on Feb. 14, National Donor Day. Halstead said she's told all the recipients are doing well so far. Halstead said she eventually wants to meet those life her daughter's death helped to save.

"It truly is a gift," Halstead said of organ donation. "If you can bring life and joy to another family, how can you not make that decision?"

Reach Lori Kersey at lori.kersey@wvgazettemail.com, 304-348-1240 or follow @LoriKerseyWV on Twitter.

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Cancer patient receives first penis transplant in US http://www.wvgazettemail.com/article/20160516/GZ05/160519643 GZ05 http://www.wvgazettemail.com/article/20160516/GZ05/160519643 Mon, 16 May 2016 11:44:47 -0400 By PHILIP MARCELO Associated Press By By PHILIP MARCELO Associated Press BOSTON - A cancer patient received the first penis transplant in the United States and is recovering well from the delicate surgery, doctors said Monday.

Thomas Manning of Halifax, Massachusetts, received the transplanted penis in a 15-hour procedure last week, Massachusetts General Hospital announced Monday. The organ was transplanted from a deceased donor.

Surgeons on the team who performed the transplant say blood is flowing to the organ. They said there are no signs of bleeding, rejection or infection, and that they're cautiously optimistic Manning will regain the function he lost in 2012 when cancer led to an amputation of the penis.

"Today I begin a new chapter filled with personal hope and hope for others who have suffered genital injuries," Manning said in a statement Monday.

The New York Times first reported the transplant.

Most of Manning's penis was removed amid a battle with an aggressive and potentially fatal penile cancer. The cancer was discovered in 2012 after the bank courier was severely injured in a work accident. Doctors treating him found an abnormal growth on his penis.

Manning told the newspaper he experienced hardly any pain during and after the procedure. One serious complication came the day after the surgery when he was rushed to the operating room after beginning to hemorrhage. He said his recovery has been smoother since, but he still wasn't ready to take a close look at the transplant.

Manning, who is single and was not involved with anyone when the cancer was discovered, said the amputation made new relationships impossible.

Manning told the newspaper that he looks forward to going back to work and hopes to have a love life again. He said he's speaking out in order to help dispel a stigma associated with cancers and injuries affecting the genitals.

The donor penis came from the New England Organ Bank. It told the newspaper that the donor's family wished to remain anonymous, but had delivered well wishes to Manning. It took three years of preparation, including operations on cadavers, before the team was ready to perform transplants, according to the Times.

Such operations are being studied as a way of treating wounded servicemen.

Cetrulo said his team will likely perfect its technique on civilians before providing transplants for injured veterans. He said the Defense Department doesn't "like to have wounded warriors undergo unproven techniques."

Dr. Dicken Ko, who directs the hospital's urology program, said candidates for future transplants will be evaluated on a case-by-case basis. They will be limited to cancer and trauma patients for now, and will not be offered to transgender people.

Another transplant is planned as soon as a matching donor becomes available for a patient whose penis was destroyed by burns in a car accident, Cetrulo said.

The world's first penis transplant was performed at the University of Stellenbosch in South Africa in December 2014.

That patient had his penis amputated three years earlier after complications from a circumcision performed in his late teens.

The university near Cape Town said in announcing the transplant in March 2015 that the 21-year-old patient, whose name was not released, made a full recovering following the nine-hour surgery and regained all function in the transplanted organ.

A man in China received a penis transplant in 2005. That operation also appeared to be successful, but doctors said the man asked them to remove his new penis two weeks later because of psychological problems experienced by him and his wife.

Associated Press writer Patrick Mairs in Philadelphia contributed to this report.

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David Grubb to travel to World Health Assembly as adviser http://www.wvgazettemail.com/article/20160514/GZ01/160519713 GZ01 http://www.wvgazettemail.com/article/20160514/GZ01/160519713 Sat, 14 May 2016 16:48:03 -0400 Lydia Nuzum By Lydia Nuzum The father of Jessica Grubb, the West Virginia woman whose battle with addiction is said to have deeply affected President Barack Obama, will share her story overseas later this month as one of three private sector advisers to the U.S. delegation to the World Health Assembly in Geneva, Switzerland.

David Grubb, a Charleston attorney, will travel to Geneva May 23 through 28 to meet with public health leaders from around the world and discuss his personal experience, as well as other dimensions of the public impact of the world drug crisis.

"It's a mixed thing for me," David Grubb said. "It will be a great experience, and it will be wonderful to be able to tell Jessie's story to a larger audience of people who are specialists in this field, but at the same time, it's very hard, because the only reason I'm going is because Jessie's no longer with us."

David Grubb first shared his daughter's story last year, ahead of Obama's October visit to Charleston to hold a forum on the opioid epidemic. At that point, Jessica Grubb was in the midst of her fourth rehabilitation and doing well in Michigan - she even listened in to the president's talk and later told her father that it was "both hard and heartwarming" to hear him tell her story.

In February, the Huffington Post reported that Obama's trip to Charleston and his meeting with David Grubb changed the way he viewed the country's opioid epidemic - in particular, Jessie's story and how familiar it had become in communities across West Virginia and the country.

"He got very emotional," an unnamed White House official told the Huffington Post of Obama's talk with David Grubb. "You're in this deep-red [conservative] environment, but people are just opening up their hearts on this. [The president] sort of was taken aback at how candid people were talking about this."

Just a few months after his visit, Jessica Grubb suffered a setback in her recovery that would prove fatal. After being released from the hospital following surgery for an infection, a discharging doctor - one who had never met Jessica before and didn't know her history - prescribed her 50 oxycodone pills on her way out the door. Jessica Grubb, 30, died that night in March.

"It's not just about getting people into treatment and getting them on the road to recovery. We have to be diligent from that point forward and make sure we're not, in essence, creating situations that cause recovering addicts to relapse," David Grubb said. "It's a real opportunity to talk about the broader part of treatment, which is what happens after."

His daughter's death and the question of how it had been allowed to happen drove David Grubb, with the help of Sen. Joe Manchin, D-W.Va., to develop Jessie's Law, a bill before Congress that would, with a patient's permission, make a patient's status as a recovering addict as prominently displayed on their medical records as an allergy.

His daughter's life has inspired the Grubb family to further Jessica's legacy in other ways, including a crowd-funding campaign to create "Jessa's Place," a residential facility for adults with autism, like her beloved sister, Emma, and others with developmental disabilities.

"I have a feeling that, because of what we've gone through, in one way or another, we're going to be working on these issues for the rest of our lives," David Grubb said. "I think right now, the pressing need from our perspective is passing Jessie's Law ... but there are so many other aspects, so many other issues, like the creation of treatment centers. Especially with our experience with Jessie - she couldn't even get into a facility in West Virginia because of the waiting lists, and so we were forced to take her somewhere far away, and that was very, very hard."

Reach Lydia Nuzum at

lydia.nuzum@wvgazettemail.com,

304-348-5189 or follow

@lydianuzum on Twitter.

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Drug diversion squad to help fight state's drug problem http://www.wvgazettemail.com/article/20160513/GZ01/160519762 GZ01 http://www.wvgazettemail.com/article/20160513/GZ01/160519762 Fri, 13 May 2016 09:18:01 -0400 MORGANTOWN, W.Va. - A new tactical diversion squad through the Drug Enforcement Agency will help north central West Virginia fight the state's growing drug problem.

WBOY-TV reports that starting next month the diversion squad will assist local law enforcement in catching drug dealers, finding pill mills and identifying false prescriptions.

U.S. Senator Shelley Moore Capito, a Republican from West Virginia, says that the squad will also coordinate its efforts with local law enforcement and share information to prevent doctors from overprescribing pills.

Capito says Charleston currently uses the diversion squad and has seen several drug convictions as a result.

- The Associated Press

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Jenkins bill aims to help babies exposed to drugs in the womb http://www.wvgazettemail.com/article/20160512/GZ01/160519787 GZ01 http://www.wvgazettemail.com/article/20160512/GZ01/160519787 Thu, 12 May 2016 18:51:14 -0400 Lydia Nuzum By Lydia Nuzum The U.S. House of Representatives has passed a bill authored by U.S. Rep. Evan Jenkins, R-W.Va., that directs the U.S. comptroller general to study the barriers to treating neonatal abstinence syndrome, which happens when a baby is exposed to drugs in the womb before birth.

Jenkins' bill that passed Thursday, the Nurturing and Supporting Healthy Babies Act, will be bundled into a larger health bill that could reach the president's desk by the summer.

House Bill 4978 directs the Government Accountability Office to identify any federal obstacles to establishing centers to treat neonatal abstinence syndrome, as well as evaluate the need for treatment and the access to treatment for infants, especially those covered by Medicaid.

According to Jenkins, the bill will join 17 others that will be folded into the larger Comprehensive Addiction Recovery Act, which originated in the Senate as bipartisan legislation and passed nearly unanimously in March; the bill will likely return to the Senate promptly, Jenkins said.

"This is an important week in Congress; it's an important week of bipartisan support for an issue that has tragically impacted not only communities in West Virginia, but cities and states across the country," Jenkins said. "This will instruct the comptroller general of the United States to collect data on the incidences of NAS across the country; you can only manage what you can measure."

Jenkins, the former executive director of the West Virginia State Medical Association, said his experience as a state senator from Cabell and Wayne County drove him to introduce the NAS Healthy Babies Act - specifically, the establishment of Lily's Place, a Huntington center that treats drug-addicted babies. Jenkins said he helped Lily's Place get off the ground five years ago, and he hopes his federal bill will clear the way for more centers operating on the same model.

"It's hard to imagine anyone more victimized than a newborn infant who's having to go through their first days, weeks or months through the ravages of withdrawal," Jenkins said. "I have held a baby who was drug exposed - their bodies shake and tremor, they cry 24/7, they are ultrasensitive to light, to sound, even to touch. It was five years ago that two NICU nurses from Cabell Huntington Hospital approached me, saying, 'We are seeing this huge increase in babies who are drug exposed, and we have to come up with models of care and treatment methods that aren't well-known.'"

Jenkins said he is confident the CARA Act, with its changes made in the House, will pass the Senate with bipartisan support again and reach President Barack Obama for approval by the summer.

"We're in close communication and working with the Senate to end up with a final package," he said. "I do not envision any substantive bumps in the road - the legislation we are passing on the House side, most of these bills are passing unanimously, so this is not a partisan tug-of-war by any means."

Neonatal abstinence syndrome is a growing problem in southern West Virginia - the issue affected 275 infants born in Huntington in 2015, with many more undetected cases, Rebecca Crowder, the executive director of Lily's Place in Huntington, told the Gazette-Mail in January. According to a study by the Association of State and Territorial Health Officials, the prevalence of neonatal abstinence syndrome has increased significantly nationally, with 3.39 cases in every 1,000 U.S. hospital births as of 2009, up from 1.20 per every 1,000 births in 2000.

Reach Lydia Nuzum at lydia.nuzum@wvgazettemail.com, 304-348-5189 or follow @lydianuzum on Twitter.

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KCHD offers free naloxone training http://www.wvgazettemail.com/article/20160511/GZ01/160519918 GZ01 http://www.wvgazettemail.com/article/20160511/GZ01/160519918 Wed, 11 May 2016 16:00:52 -0400 The Kanawha-Charleston Health Department will hold another training on how to administer the overdose-reversing drug naloxone today, and will provide auto-injector naloxone kits to those who complete the training.

The training, which will be held at 1:30 p.m. at the health department's offices at 108 Lee St. E., will be led by trainers from the University of Charleston School of Pharmacy. The one-hour training is free and open to the public, and anyone who completes the training can then receive an Evzio kit from KCHD health officer Michael Brumage.

The Evzio, which works like the Auvi-Q epinephrine auto-injector used to reverse anaphylaxis, is an auto-injector that uses spoken instructions that guide the user through the injection process. In March, the health department received 200 of the auto-injectors to distribute. For more information, call 304-348-6493.

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DHHR notifies more Raleigh Heart Clinic patients about hepatitis risk http://www.wvgazettemail.com/article/20160509/GZ01/160509515 GZ01 http://www.wvgazettemail.com/article/20160509/GZ01/160509515 Mon, 9 May 2016 21:09:00 -0400 Elaina Sauber By Elaina Sauber State health officials have notified more patients who may have been exposed to hepatitis B, hepatitis C and HIV at the Raleigh Heart Clinic in Beckley.

The West Virginia Department of Health and Human Resources announced Monday that four additional cases of hepatitis C were detected by the state Bureau of Public Health.

All of those cases were contracted before March 1, 2012 - which was the original date state health officials had said patients at the Beckley clinic were first exposed to risk.

The agency now recommends anyone who may have received a stress test at the clinic prior to that date should consider being tested for those diseases, according to a DHHR news release.

A bureau investigation conducted from November of 2014 to March of 2015 identified 12 patients who had contracted hepatitis B or hepatitis C - all of whom received the cardiac stress tests.

While those cases all linked back to the clinic, there's no definitive answer as to how they were transmitted. Aside from reusing needles, the viruses could have also been spread by medical staff reusing single-use vials of medicine, not wearing proper equipment or not sanitizing the area of the injection site, according to previous Gazette-Mail reports.

On March 11, the bureau issued more than 2,300 notifications to Raleigh Heart Clinic patients who underwent stress testing with the use of injectable medications between March 1, 2012, and March 27, 2015.

Dr. Rahul Gupta, state health officer, said the extent of possible exposure to the diseases was unknown in March, when the notifications were first sent out.

The bureau also set up a hotline that patients from the clinic could call to report any additional diagnoses.

"We got calls from an individual who was diagnosed with Hepatitis C as far back as October of 2010," Gupta said.

On April 18, the department expanded its Frequently Asked Questions page on the pathogen exposure, encouraging patients who received a cardiac stress test at the clinic prior to March 1, 2012, to talk to their doctor about whether they should be tested.

The bureau then heard from three more patients who were diagnosed with Hepatitis C sometime between October 2010 and March 1, 2012.

"When we [received] more calls, we felt compelled to expand the notification process to patients who'd had such tests ... at that clinic to ensure all individuals should get tested," Gupta said.

He added that the "overwhelming majority" of calls made to the hotline were from residents of Raleigh, Fayette and Wyoming counties.

The four new cases, however, "cannot be conclusively linked to the clinic," according to the press release.

Gupta stressed there have been no reported transmissions since March 30, 2015, when the clinic's employees underwent training measures to ensure they used only single-patient-dose vials and medications. The state Health Department also ordered the clinic to switch to needle-free injection systems, and staff was advised to obtain training on infection control and injection safety.

The local health department has since visited the clinic to verify those recommendations were followed, according to the Department of Health and Human Resources.

It's unclear how long the clinic had been conducting cardiac stress tests via injection. Calls made to the clinic Monday were not returned.

The original 12 patients diagnosed included eight who contracted hepatitis C after a heart stress test on three different days, and four who got hepatitis B after a heart stress test on two different days, according to health officials.

While there hasn't been any evidence of HIV transmission, patients are recommended to get tested because it is transmitted the same way as hepatitis.

Left untreated, hepatitis C can cause liver cancer and cirrhosis.

At least two lawsuits have been filed against the clinic since late March in Raleigh Circuit Court.

The suits, filed by two women who were patients during the exposure period, allege that the clinic recklessly and knowingly put patients' lives at risk by exposing them to potentially deadly blood-borne diseases.

Those who want to be tested may receive testing by their healthcare provider or local health department.

The bureau's hotline is available at 1-800-642-8244 to answer questions from patients of the clinic who have questions about the notification.

Reach Elaina Sauber at elaina.sauber@wvgazettemail.com, 304-348-3051 or follow @ElainaSauber on Twitter.

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