Second, support for Arkansas Week provided by the Arkansas Democrat Gazette.

The Arkansas Times and KUARFM 89.

Hello again everyone and thanks very much for joining us for this special one hour edition of our broadcast.

In a couple days, Arkansas and the rest of the nation will begin this year's Red Ribbon Week.

For almost 40 years now, it's been a time to highlight the agony of drug abuse.

Its cost in lives and livelihoods, its costs to our systems of education, health care and criminal justice.

And those costs are staggering in the Minutes to come.

We'll speak with professionals and law enforcement and addiction recovery about the epidemic and some new approaches to curbing it.

First, though, we're joined by Doctor Kiffany Pride, the state Education Department's assistant Commissioner for elementary and secondary learning.

Doctor thanks very much for for being with us.

We we know from experience, drug awareness education should begin at a very early age, so Red Ribbon week this week in the schools.

What are these youngsters going to focus on?

What are we going to know?

Yes, so excuse me each year we provide activities and resources to our schools to promote drug awareness in a in education and so because we know this plays a critical role in prevention.

We partnered with the FBI, DEA, Arkansas Drug Director's offices and Arkansas PBS to spread the word about the harmful effects of opioid addiction.

And we know it all starts with education, educating.

Our students, our families and communities about this epidemic.

So we are going to be providing lots of resources and tools for our for our school communities because we know effective prevention measures not only help save lives, but they help reduce the need for our law enforcement activities down the road.

And so we're excited to join with our partners to provide resources and activities for our schools age appropriate materials doctor.

I'm sorry I didn't hear yeah or are these materials age appropriate?

Are we giving them more than they can handle at this age?

No, we are.

We have ensured that we have provided resources and materials we provided our classroom teachers with the documentary A preview of the documentary, A classroom discussion guide and information that they can share with families.

And so we give them to give that to them in adequate time for them to plan for each grade level and to provide and to make choices.

That are appropriate for each grade level.

Let's see if we can.

Let's pause for a second doctor prod and take a look at.

We'll have a preview of the documentary.

It's powerful stuff.

And so, with heroin, it felt like a warm blanket coming out of the dryer and somebody wrapping you super tight in it.

I don't know, it was just.

A calming feeling I guess but.

Also it was.

Killing me.

Mackayla we're seeing more and more prescription medications and opioid based narcotics affect our community.

Like when drugs are involved.

Like it's never going to be OK never, and if patients are given seven days of opioids, just seven days, they have a one in ten chance of being on opioids in a year.

While a lot of people love coffee, most people aren't going to sell their car or steal from their family members to pay for their cup of coffee the next day.

Unfortunately, the love of opioids can become so powerful that people start to do those things, damaging their family.

For themselves for that drug.

When we started all the people I did drugs with, there was twenty of us.

There's four of us left.

And so really drug use today is like playing Russian roulette, but adding fentanyl to the equation is like adding another bullet to the chamber.

I have overdosed 14 times.

As a parent, you know nobody prepares you.

For what to do when your child's struggling with addiction.

I'm sure she knew people who had done exactly what she did before that didn't die, but now she's never gonna know.

Can you?

Can you make it somewhere to get some help?

Drug use overdose?

It does not matter who you are, where you come from.

It doesn't matter how old you are, what color your skin is, how nice your house is, how much money you make.

If you go to church or not.

If your family is divorced or not.

I think we're just in a crisis situation in our country.

And again, that documentary will air Monday here on Arkansas PBS at 8:00 O'clock.

Powerful stuff and we urge you to watch Doctor back to you there.

The students are going to get this year.

They're going to get more than just a documentary.

They'll be leaving the classroom with some materials, correct?

Yes, we have a huge selection of classroom ready resources.

As I mentioned earlier, they have the preview of the documentary, A discussion guide.

They have some resources that can be shared with families so students will leave with information to help them understand the seriousness around this opioid crisis and just around drug use.

And so they'll be more informed as a result of these resources.

Doctor thanks so much for for walking us through a doctor.

Kiffany pride of the state education department.

Thank you.

And we'll be right back with more.

And we are back more often than not, addiction has innocent beginnings.

Opioids prescribed for individuals who truly need them can begin to disappear.

Dose by dose taken, not always by the patient, but sometimes by an intruder or by someone sharing the home either for their consumption or sale.

On the street, unused doses have a way of being used.

So October 23rd is the latest take back day time for the safe.

No questions asked.

Return of unused prescription medications of all sorts, specially opioids.

Previous take back days have recorded absolutely incredible amounts of unused pharmaceuticals, including opioids.

As we are about to hear from 3 gentlemen for whom.

Every day is take back day in one sense or the other.

Kirkland is the Arkansas drug director James Dawson, special agent in charge of the FBI's Little Rock Field Office, and Jared Harper is the assistant agent in charge of the DEA, the Drug Enforcement Administration's Little Rock district.

Gentlemen, thank you very much for coming in Director Lane.

Let's start with you.

I mentioned at the top there the staggering amounts of drugs that can be collected in a take back day period.

Can you in the last, take back Dave what?

What happened?

What well, today we have collected and safely destroyed 221 tons of unwanted unneeded prescription medication from 221 tons.

That is correct.

We're pretty proud of that amount.

It's really indicative of how good we are getting that message out there because they take back program really is an educational program about how the monitor secure and safely dispose of your prescription meds.

Of that of that tonnage, do we know how much was was potentially dangerous?

I mean, in the addictive in the terms of opioids, so we have completed some surveys on that.

About a third of that.

Medicine that's turned in is the stuff that we really need to get off the street.

And I think it's worth mentioning that there are at pharmacies across Arkansas.

Some pharmacies have a receptacle there year round.

You can take back unused prescriptions and cause them safely.

We actually have 200 and 7024 hour, seven day, week take back boxes, at least one in every county of this state.

Gentlemen, the last time we we had one of these conversations.

We were trying to prison the opioid crisis through the pandemic lens that people were staying in and it increased the societal pressure, increased depression, any number of maladies, has that represent.

How does that stand now in terms of two epidemics instead of of 1?

Yes, Sir, so you know anytime you know people are not working they have idle time.

There's an opportunity to try to find something to ease the pain, whether they've lost a job, whether their their family needs food or or gas, or that just a normal essentials, they turn to to something that they think is going to give them a temporary fix, which ends up being leading a lot of times to death.

When involved in these opioids that are highly addictive and it doesn't include some of the other things that are coming up from the southwest border to include the counterfeit pills that we're seeing here in Arkansas that are laced with fentanyl.

So we're seeing a lot of synthetics.

Well all along, a lot of synthetics.

Yes, yes Sir.

In fact, nine and a half million counterfeit pills laced with fentanyl have been seized in the in this this year alone and four out of 10.

The pills that we're seeing across our seven labs at DEA have a lethal dose which has only two milligrams of fentanyl.

This stuff is incredibly powerful.

Fentanyl, yes, Sir, lethal it is Mr Dan.

So from the FBI's perspective, we believe it's possible that the opioid epidemic that we're seeing right now, especially fentanyl.

It's really driven by the availability of fentanyl as a narcotic.

It is incredibly cheap.

It is less than a pack of cigarettes for someone to buy a lethal dose of fentanyl that will kill them.

And fentanyl has become readily available across the United States and in the state of Arkansas.

Its availability has certainly grown, so it's in in terms of one measure, we can look at the pandemic as a driving influence and people looking to escape the harsh realities of life.

People tend to do that.

People tend to use drugs for that reason, but the availability of fentanyl has become prevalent across the state of Arkansas.

And that's driving a large number of the overdose.

Deaths that we're seeing.

Ultimately, I suppose it doesn't matter, or perhaps it does, but the this easy availability is it.

Is it domestically produced that you're encountering out domestically produced or brought in from overseas?

So so, So what we're seeing with the DEA is that these chemicals to make this synthetic opioid fentanyl, is coming from China.

And places like India the chemicals and then sent to Mexico.

And these cartel groups.

In Mexico are forming these super labs and making this substance with no standard of any kind.

And then you know mass producing this and pressing out these pills you know with no regulation and sending them domestically here in the United States, which is which is a big problem because they're doing it solely with with reckless intent and purely to just make money.

Off of the Americans here in the US and it's it's a sad thing because some of these kids are thinking they're taking Xanax or Adderall or ecstasy, or percocet, when in fact it's it's a counterfeit pill that's been pressed.

It looks just like an industry standard pill, but yet it's laced with fentanyl and they're dying.

Completely agree with Jerrod.

Our intelligence reporting clearly indicates that most of the narcotics most of the fentanyl that's entering the United States is coming through Mexico.

It's being produced by labs in Mexico from overseas components from principally from China and some from India, and it is making its way into all kinds of drugs here in the United States.

It's used to boost the efficacy of methamphetamine of marijuana of heroin.

It's coming in the form of press fentanyl pills that are being.

Purchased either on the street or via the dark web.

We've seen a huge increase in the amount of narcotics, and specifically fentanyl that's available in pressed fentanyl pill format via the dark web, a a tablet of, say, hydro codon are a quote legitimate pharmaceutical manufacturers.

United States might be dangerous, might be necessary for some people, but it at least had FDA certification.

It was pure, it was, and this stuff is being manufactured, like meth was what, ten years ago, out of radiators and?

With all all manner of bizarre chemicals Mr. A lot of and a lot of times stamped with clandestine pill presses and tomate made to look like other drugs.

And that's where that mistake comes in.

No, Leslie isn't all the more lethal.

Yes, Sir, no.

What are we doing now?

What can we do besides Red Ribbon week in terms of uh, I think it's generally agreed in the law enforcement community that law enforcement alone is not going to handle his problem.

So if you would reflect for a moment on Red Ribbon Week, can it work and it make that much difference?

Education has always been a key component in everything we do on the state level and and even partnering with our federal partners on what we're going forward.

Whether it be educating doctors, communities.

School populations all populations need to understand what's going on as an awareness also as a deterrent to what's going on in the recent legislative session, we have increased fines and and sentencing for fentanyl distribution because our our current or our previous.

Laws were based on prescription fentanyl and not the illicit fentanyl that we're describing in this in this program, and so we had to be changed, and it had to be adjusted and in truly got more restrictive than it ever has been.

So educating law enforcement on how to deal with that, how to investigate past the overdose has been part of the solution to this problem.

Probably.

Should we mention that fentanyl does have legitimate usage in in the clinical community?

It's it's not a completely.

Off the charts concoction right.

Most of the problems that we're saying is with illicit fentanyl.

You know stuff.

It's cooked basis, correct?

We have a couple of graphs here.

Gentlemen director lane.

Particularly if you could kind of walk us through this.

The first we have a involves drug usage nationally, right?

This is a national graph and it shows the amount of opioid sales.

As you know, Arkansas is one of the second highest prescribing state in the nation.

It has been for some time even though we have trended downward for a number of years, we're on the right path way, but you can see where opioid deaths and how how that is rising and then also treatment emissions that we're seeing.

Opioids are now climbing as one of the primary sources of treatment emissions in our state.

Methamphetamine, alcohol, and marijuana were our highest one and opioids are now our 4th highs.

One in our state that we have an Arkansas graph.

Or did we have that up just a second ago?

There we go, so this graph is disturbing 'cause for the first time in 2020 fentanyl is taken over as the leading cause of a drug overdose death in our state used to be methamphetamine, but fentanyl is going past that.

But you also see the yellow line in there where combination of drugs, meth and fentanyl.

What we call Poly drug intoxications and we're also seeing it in heroin, were saying in cocaine we're seeing it in marijuana.

We're seeing mixed into a lot of drugs to make them more potent and make them more attractive to people that are abusing them.

So I think he raised a really good point.

Law enforcement will not arrest its way out of this issue is simply impossible.

And really, I think the American public doesn't want that matter of fact.

I know federal law enforcement doesn't want that.

So an education campaign is geared towards children and are vulnerable.

And it's really important.

Get the word out of the permanence of the effect that drug addiction can have on a person's life.

I mean, it can wreak havoc in a person's life, and for those that are left behind as a result of drug overdose.

Impact is is is beyond compare.

They've lost these loved ones at a young age or at any age as a result of this addiction and the Department of Justice, the FBI and the DEA have long had a program geared towards education and educating the American public of the dangers of drug use and what it can do, and far be it from the federal government to tell Americans how to live their lives.

Constitutionally prevented from doing that.

That's not a part of who we are, but we do have the.

Ability to express that there are consequences.

The ultimate consequence for drug use can be death.

Other concepts can.

Consequences can be, you know, incarceration deprivation from really living in American life and we don't want that.

And I think that will do everything that we can and continue to do everything we can to express to the American people that there are consequences for utilizing these drugs.

Mr Harper can't be avoided there.

There have been problems in the enormous problems in the past with in the clinical community in terms of renegade practitioners either.

Pharmacies, or prescribing physicians?

Dentists even are we making progress in curbing that aspect of the problem?

Yes Sir, we have a diversion agents within the DEA that specifically look at doctors and practitioners and nurses the compliance and the regulatory issues that we sometimes are are even more times than not now seeing where there's over, prescribing or prescribing without a medical purpose.

And we are constantly looking at the data.

We're looking at the to see you know what?

What is being prescribed now, what levels it's being just prescribed.

Because here in Arkansas, I mean you've got almost two 2.9 million prescriptions of opioids being prescribed and 151 million pills that come across the state of Arkansas is just an enormous amount of opioids, and it's fueling not just this dependency and addiction and death.

But it's fueling violence in our city and and it's just our three offices alone in Little Rock, Fayetteville, and Fort Smith.

We've seized 342 guns and encountered 50 armed drug traffickers trying to fight this big animal that all of us are trying to put our arms around.

And that's what it's going to take a full court press and all hands on deck from all community professionals in the in the state of Arkansas.

We want to emphasize Kirk, I'm sorry.

Did you want to add to that?

You know the only thing I would add to it is as we're building infrastructure in our enforcement, our capacity to educate.

We're also building infrastructure and the availability of medicated, medicated, assisted treatment.

And we're also developing a tremendous recovery community using peer.

Recovery support specialist people with lived experience through way into that to take people and give them sustained abilities to recover.

In the sense of what, like a 12 step program sponsorship is that it's much beyond that.

It's somebody that has lived experience that becomes a credentialed peer recovery specialist that can work with somebody for a long period of time and lead them through the steps to recover.

Alright, we want to put up a graphic because one more time I want to emphasize some dates that are important.

Drug take back day.

Saturday October 23rd, 10 until two and there is a website Kirkland.

I think that anyone can with a computer can readily access to find a location.

That's right, they can go to that website.

There's a tab on that website where they can put in their ZIP code or their address.

It will give him the closest take back event site or the 24 hour take back site to them on that website.

And of course two again there are more than 200, I believe.

You said locations around the state where 270.

Where 24/7 you can drop off, that's correct and unused prescription.

So if they can't make that 4 hour window they can stop off at anytime.

Mention was made just a moment ago of and much has been made in recent months of the the nation's homicide rate and it's increasing violent crime even as other crimes, burglary, whatever may be declining.

Violent crime is up.

Can we quantify that in terms of what role substances illegal substances have played in that?

It is significant so the the narcotics trade disproportionately has an impact on the amount of violent crime on our streets.

Frequently we'll see inner city gangs and groups that compete with one another for the privilege of distributing narcotics within their area of responsibility to our force and turf wars.

And they happen all over the United States predominantly.

They're taking place in our major metropolitan areas and many of the deaths that we see on our streets.

The result of competition.

In order to traffic drugs on our streets.

Yeah, Mr Harper, you concur with that I guess I I definitely concur, Sir, we're seeing a huge uptick in violence across our cities here in Arkansas, fueled by the drug trade, which brings guns and brings money and greed and power.

And you know, our community deserves to have their children be able to walk outside to the park without having to be intimidated or fearful of being shot.

Or killed and it's and it's a horrific thing.

But make no mistake, we're we are binding together.

Law enforcement is and combatting and and and leveraging all resources that we have to combat this violence.

And at the end of the day, we will continue to do that.

We will relentlessly pursue these traffickers and and and and put a curb to this violence that we're seeing.

Because we're out of time is to Hopper, Mr. Dawson Kirkland.

Thank you all for being with us.

Come back soon.

Thank you.

Yes, Sir, thank you will be back with more in just a moment.

Thanks for staying with us.

Opioid addiction is not always, in fact, is rarely the product of strictly recreational use.

Thrill seeking, as we saw in our documentary clip, it can begin with clinically appropriate treatment for pain, but then quickly devolve into something absolutely criminally inappropriate.

There are some new approaches.

To not only the treatment and alleviation of pain, but to recovery from opioid addiction, whatever its origin.

So we're joined now by Doctor Jonathan Gorey, director of the Chronic Pain Division at University of Arkansas for Medical Sciences and also Doctor Michael Mancino, program director for the Center for Addiction Services and treatment at UAMS doctors.

Thank you for very much for coming in misdiagnosis on diagnosis is has been in the past.

We know doctor.

The the source of some problem progress in that regard within the clinical community, I think so.

You know, most people come to the doctor because they have pain, that her pain is the warning system that something is wrong, and so we are doing better at understanding why patients have pain.

Diagnosing the source of their pain and then tailoring treatments and not just using opioids as a catch all documents you know?

Yeah, I think we're doing a better job just because we know now that there's a problem with throwing opiates at every.

Pain, I think that we're doing better with realizing that opiates don't actually change the underlying condition.

They don't actually improve the underlying condition, and so we're doing a better job of trying to treat the underlying condition.

Are we making progress in terms of pharmaceuticals that can move us away from opioids that can tackle the problem of pain, severe pain, chronic pain, without an addictive quality to them, I would say yes.

I think part of it is we better.

Understand how to use opiates.

Opiates are needed after surgery.

Opiates are needed in cancer situations or when patients have severe pain.

I think we now know that patients need to be aggressively treated when pain starts, but we need to get them off of those opiates as soon as possible.

The longer that they're on those medications, the better, or it increases their chances of developing an opioid.

Use disorder, so I think it's the Holy Grail for the Pharmaceutical industry.

Right there, they're spending lots and lots of money and time and effort and energy, and the government is trying to support the development of those agents.

Some of them are sort of mixed agents where there's an opiate in there.

But then there's an opiate blocker type agent to prevent it from being used by a route that it shouldn't be used right.

A lot of times you can prescribe someone an opiate and it's designed to be taking by mouth.

But then the person crushes it and snorts it.

The person puts it in solution and injects it.

Or the person smokes it.

A good example of that was Oxycontin, notorious for being misused by those routes I mentioned.

And they made them change the formulation.

So it was much more challenging to snort smoke shoot.

So we have the technology to make these drugs less likely to be abused again, just because you.

Only take it orally doesn't mean you won't develop an addiction.

Sure and and a lot of this is leftover study from patients here.

OK, I'm better now I've got 5.

Doses remaining here.

I better do something with this.

So an example.

My wife's a surgeon.

Surgery residents are often left on their own.

I have to write a script for this patient after surgery for their hernia.

I don't know how much to give them.

Nobody's really trained me on that and so the idea is, well, I'll just give him 30 days worth.

That's what I give for most other medications I prescribe, and that's probably about 25 days too many.

I think we also we want patients to be satisfied.

We don't want patients to be in pain and so kind of the altruistic nature of medicine encourages us at times to over treat and we don't realize we're actually doing more harm than good doctors want their patients to feel good about them and and to be able to move forward with their life.

That sure so.

But we now realize that over shooting leaves a very dangerous medication in the medicine cabinet.

Are we moving in terms of clinical medical, education, UAMS or any other?

Training facility at Fort Smith, Jonesboro.

Are we incorporating a in the curriculum?

A, uh?

An index of four for pain management now for pain treatment and yes, and and we are there is there are lectures about pain treatment in the medical school education.

There are now many of the residents in different areas.

Rotate with our group and I'm sure Dr Mancino's group to understand more about pain treatment as there.

Whether they're surgeons, whether they're psychiatrists, no matter what your specialty is, you're probably going to encounter patients who are in pain, so you have to.

Understand how to treat it appropriately and over the past couple of years we've developed advanced training programs in both chronic pain therapy and addiction that will train physicians to be able to combat these specialized kind of these more complex cases in Arkansas.

What are we understanding more?

Do we know more than we did last year about the nature of addiction itself?

I don't know that we know anything more about the nature of addiction itself.

I think what we're understanding is that we need to provide better treatments for patients that we identify as having addiction.

I think the biggest barrier is there are a lot of physicians that are out there practicing medicine who do not understand addiction.

I've gone around the state of Arkansas and been shocked by the number of doctors that stand up in a room full of other doctors and say I don't know anything.

It's all about addiction and you would never catch that doctor standing up in a room of other doctors and saying, I know nothing at all about heart disease, right?

You would at least know that if someone walked into your office with chest pain, you probably need to do something fairly urgent for that patient.

But doctors are comfortable saying they don't understand addiction and what they're really saying is I don't want to have to deal with the patient that has addiction because they're extremely difficult for me to deal with.

And they take a lot of time.

You mentioned earlier a referral and you spend a lot of time trying to tease out what's what's really an underlying pain condition and what has moved into an addiction condition.

And that takes a whole lot of effort, time and energy, and puts you behind for all the other patients that you have to see.

And taking that a step further, if you prescribe opioid medications, you have patients in your practice.

That are probably addicted.

It's just the nature of the numbers.

And so when physicians say I don't understand addiction or I don't have addiction or I don't treat addiction.

Addiction could be the thing that is most dangerous to that patient that you're seeing them.

While you may be seeing them for something else, the opioids that are in their medicine cabinet could be what could ultimately kill them.

And so if our goal is to do no harm and to help patients as much as possible, we all should be screening for addiction and getting patients to the appropriate treatment modalities they need.

But, but to an extent that say, a General practitioner of.

Who need to be need to be schooled in addictive medicine to a greater extent than psycho?

I mean, if I was a GP and you came in with chest pains, I would refer you to a cardiologist.

Absent, you know immediate need for CPR are do we see addictive medicine growing and in terms of a specialty now document so addiction medicine is trying to be grown as a specialty.

We're trying to get more people interested in that specialty.

There are fellowships that have been generated.

In the last 20 years, called Addiction Medicine fellowships, those didn't exist 20 years ago and they're sprouting up all over the country.

We now have an addiction medicine fellowship here at UAMS, and we had our first fellow this year who is a family practice or internal medicine doctor.

And So what we want is him to go back into the internal medicine clinic with his colleagues and help educate them and make them more aware of addiction and the fact that we have effective treatments and that we can manage this effectively.

Yeah, I I agree 100% and I would.

I would say that.

We have to be able to recognize in the same way that you know.

When I was taught in medical school that one of the best things I could do for patients is to encourage them to stop smoking because whether I was seeing them for heart disease or for pain in their leg, one way I could prolong their life is to get them off of cigarettes.

With where the opioid epidemic has gone?

At this point, I feel we should look at opioids the same way every patient.

We should have a conversation with them, even as a baseline conversation about their relationship with pain medication, especially if they're on them and then get them over to the right.

Treatment for physicians who might choose a career or that discipline.

Addiction medicine.

If you're an orthopedic surgeon, one suspects that you can do.

After a while.

You can do a pretty good need your success rate on a total knee is pretty good.

Or if you are a cardiologist, your bypass survival rates pretty good.

Your rate of success in addiction of medicine is a little more problematic.

Is it not?

Doctor?

It's just the nature of the disease itself and and that's the myth, right?

That's the myth.

The myth is the same for mental health, right?

We don't have effective treatments for mental health we have.

Just as equal, effective treatments for mental health disorders and substance use disorders as we do for any other chronic condition, our rates of success in chronic medical conditions is not very good, hypertension, diabetes, COPD, etc.

We see addiction often as a moral failing or a weakness on the part of the patient and so we feel like, well, we can't help that person because that's their nature.

Well, we can help that.

Person and part of the problem is we view addiction as a moral failing, but we don't recognize that diabetes is a disorder of insulin.

Whether it's you know problem with the pancreas, but there's also a behavioral component to that problem.

If I eat, it doesn't Donuts every morning my blood sugar is going to be over 400 and I'm going to have poorly controlled diabetes.

It's the same thing.

Addiction is a brain disorder with a behavioral component and we need to manage both of those aspects of the disease, just like we do with a patient with diabetes.

We don't just say here's insulin, eat whatever you want, we send them to a nutritionist to talk to them about their diet and those sorts of things.

And in addiction medicine, it's a counselor.

It's a therapist along with a lot of the medications that we use to help the brain disorder.

Part of things well is the burden of stigma diminishing.

Do you see that?

I think so, but I think we have a long way to go.

I think in among specialists among a number of physicians, it's a lot better than it was, but I still feel that stigma when I see patients when among patients and among the general public.

And so I think conversations like this help education helps and having more specialists in the field also helps.

I I think it's improving, but like Doctor Gorrie said, we've got a long way to go.

But these conversations, conversations with patients around you know, I understand that your family doesn't like the fact that you're taking this medication, but would they prefer that you take the medication that you're out of control with rather than a medication that's being prescribed by a physician?

Inappropriate dose in an appropriate manner, and your life has turned around?

Right, you're doing so much better.

Why is there the stigma around the fact that you're taking medication?

We don't stigmatize to the same degree if you're taking insulin.

How long are you going to have to take insulin, right?

We don't ever ask that question, right?

And I think we are.

Medical paradigm is changing a little bit as positions in medical school you're taught to diagnose disease and then fix it, you find the problem and you fix it.

I think we're learning that it's more about quality of life patients come to us because.

They want their life to be better than it was before they met us, and so necessarily fixing the problem or ending a diagnosis or getting someone off medication may not be the answer.

Sometimes it's getting someone so that they can play with their grandkids or go to the grocery store or enjoy life a little bit more than they did before.

Do you sense 2A?

Broader cultural in the broader populated the general population?

A greater willingness to accept addiction as a true medical condition as opposed to a moral or character failing.

I think so.

I mentioned earlier before we started.

People are starting to acknowledge that a loved one that died died from an opioid overdose, right?

That's really putting yourself out there, and I think that's increasing because they recognize that this is a treatable condition.

That's a medical condition that we can help people with and we shouldn't hide it because if we hide it then no one that other person that has a child that has an addiction.

And doesn't think there's any hope or any help for that person can maybe reach out and find hope and find help and save that person from the same faith that the overdose that occurred, right?

I believe that I have an open or a substance problem or my spouse does, or a child, or a relative, or a friend.

What should if it's me, what should I do?

Well, the easy answer for me is to call UAMS.

And and it's the Center for Addiction Services and treatment and the phone number is 501-526-8400.

That's 501-526-8400 and say I think I have a problem with opioids.

Can you help me?

And the answer is going to be absolutely and we can get you in pretty darn quick.

And I I'll even add, you know, I have given out that number to patients.

And if you have a family member, the other thing you can do is have that conversation you know, let them know that you care about them and that you have their best interest in heart and that you think that they have a problem and that you support them in their seeking help.

What about the expense of recovery treatment?

So the beauty is, our clinic accepts insurance.

All insurance, including Medicaid, Medicaid is now paying for medications for opioid.

Use disorder, they cover the costs of the medication they cover, the costs of the doctor visit.

They cover the cost of the therapy that's associated with it, and so that barrier has been significantly decreased over the last several years.

There are still issues around coverage of some sort of more intensive treatments like residential treatments where you go away for 28 days and stay at a facility for 28 days.

Part of the reason is that doesn't work.

It's long term treatment, right?

We wouldn't.

Say somebody with diabetes.

Well, here's insulin for 30 days and now you're cured, right?

We treat them for years and years and years.

The same thing is true for patients with substance use disorders.

They need treatment for years and years and years.

You go on the Internet and put search for need help for opioid problem or you're going to come up with resources pretty darn quickly.

Doctors, doctors go right.

Doctor Mancini thank you very much for your time thanks.

Perhaps you're aware of the multibillion dollar settlement between state and local governments across the country and the manufacturers and distributors of prescription opioids.

Arkansas share will be almost $220 million to be divided fairly evenly between State, County and city governments.

We spoke with Attorney General Leslie Rutledge about the settlement and what's to follow.

General Rutledge, thank you very much for being with us for your time.

The settlement now for the state, cities and counties is about $216 million.

In retrospect, the best we could do.

It is actual terms absolutely.

I mean, there's never enough money Steve to replace the lives that are lost to opioid addiction.

But this $216 million settlement that we announced in the last couple of weeks was a collaboration with the state of Arkansas.

With I was acting as the Attorney General.

The cities, all the cities and counties.

This is all of Arkansas coming together to basically deliver in a settlement agreement with these companies who we are holding accountable for creating.

This epidemic across our state we have lost so many lives to the opioid epidemic.

These resources will be able to provide us with the money to pay back the Medicaid system, but will also be able to provide communities with the treatment and the education programs that we need to ensure that we save lives.

You know, people always talk to Steve about how we need to save money in terms of less prison population.

But yes, we need to save money, but we also need to get back in the business of saving lives.

And that's what this money.

Will allow us to do after the Medicaid, recompense and attorneys fees.

Do you know, do we know how much we will have net to put on programs?

Well, the precise amount has yet to be set that will determine how many cities and counties that we need.

All of the cities have to sign the agreement by October 29th.

That's what we're encouraging them to.

We're reaching out to each city.

There's 500 towns in the state of Arkansas.

We're reaching out to all of them, working with the municipal league.

People are extremely encouraged because they know the heartache and the cost.

Again, the cost not just in lives of Arkansans in their community members and family members loss, but the cost to their local police department's their first responders in this effort.

This this these monies will allow us to buy things such as more Narcan for our first responders and not just for the EMTs and police officers.

But we need more pastors, for example, more family members, more schools.

Having access to Narcan, we need more educational opportunities for young people so they can learn that God has a better plan for them than to fall prey to addiction.

The biendo by the cities and counties.

Any doubt in your mind is is that coming together as you had hoped it is and we couldn't have been more proud as we all stood together in the last couple of weeks represented by numerous cities and counties as well as the officials from the Municipal League and the Arkansas Association of Counties to talk about how all of Arkansas is united in this effort.

For the last couple of years, we've each been working on our respective lawsuits and for us to be able to come together.

Demonstrates to the rest of the country.

This is how we get things done in Arkansas.

We get things done by working together.

It does sound though a bit complicated though general.

How do you anticipate this?

Working from an administrative standpoint, now you're going to have to secure a panel to oversee the the expenditure funds.

Is that correct?

That's great.

And So what we'll do?

Whether it's in this upcoming legislative session, the special session that the governor is going to call on taxes, or if it will need to wait until the fiscal session next year.

But we will have to have a law put in place to create.

A Commission that will distribute the funds each state gets 1/3 the cities get 1/3 in.

The county gets 1/3 once attorneys fees are paid out of that from the respective entities and particularly the cities and counties.

Once we've paid back from the Medicaid system that will go back into a pot of money that all of us will have access to.

With a Commission appointed by myself, the Governor, cities and counties will be represented on it because we want to make sure that this money.

Is not just used for one offs, but for long term for all corners of the state.

Because people in Southeast Arkansas have problems Northeast Arkansas, Southwest, and northwest Arkansas, that opioid addiction does not care if you're black, white, Hispanic.

It does not care if you're rich or poor.

It impacts every family in every community under the Omnibus Agreement or there are their expenditure of uses of the funds that are not permitted.

Can the state, the cities and counties do well that will be set forth in that legislation and in the Memorandum understanding again we are setting forth how the initial funds that one third, one third, one third with cities, counties and state, making certain that we pay our bills and that we reimburse taxpayers to the Medicaid system.

But the Commission will determine the grants that are given out and how that money is spent, and we'll have to do that through a special law that will be passed or in either this upcoming special session.

In October or during the fiscal session, how would you do what?

What program would you design?

Well, I think it all is important, whether it's education, educating young people, educating our junior high and high school students about the dangers of opioid addiction.

That's why I launched a prescription for life program recently each year as the Attorney General, I host a prescription drug summit where we have 1000 to 1200 people come together.

We have a law enforcement tracked and educator track day.

Medical provider tracked family tracked in each of those areas is important.

We also have to offer more resources for those battling addiction.

One thing Steve that I hear from family members is that their loved one.

It's too difficult to find a place for their loved one to get help.

20 days and 30 days.

If you're battling, addiction is not going to cut it.

I'm a big fan quite frankly of the faith based organizations such as John 316 or Renewal Ranch right here in Conway.

Those are the programs that remind.

Those battling addiction that God has better plan for them and that their life it can be focused on something and they can let go of that addiction and walk away from it because they have something stronger than that addiction to fight for.

But we also have to use those funds to to ensure that our first responders and others who are helping those with addiction have the resources they need.

We have Red Ribbon week coming up.

You have high hopes for it.

What we do each year and I remember even as a young student participating in red.

Ribbon week and this is something again.

That's part of the educational program.

Perhaps the last person many of us remember making drug education at the forefront of was the former First Lady of the United States, Nancy Reagan and just her just say no to drugs campaign.

However, the use of prescription medications has become prevalent among young people.

We've had overprescribing we've had bad doctors.

Most doctors are good, but unfortunately there are bad actors and we have to shut down those pill mills.

We also want people to clean out their medicine cabinets up coming on October 23rd when the University of Arkansas and the University of Arkansas Pine Bluff Battle each other at War Memorial Stadium, we're going to have these statewide prescription drug take back.

If you have old and expired medications in your medicine cabinet.

Well, most people don't have a medicine cabinet anymore.

They simply have it sitting out on their kitchen counter.

But if you have medications that you haven't used, get rid of those because young people loved ones.

Come into your home.

They take those medications, or even if someone has passed away from cancer, there's some very powerful medications people will take advantage and take those medicines when they don't need them.

Clean out those medicine cabinets, folks general roughish.

Thank you very much for being here.

Thank you, Steve.

Come back soon.

I had we also spoke to the Attorney general about her gubernatorial campaign.

You can watch that on our website and our YouTube channel good roots coming up next.

Stay with us.

Arkansas Row crops and commercial horticulture are in full swing during the fall.

Besides being the largest producer of rice in the United States, Arkansas as a major producer of a variety of agronomic crops and while big farming, is big business, Arkansas farmers know that good stewardship of the land is key for the future generations of farmers.

We learn about an Arkansas program promoting agricultural sustainability and environmental awareness.

In this episode of Good Roots.

Second, I'm at Stevens Farm just outside of Dumass, where the cotton harvest is in full swing.

Did you know that Arkansas produces over 1,000,000 pounds of cotton bales and nearly 400,000 tons of cotton seed?

That's fourth in the nation.

It takes months of planning and preparation to produce canes like this, and it all starts in the soil.

The Arkansas Discovery Farms programs goals is to determine the effectiveness of water and soil conservation practices utilized on working farms like this.

My name is West Kirkpatrick.

We're here at CB Stevens Farms incorporated.

We formed a little over 4000 total acres anywhere from 500 to 1000 will be cotton every year.

We typically start planting cotton sometime in April.

Temperature soil temperature is really the dictator of when we start planting about the middle of September 1st of October is about when we start our harvest process in order to make yield, we have to irrigate with the University of Arkansas were part of what's called the Discovery Farm.

We've got 110 litre bottle inside of here.

Wait monitoring stations that anytime there's a runoff event off of the field, be it rain event or an irrigation event, the automated system samples that water that's leaving the field.

So the university is able to measure how much nutrient is leaving the field, and we also know obviously how much we're putting on the field.

The Discovery Farm has been pretty beneficial to us to help monitor those nutrient amounts.

Cotton farming has been in your family well all your life.

Yes all my life.

You literally grew up.

Right, right across the field.

Yes, that's incredible.

Yeah, now you are part of this program.

You're in Arkansas Discovery farm.

Tell me about your involvement.

Well, when I was first approached, they basically said they wanted to monitor our nutrient runoff, nitrogen and phosphorus.

Because of the epoxy on the Gulf of Mexico and EPA and industry just felt like that farmers were contributing to the epoxy and they wanted to look at a cotton farm that had water running into the Mississippi River to see if we were contributing.

I first said no to the program because I was fearful that maybe we were contributing and I didn't want EPA breathing down my neck all of a sudden, hey, they're going to have numbers from my field, but I was convinced if we had a problem.

It would help me solve it.

The first thing that we found was pleasant surprise are in and pee runoff numbers were very very low.

When we irrigate, we don't run a lot of water off the field to the point where we're 90% efficient today in our watering program and this helped us to do that based on having the equipment to measure the water, we pumped the water that runs off the field.

And just to make sure that we can be as efficient as possible solely, what are you actually looking for when you get a sample from this?

So we're specifically looking for agronomic nutrients so farmers are putting nitrogen, phosphorus and potassium on their fields to produce their crops, and we want to know are the crops using it?

Is it staying in the field or is it leaving the field in the water runoff?

And so we take a subsample from the composite sample of every runoff event and we send it to the Arkansas Water Resource Center in Fayetteville?

And it's analyzed for nitrogen, phosphorus, dissolved phosphorus and potassium, and total suspended solids.

Every location we monitor just for the infrastructure is probably 15 to 20,000 depending on what equipment we need at this site.

And then we're talking about the analysis of each water sample over $100 apiece, so it's expensive program.

That's why we don't monitor everywhere.

That's a pretty decent year up there, Terry dabs, he said, you know, I think I might be a candidate for this.

Every farms because I have absolutely no groundwater on my farm.

Everything he uses his surface water and we thought it would be a good location because he recycles all the water that he uses.

Their results.

We've been saying I've been very promising.

We were actually losing very little nutrients, so when we got our test back we farm about 8 miles South of Stutgart in a family partnership farming operation which consists of myself, my son and my wife.

Yeah, Discovery Farm program was something that when my dad first approached me about it I was like are you crazy?

I mean you, you want environmentalists and and other groups out here.

You know trying to watch what we're doing.

I'm not too not too sure about that, but the more we talked about it and the more I learned about the program.

I was excited.

We grow about 800 acres of corn so monitoring the the nitrogen, phosphorus mainly or the two that were really looking at.

And that's important 'cause we don't.

We don't want any running off into our irrigation system or getting further down in the river.

And eventually to the Gulf of Mexico.

That monitoring let us know how are you doing this right?

Or we're doing something wrong.

It's very important that we have that data from a third party that we can go to our legislators, our EPA, or whoever.

When they're getting ready to pass laws and regulations that affect us, we can say look, you know we've got data here that proves we're not doing this.

So the overarching goal of the Arkansas Discovery Farms Program is to gather and gauge the water and soil quality of these Arkansas lands.

But the data that is harvested empowers these farmers to make the changes they need for a bigger yield and a better environment for all.

This is good roots and I'm Lauren McCullough.

Major funding for good roots is provided by Arkansas Farm Bureau, Arkansas Farm Bureau advocating the interests of Arkansas's largest industry for more than 80 years.

Arkansas counts on agriculture, agriculture counts on Farm Bureau.

And that's our program.

Our special one hour audition of Arkansas Week for this week.

Remember Red Ribbon Week is coming up a very opportune time to remember the hazards of opioids and to get rid of them safely and securely.

Again thanks for joining us.

See you next week.

Support for Arkansas Week provided by the Arkansas Democrat Gazette.

The Arkansas Times and KUARFM 89.