♪ ♪ GOOD EVENING.

WELCOME TO KENTUCKY TONIGHT I'M RENEE SHAW.

THANK YOU FOR JOINING US TONIGHT NEW NUMBERS JUST OUT TODAY SHOW THAT MORE THAN 2200 KENTUCKIANS DIED FROM DRUG OVERDOSES IN 2021.

THAT'S UP MORE THAN 14% FROM THE PREVIOUS YEAR AND THE REPORT SAYS 70% OF THE DEATHS WERE FROM FENTANYL.

GOVERNOR ANDY BESHEAR WANTS TO PROVIDE MORE HELP TO PEOPLE FIGHTING ADDICTION.

LAST WEEK, ATTORNEY GENERAL DANIEL CAMERON ANNOUNCED MEMBERS OF AN OPIOID TASK FORCE TO OVERSEE THE SPENDING OF MORE THAN THERE 200 MILLION OBTAINED IN A DRUG SETTLEMENT WITH DRUG MAKERS.

WHAT CAN BE DONE TO DISCUSS THIS PROBLEM, WE ARE JOINED BY TIM ROBINSON, FOUNDER AND C.E.O.

OF ADDICTION RECOVERY VAIR.

VAN INGRAM, DIRECTOR OF THE DRUG CONTROL POLICY.

TIFFANY COLE HALL, CHIEF OPERATING OFFICER OF VOLUNTEERS OF AMERICA.

REPRESENTATIVE JODI JENKINS, A DEMOCRAT FROM SHIVELY AND HOUSE MINORITY FLOOR REARED AND SENATOR RALPH ALVARADO REPUBLICAN FROM WINCHESTER AND SENATE OF THE HEALTH AND WELFARE COMMITTEE.

SEND US YOUR QUESTIONS TONIGHT SEND AN EMAIL TO KY TONIGHT@ORG OR USE THE WEB FORMAT KET.ORG/KYTONIGHT OR YOU MAY GIVE US A CALL AT 1-800-449-7605.

WELCOME TO ALL OF OUR GUESTS FOR BEING HERE IN THE STUD YO' THIS EVENING ON SUCH AN IMPORTANT ISSUE AND VAN, I WANT TO BEGIN WITH YOU, Mr. INGRAM.

THANK YOU FOR BECAUSE YOU ARE OFTEN ON THESE PROGRAMS WHEN WE HAVE HAD FORUMS AND THE LIKE ABOUT THIS AND WE SEEM TO COME AROUND TO THIS WHEN WE GET THE OVERDOSE FATALITY REPORTS AND TODAY THAT WAS JUST RELEASED AND IT LOOKS LIKE, AND I'M JUST GOING TO GO BACK TO 2019.

THERE WERE 1316 OVERDOSE DEATHS.

2020, 1964, 20212250.

SO IT'S GONE UP YEAR OVER YEAR.

IS IT ALL PANDEMIC RELATED OR WHAT ARE THE FACTORS AT PLAY?

>> REALLY RENEE, GO BACK TO 2018 WHEN WE SAW A 15% DROP IN OVERDOSE DEATH RATES AND WE THOUGHT WE'VE GOT A GOOD PLAN, WE ARE MOVING IN THE RIGHT DIRECTION.

FAST FORWARD TO 2019, DURING THAT LAST QUARTER OF THAT YEAR WE STARTED TO SEE A INCREASE IN FENTANYL.

2020 ROLES AROUND, MORE FENTANYL AND WE HAVE A PANDEMIC A PERFECT STORM IS HAPPENING HERE.

THE PANDEMIC CERTAINLY STRESSED EVERYONE, NOT JUST THOSE WITH SUBSTANCE USE DISORDER.

WE ALL FELT IT.

FOR FOLKS A SUBSTANCE ABUSE DISORDER, THEY FELT IT EVEN WORSE.

THAT DROVE THE NUMBERS UP INTO 20 AND 216789 FENTANYL IS THE SEE.

72.9% OF ALL DEATHS IN KENTUCKY IN 2021 INVOLVED A DRUG CALLED FLAL OR FENTANYL ANALOGUE $TELL US WHAT THAT IS BECAUSE WE DON'T UNDERSTAND HOW POTENT IT IS.

>> I'LL YIELD TO Dr. ALVARADO ON THE SCIENCE OF FENTANYL BUT IT IS A GOOD DRUG DEVELOPED FOR CANCER TREATMENT MOSTLY.

BUT THAT'S NOT WHAT IS DIVERTED ON THE STREET.

FENTANYL IS PRODUCED IN CHINA, MEXICO AND CENTRAL AMERICA AND DISGUISED WITH HEROIN, METHAMPHETAMINE AND COCAINE BUT DISGUISED AS PHARMACEUTICAL, MADE TO LOOK LIKE A XANAX BAR OR PERCOCET.

PEOPLE ARE BUYING WHAT THEY THINK ARE PHARMACEUTICAL AND IT TURNS OUT THE ACTIVE INGREDIENT IS FENTANYL $AND IT'S DEADLY.

50 TIMES MORE POWERFUL THAN MORPHINE.

IT DOESN'T TAKE MUCH TO TAKE A LIFE.

>> AND WE'VE TALKED ABOUT THIS BEFORE IN THIS STUDIO ABOUT LAW ENFORCEMENT OFFICERS BEING EXPOSED TO THAT, EVEN EXPOSURE ALONE CAN BE FATAL.

>> A VERY DANGEROUS DRUG AND I APPRECIATE THE PROGRAM TO GET THE INFORMATION OUT THERE.

WE TRY OUR DEFENDANT TO EDUCATE OW DANGEROUS THESE PRODUCTS ARE $I WANT TO GO TO YOU Mr. CHAIRMAN, ALVARADO BECAUSE YOU CHAIR THE COMMITTEE IN WHICH YOU TALK ABOUT THIS A LOT AND YOU ARE ON THE ADVISE ARE I BOARD AS WELL.

SO WHEN YOU HEAR THIS REPORT ABOUT OVERDOSE FATALITIES BEING UP 14.5% INCREASE OVER 2020.

WHAT DOES IT TELL YOU ABOUT WHAT NEEDS TO HAPPEN IN KENTUCKY NEXT ON THE POLICY FRONT?

>> THANKS FOR HAVING ME ON.

A LOT OF DISTINGUISHED PEOPLE ON THIS PANEL.

I'LL PROBABLY LEARN A LOT LISTENING TO THE PEOPLE HERE TODAY.

WHAT CAN BE DONE IS SOMETHING WE ASK OURSELVES.

WE TALK ABOUT SUBSTANCE, YOU KNOW, DISORDERS.

THIS HAS BEEN AROUND FOR PLINNIA MILLENIA, PEOPLE HAVE BEEN USING THIS A LONG TIME.

WE HAVE TRIED SO MANY DIFFERENT THINGS FROM A GOVERNMENT ANGLE WHAT CAN BE DONE TO HELP IMPROVE THE SITUATION.

AND GOVERNMENT HAS DONE A LOT OF THINGS.

WE'VE WORKED IN A BIPARTISAN FASHION THE LAST SEVERAL YEARS.

PEOPLE ARE LOOKING AT THIS NOT FROM A POLITICAL ANGLE, WE HAVE ALL HAD FRIENDS, WE'VE ALL HAD FAMILY MEMBERS, PATIENTS FOR ME, THAT HAVE BEEN IN THIS SITUATION I FIND MYSELF NOW WORKING IN THE FIELD ALSO IN THIS, SOMETHING I NEVER THOUGHT I WOULD BE DOING PERFECTLY HONEST.

WAS VERY UNCOMFORTABLE WITH THIS YEARS AGO AND NOW I'M WORKING WITH AN ORGANIZATION THAT IS WORKING ON SUBSTANCE USE RECOVERY FOR PEOPLE TO HELP THEM.

GOVERNMENT HAS DONE A LOT OF GOOD WORK OVER THE LAST SEVERAL YEARS TRYING TO IMPROVE THE TREATMENT OPTIONS FOR FOLKS, TRYING TO DESTIGMATIZE THE SITUATION.

ECONOMIC DEVELOPMENT, TRYING TO, YOU KNOW A LOT OF THIS IS LINKED TO PROBLEMS WITH CHILD ABUSE MUCH WARM FRONT' DONE GOOD BILLS ON CHILD ABUSE ISSUES THIS YEAR.

A LOT OF GOOD WORK HAS BEEN DONE FROM A GOVERNMENT ANGLE BUT THIS PROBLEM IS LIKE A BUCKET WITH 50 HOLES IN IT.

GOVERNMENT CAN PLUG A FEW OF THOSE HOLES BUT IF YOU TRY TO HOLD WATER, IT IS GOING TO CONTINUE TO LEAK.

THIS IS REALLY A SOCIETAL PROBLEM.

IT IS GOING TO TAKE NOT JUST GOVERNMENT.

IT'S GOING TO TAKE OUR FAMILIES, OUR SCHOOLS, OUR CHURCH, ANYBODY IN BUSINESSES, ANYBODY ANYWHERE THAT HAVE PEOPLE TO HELP A LOT OF THESE FOLKS THROUGH THIS.

AND UNFORTUNATELY IT'S GOING TO BE SOMETHING WE CAN DIMINISH BUT GOING TO CONTINUE TO BE OUT THERE.

EVERY COUNTRY AND STATE IS HANDLING IT IN DIFFERENT WAYS BUT IT'S SADDENS ME TO HEAR THE NUMBERS GO UP.

IT'S VERY DIFFICULT AND WE TRY TO KEEP DOING THINGS AND I THINK WE ALL HOPE EVENTUALLY WE ARE GOING TO GET THE BUCKET WHERE IT CAN HOLD WATER BUT IF WE CAN GET POINT THAT IT HOLD WATER FOR A LONGER PERIOD OF TIME, WE WILL BE BETTER OFF $LEADER JENKINS, THANK YOU FOR BEING ON THIS PROGRAM.

I KNOW THIS IS A VERY PERSONAL ISSUE FOR YOU BECAUSE OF A NEPHEW LOST.

IF YOU WOULD LIKE TO SHARE THAT EXPERIENCE WITH US, I WILL ALLOW THAT TIME AND WHY THIS ISSUE HAS BEEN SO IMPORTANT FOR YOU BECAUSE YOU HAVE BEEN AROUND FOR A WHILE AND WORKED BACK ON THIS ISSUE IN 2013, ET CETERA.

TELL US ABOUT THAT.

>> WELL, THANK YOU.

ARE YOU WOULD THINK AFTER NINE YEARS IT GET EASIER BUT IT DOESN'T.

I LOST A NEPHEW WHO WAS 23.

NINE YEARS AGO.

MEMORIAL DAY WEEKEND.

HE WAS A GREAT KID.

HE WAS A WORLD CHAMPION BASEBALL PLAYER.

JUST THE LIGHT OF OUR LIVES AND WHEN 3 HE WAS PRESCRIBED MEDICATIONS FOR WISDOM TEETH, HE BECAME ADICKED TO OPIOIDS AND GRADUATED TO HEROIN.

WAS IN AND OUT OF TREATMENT HAD BEEN CLEAN FOR A WHILE AND WENT BACK THAT ONE LAST TIME, WHICH WE SEE HAPPEN SO OFTEN.

AND FROM OUR FAMILY'S EXPERIENCE, CAME THE LEGISLATION FROM 2015 BECAUSE HE DIED IN THE FRONT YARD AND NOBODY CALLED THE COPS.

SO WE THOUGHT IT WAS IMPORTANT TO HAVE A GOOD SAMARITAN LAW IN THE 2015 LAW.

NARL NARCAN WAS JUST STARTING TO BE TALKED ABOUT IN 2013 AND SO PART OF OUR QUEST WAS TO MAKE SURE THAT THAT WAS VERY AVAILABLE AND THROUGH THE YEARS WE HAVE DONE, TO MAKE IT VERY, VERY AVAILABLE FOR FOLKS.

AND TO MAKE SURE THAT IF ANYBODY IS ADMINISTERING IT, THAT THERE IS NO LIABILITY WITH IT.

EVEN IF YOU USE IT INCORRECTLY, YOU CAN'T HURT ANYBODY.

IN FACT, THE HOUSE DEMOCRATS WERE ALL TRAINED TO USE NARCAN AND WE ARE ALL CARRYING IT WITH US IN CASE WE SEE SOMEBODY IN DISTRESS.

WE DID SOME WORK ABOUT WOMEN WHO ARE ADDICTED AND PREGNANT.

DID SOME IMPORTANT WORK WITH THAT THAT HAS CONTINUED ON, D.O.A.

HAS A WONDERFUL JOB WITH REGULAR MANT WOMEN.

SO OUT OF THAT PERSONAL TRAGEDY, I THINK, AS PART OF MY OWN PERSONAL HEALING, IT WAS VERY IMPORTANT FOR ME TO SEE THOSE CHANGES $NEEDLE EXCHANGE, HARM REDUCTION.

IF WE CAN TALK ABOUT HARM REDUCTION, YOU KNOW, THAT WAS VERY CONTROVERSIAL.

I REMEMBER THAT NIGHT THAT BILL PASSED.

BUT NOW LOOK HOW FAR WE'VE COME IN EMBRACING THINGS THAT WE THOUGHT WERE MORE TABOO BACK THEN.

>> I THINK KENTUCKY HAS REALLY STEPPED UP AND WE HAVE MORE NEEDLE EXCHANGES THROUGHOUT THE STATE THAN I THINK ALMOST ANY OTHER STATE.

AND WE CAN'T EVEN QUANTIFY HOW MANY LIVES WE HAVE SAVED, HOW MANY HEP-C CASES WE HAVE AVOIDED, H.I.V.

CASES, BAD SEPTIC AND I WAS SO HONORED TO GO AND WATCH HOW THE NEEDLE EXCHANGE IN LOUISVILLE WORKED AND SEE THESE PROFESSIONALS THAT BROUGHT FOLKS IN AND TREAT THEM LIKE HUMAN BEINGS AND BE SO CARING AND GENTLE WITH THEM.

WE KNOW FOLKS THAT REACH OUT FOR THAT TYPE OF SERVICE, ARE TWO TIMES MORE LIKELY TO GO INTO TREATMENT AND MORE LIKELY TO BE SUCCESSFUL.

>> THAT WAS PART OF THE NEEDLE EXCHANGE PROGRAM.

THAT THEY WOULD BE GIVEN INFORMATION ABOUT TREATMENT AND REHABILITATION, RIGHT?

AND NOT THE ENABLER THAT IT WAS SUSPECTED AT THE TIME.

>> RIGHT.

>> .

WELL, WE ARE GLAD TO HAVE MISS TIFFANY HALL HERE, VOLUNTEERS OF AMERICA.

TELL US ABOUT YOUR ORGANIZATION AND WE'LL TALK MORE ABOUT EVEN SOME ANNOUNCEMENTS TODAY WITH THE GOVERNOR ABOUT THESE RECOVERY EFFORTS, BUT TELL US WHAT VOA DOES AND HOW YOU ARE HELPING TO WAGE THE BATTLE AGAINST OPIOID ADDICTION?

>> THANK YOU VERY MUCH FOR HAVING US HERE.

V.O.A.

HAS BEEN AROUND FAIRWAY A LONG TIME AND WE REALLY HAVE AN INTEGRATED MODEL OF CARE WHERE WE NOT ONLY REALLY DO SUBSTANCE USE SUBSTANCE USE DISORDER IN THE COMMUNITIES WE ARE IN BUT WE HAVE A LONG HISTORY IN WORKING WITH COMMUNITY HEALTH SPACE, IN HOMELESS AND HOUSING AND PREVENTION EFFORTS AND SOME OTHER PIECES OF THE PUZZLE.

I THINK, IN MY OPINION, THIS IS WHERE KENTUCKY SHINES WHEN I THINK ABOUT REALLY WHAT I CALL POLICY INFORMED PRACTICE AND PRACTICE INFORMED POLICY.

WHEN I THINK ABOUT HOW WE REALIZE THAT ONE SIZE DOESN'T FIT ALL THE DECISION MAKERS REALIZE THAT AND PRACTITIONERS AND WE ARE ABLE TO OFFER REALLY A LARGE ARRAY OF SERVICES TO FOLKS WHEREVER THEY ARE IN THE CONTINUUM.

OF CHANGE $AND FOR PREGNANT WOMEN.

HOW IMPORTANT THAT IS AND THE SUCCESS OF THAT SO THAT THESE WOMEN CAN HAVE SUCCESSFUL PREGNANCIES AND HOPEFULLY VERY HEALTHY BABIES.

>> WE ARE ALMOST AT OUR 300th BABY BORN HEALTHY AND NOT, WITH NO NICU STAY, WITH NOW THE AN N.A.S.

DIAGNOSIS.

IT'S PRETTY EXCITING.

WE HAVE BEEN AROUND-- WE HAVE HAD THE FREEDOM HOUSE MODEL SINCE 1993.

OBVIOUSLY IN 2015 OR 16, THE NEED FOR IT BLOW UP AND SO WE WENT FROM AN EIGHT TO 10 BED PROGRAM THAT WE QUIETLY RAN FOR A LONG TIME IN LOUISVILLE, TO DOUBLING AND TRIP TRIPLING AND GRAWD RUP WILLING AND REPLICATING OUR MODEL IN SOUTHEAST KENTUCKY AND WE ARE ABLE TO REPLICATE AND GROW MORE SO EVER THE NEXT COUPLE OF YEARS WE ARE GOING TO ADD FOUR MORE LOCATIONS THROUGHOUT STATE.

AND SO IT ALLOWS THE MODEL THAT ALLOWS MOMS TO COME IN PREGNANT, POST-PARTUM OR PARENTING, REALLY TARGETING THAT PREGNANT MOM, WHERE WE BRING THE WHOLE FAMILY IN OR WE WORK-- WE HELP MOM WORK TO GET, TO REUNIFY WITH THE KIDDOS IF SHE DOESN'T HAVE CUSTODY OF HER KIDS, REALLY WORKING CLOSELY WITH THE CABINET AND TRYING TO GET KIDS BACK INTO HER CARE AS SOON AS POSSIBLE.

SO SHE CAN HAVE ALL OF HER CHILDREN THERE NO MATTER WHAT THE AGE AND NO MATTER HOW MANY KIDS THAT SHE HAS.

SO REALLY TREATING THAT FAMILY UNIT AND THAT TRAUMA REALLY AS A FAMILY UNIT $WE COULD TALK ABOUT THAT TRAUMA THAT THE WHOLE FAMILY ENDURES, RIGHT, WHEN THERE IS ONE WHO IS SUFFERING FROM ADDICTION.

Mr. ROBINSON, THANK YOU FOR BEING WITH US.

WE ARE GLAD TO HAVE YOU WITH ARC, I'M SURE EVERYBODY ABBREVIATES IT.

EXPLAIN WHAT IT IS AS YOU ARE THE FOUNDER AND C.E.O.

YOU HAVE A PERSONAL STORY AND CONNECTION TO THIS ISSUE, TOO, THAT I HOPE WILL YOU SHARE WITH OUR AUDIENCE.

>> THANK YOU FOR CONVENING THIS VERY IMPORTANT CONVERSATION.

IT'S IMPACTING THE COMMONWEALTH AND IMPACTING US NATIONALLY.

WE LOST 2250 OF OUR NEIGHBORS IN KENTUCKY.

BUT LAST YEAR WE LOST 100,000 AMERICANS.

THESE ARE FOLKS, THESE ARE THEIR SONS, THEIR NEPHEWS, SIBLINGS.

AND SO THIS CONVERSATION IS VERY IMPORTANT.

AND FOR ME, THIS WORK IS PERSONAL.

THIS DECEMBER I CELEBRATED 15 YEARS OF SOBRIETY.

>> CONGRATULATIONS.

>> I WASN'T-- I WASN'T THE TYPICAL PROFILE FOR SOMEBODY HAT WOULD END UP IN ADDICTION.

I GREW UP IN A CONSERVATIVE HOME, WITH A DAD THAT WENT TO WORK EVERY DAY.

I HAD AN EDUCATION.

I WAS AN ATTORNEY, BUT I ALSO HAD A SECRET THAT I WAS DRINKING MYSELF TO DEATH AND MY LIFE CHANGED 15 YEARS AGO.

AND BECAUSE OF MY FAITH AND BECAUSE OF ALL KINDS OF FOLKS WHO HELPED LOVE ME BACK TO LIFE, I GOT SOBER AND ONE OF THE HALLMARKS OF RECOVERY IS TO GIVE AWAY WHAT HAS BEEN GIVEN TO YOU.

AND SO I HAVE BEEN BLESSED THESE LAST SEVERAL YEARS TO GET TO START AND LEAD ARC.

TODAY WE HAVE ABOUT 35 TREATMENT CENTER AS ROUND THE STATE, ABOUT 1100 EMPLOYEES OF THOSE 1100 EMPLOYEES, HALF OF OUR WORKFORCE ARE IN RECOVERY.

THEY'RE PROOF POSITIVE THAT SECOND CHANCE EMEMPLOYMENT OR FAIR CHANCE EMPLOYMENT WORKS, THAT PEOPLE THAT ARE IN RECOVERY MAKE GREAT WORKERS.

THAT'S ONE OF THE THINGS THAT WE HAVE TRIED TO REALLY FOCUS ON AT ARC IS YES, WE DO WORLD CLASS TREATMENT, RECOVERY, BUT PEOPLE NEED A WAY TO MAKE A LIVING.

AND FOR A LOT OF FOLKS, THEY HAVE CRASHED THEIR ECONOMIC OPPORTUNITY.

OUR NATION IS AT A FOUR-YEAR WORKFORCE PARTICIPATION LOW N. OUR STATE, I ESTIMATE THAT WE HAVE OVER HALF A MILLION PEOPLE WITH SUBSTANCE USE DISORDER AND SO A LOT OF OUR OWN WORKFORCE PARTICIPATION ISSUES ARE CAUGHT UP IN THIS ADDICTION PROBLEM.

AND SO THAT'S ONE OF THE THINGS WE'VE TRIED TO DO IS NOT ONLY TO CREATE THE TREATMENT OPPORTUNITIES BUT VOCATIONAL REHABILITATION, JOB TRAINING AND HELP TAKE PEOPLE FROM THEIR CRISIS TO CAREER.

AND I THINK THAT HAS TO BE PART OF OUR STRATEGY.

>> CRIES TOYS CAREER.

I LIKE THAT.

DRIES-- CRISIS TO ACEER.

I LIKE THAT.

BUT THERE ARE PROBABLY MOMENTS OF RELAPSE.

IT'S NOT A FOREGONE CONCLUSION BUT RECOVERY IS POSSIBLE AND SUSTAINABLE.

BUT CAN YOU TALK TO US ABOUT THE EXPERIENCE OF TRYING REALLY HARD AND THEN JUST...

FALLING.

>> SOMETIMES THE PROBLEMS SEEM SO DAUNTING AND HOPELESS BECAUSE SOMETIMES IT TAKES A WHILE.

SOMETIMES IT TAKES SEVERAL TIMES IN TREATMENT.

SOMETIMES IT TAKES SOME FALL DOWNS TO GET BACK UP AND STAY UP.

AND SO WE DO HAVE TO GIVE SECOND CHANCES AND THIRD CHANCES AND FOURTH DOWN CHANCES.

BUT RECOVERY IS POSSIBLE.

I SEE IT EVERY DAY.

I WALK AROUND THE HALL AND MY OFFICE AND I SEE CORPORATE EXECUTIVES NOW THAT USED TO BE OPIOID USERS.

MY NUMBER TWO AT OUR COMPANY WAS A 300-MILLIGRAM OXYCODONE USER.

FOR PEOPLE OUT THERE, I DON'T WANT PEOPLE TO LOOK AT THIS AS HOPELESS.

WE ARE IN A STATE THAT YES, WE HAD SOME UPSETTING NUMBERS COME OUT TODAY.

BUT WE MAY BE GROUND ZERO OF THIS PROBLEM BUT WE HAVE BEEN TBROWRS FOR A LOT OF NATIONAL SOLUTIONS AND THE NATION IS LOOKING AT OUR COMMONWEALTH BECAUSE WE HAVE FORGED ISSUES.

WE HAVE FORGE SOLUTIONS TO THESE PROBLEMS AND SO IT'S NOT HOPELESS.

AND IT'S NOT HOPELESS FOR OUR STATE BECAUSE WE ARE GOOD WHAT THE WE ARE DOING AND WE ARE GETTING BETTER AT IT.

WE ARE LEARNING.

WE ARE INNOVATING AND WE ARE GOING TO COME OUT OF THIS $I WANT TO GO BACK TO YOU Mr. INGRAM TO TALK ABOUT THE AGE CATEGORIES WHERE, YOU KNOW, THE OVERDOSE FATALITY RATE IS THE HIGHEST.

I THINK IT'S 25-34.

>> 35-44 THIS YEAR.

$AND IT HAS BEEN THAT SAME CATEGORY FOR A WHILE NOW OR DOES IT EBB AND FLOW.

>> 45-54 FOR A WHILE WAS OUR BIGGEST AGE FACTOR.

AND IT'S GONE BACK AND FORTH BETWEEN 35 AND 44 SINCE THEN.

THOSE TWO GROUPS CHANGE OUT BACK AND FORTH, IT SEEMS LIKE EVERY YEAR.

BUT IT WAS A MAJOR INCREASE THIS YEAR IN THAT AGE GROUP.

AND ANOTHER THING THAT WAS DISTURBING IS IF YOU LOOK FROM 2019 TO 2021, WE DOUBLED IN AFRICAN-AMERICAN OVERDOSE DEATHS $ANY EXPLANATION FOR THAT?

OR.

>> THE SAME FENTANYL EQUATION BECAUSE OVERDOSE DEATHS ARE GOING WAY UP OVERALL.

IT STAND TO REASON IT WOULD GO UP IN THAT POPULATION AS WELL BUT IT JUST SEEMS LIKE A LARGER INCREASE THAN IT SHOULD BE SO, THE DEMOGRAPHICS, YOU KNOW, THEY'RE RICH, THEY'RE POOR, THEY'RE BLACK, THEY'RE WHITE, EDUCATED, UNEDUCATED $I WANT TO TALK ABOUT GEOGRAPHY WOE KNOW AT EASTERN KENTUCKY, WESTERN KENTUCKY AND JEFFERSON COUNTY HAS THE HIGHEST FENTANYL DEATH.

CAN YOU EXPLAIN THE SIM PLAIRTS-- SIMILARITIES.

>> CENTRAL KENTUCKY IN 2021, THE SECOND HIGHEST YOU ARE MOVING NORTH.

KENTON COUNTY.

>> Renee: AND HARRY COUNTY.

>> GOING EAST.

STILL A PROBLEM IN WESTERN KENTUCKY BUT NOT TO THE DEGREE WE HAVE SEEN IN CENTRAL AND EASTERN KENTUCKY.

IT'S A STATEWIDE ISSUE REALLY.

SOME OF THE SMALLER COUNTIES, THEIR NUMBER LOOKS HIGHER THAN IT COULD BE BECAUSE 12 DEATHS IN A COUNTY OF 10,000 PEOPLE IS MUCH MORE-- IT'S GOING TO SHOW UP HIGHER PER CAPITA.

>> Renee: THAT'S RIGHT.

BECAUSE PERRY, THE RATE OF DRUG OVERDOSE DEATHS PER ONE HAD YOU BEEN,000 RESIDENTS IS 141.

YOU KNOW, BUT 35 NUMBER OF DRUG OVERDOSE DEATHS WHICH IS HIGHER THAN 22, THAT EXPLAINS SOME OF THAT.

WHAT DO YOU TAKE AWAY, LEADER JENKINS, WHEN YOU LOOK AT JEFFERSON COUNTY.

THESE ARE DRUG OVERDOSES, THE DEATHS INVOLVING FENTANYL.

3477.

SO THIS GOES TO THAT PREVALENCE OF FENTANYL AND PERHAPS I'M MAKING AN ASSUMPTION HERE, THE SKEW OF THE AFRICAN-AMERICAN NUMBERS BEING HIGHER.

CAN YOU MAKE ANY EXPLANATION THERE?

>> I THINK IT'S THE AVAILABILITY OF THE DRUG THAT WE ARE SEEING MORE AND MORE PEOPLE HAVE ACCESS TO IT.

>> Renee: AND HOW ARE THEY GETTING ACCESS TO IT?

>> WELL, THROUGH PEDDLERS ON THE STREET.

I MEAN IF YOU ARE LOOKING FOR THE DRUG IN ALMOST ANY COUNTY, JEFFERSON COUNTY INCLUDED, YOU DON'T HAVE TO LOOK VERY FAR TO FIND THE DRUGS.

THE CARTELS ARE VERY GOOD WHAT THE THEY DO.

THEY HAVE BEEN MOVING DRUGS ACROSS THIS COUNTRY FOR 40 YEARS AND MAYBE THE DRUGS CHANGE, BUT BUSINESS OPERATIONS ARE THE SAME.

LOOK AT FENTANYL FROM A LOGISTIC STANDPOINT, IT'S 10 TIMES MORE POWERFUL THAN HEROIN, I ONE POUND OF FENTANYL, IT TOOK 10 POUNDS OF HEROIN TO DO SO IT'S A BUSINESS MODEL THAT'S GOING TO BE AROUND AS LONG AS THEY GET PRECURSORS, THERE IS NOT GOING TO CHANGE.

>> I THINK WE FIND PEOPLE PEDDLING OR SELLING, THEY'RE NOT THE BIG GUYS BUT THEY'RE SUSTAINING THEIR OWN ADDICTION.

>> Renee: KENTUCKY HAS MADE THE DISTINCTION BETWEEN THOSE WHO SURF FROM ADDICTION AND SUBSTANCE USE DISORDER VERSUS THOSE WHO ARE REAF TRAFFICKERS, CORRECT?

>> THERE WAS A BILL IN THE PAST SESSION THE GOVERNOR SIGNED THAT INCREASED PENALTIES FOR AGGRAVATED TRAFFICKING OF FENTANYL.

VERY SMALL AMOUNTS WOULD NOT BE I AM PACKED BY THAT.

85% SERVEOUT BUT AGGRAVATED TRAFFICKING WHERE IT WAS A HIGHER AMOUNT, WOULD BE IMPACTED.

>> Renee: SERVING 85% OF THE SENTENCE WOULD BE AUTOMATIC THERE.

I WANT TO GO TO YOU SENATOR ALVARADO, FROM A PHYSICIAN'S PERSPECTIVE AND YOU MENTION YOU HAVE PATIENTS YOU DEALT WITH WHO WERE OR DEALING WITH THIS ISSUE.

WHAT MORE CAN BE DONE.

YOU CAN AGGRAVATE OFFENSES AND DO ALL OF THAT AND WE TALK ABOUT HOW DO WE SOLVE OUR MASS INCARCERATION PROBLEM.

ALL OF THIS STUFF IS VERY WELL CONNECTED BUT HOW DO YOU PREVENT THE ABUSE FROM HAPPENING TO BEGIN WITH?

IS THERE SOMETHING THAT LAWMAKERS ARE MISSING THERE THAT CAN STAVE IT OFF BEFORE IT STARTS?

>> YEAH, I THINK WE'VE PASSED A LOT OF LAWS TO RESTRICT PROVIDERS IN TERMS OF HOW MUCH THEY CAN PRESCRIBE.

THIS COMES TO PRESCRIPTION DRUGS AND WE ALL KNOW THE STORIES OF OXYCONTIN, THE LAWSUITS THAT HAVE COME DOWN NOW.

WE HAVE BEEN PARTICIPATING IN AND OUR ATTORNEY GENERAL HAS BEEN ABLE TO GET A LOT OF FUNDS FROM THOSE COMPANIES.

A LOT OF LAWS HAVE BEEN PASSED TO RESTRICT KIND OF SHORT-TERM NARCOTICS SO I THINK IF YOU ARE IN AN E.R., YOU ARE A DOCTOR, YOU PRESCRIBE THREE DAYS WORTH.

THERE WAS A LOT OF DEBATE SHOULD IT BE THREE, SEVEN.

OUR CASPER SYSTEM WHICH HAS BEEN A GOLD STANDARD FOR A LONG TIME ALREADY ELECTRONICALLY TRACKS.

>> EVERY TIME YOU WRITE A PRESCRIPTION AS A PHYSICIAN, IT GOES IN AND TRACK THE PROVIDER, THE PERSON RECEIVING THE MEDICATION, IFFYY HAVE TO HAVE IDENTIFICATION FOR THAT AND DOCTORS YOU NOW REQUIRED TO CHECK THAT.

BACK IN 2011 WE PASSED A BILL, FAMOUS BILL THAT A DOCTOR LIKE ME WHO WOULD PRESCRIBE SOME OF THESE THINGS RESPONSIBLY SUCH STIFF PENALTIES THAT I STOPPED WRITING EVERYTHING.

A LOT OF DOCTORS STOPPED WRITING EVEN BACK THEN.

IT HAS HAD THE DESIRED EFFECT.

A LOT OF PHYSICIAN WRITE A LOT LESS.

I RUN THE NUMBERS EVERY YEAR TO SEE WHERE PHYSICIANS ARE WRITING LESS AND LESS OF THE MEDICATIONS, A LOT OF OPIOIDS.

REDUCTION IN THE OVERALL NUMBER OF PRESCRIPTION PRESCRIBED BUT AS PROVIDERS ARE LEARNING, WEARIED INDICATING DOCTORS, AT THE UNIVERSITY OF KENTUCKY, TRAUMA SYSTEM, THEY'RE TEACHING THEIR RESIDENTS NOW, SOMEONE COMES IN WITH TRAUMATIC INJURIES, MAJOR GRABBING TURS, YOU WOULD THINK A LOT OF PAIN, THEY'RE USING I.V.

TYLENOL AND IBUPROFEN AND GETTING GOOD RESULTS AND PEOPLE ARE BEING DISCHARGED INSTEAD OF NARCOTICS.

I THINK AS PHYSICIANS WE ARE LEARNING MORE ABOUT HOW THE PROBLEM WORKS.

IT HAS BEEN A PROBLEM THAT HAS BEEN AROUND A LONG TIME BUT WE ARE LEARNING ABOUT HOW THE BRAIN IS WIRED, HOW PEOPLE RESPOND.

CAN WE USE OTHER MEDICATION ARE AVAILABLE FOR THAT.

TEACHING NEW RESIDENTS, WE HAVE MADE IT TOUGHER FOR DOCTORS PRESCRIBING IT.

WE HAVE A BOARD OF MEDICAL LICENSURE AND NURSING TO TRACK THE BAD PROVIDERS TO MAKE SURE WE DON'T LET THEM GET OUT AND PRACTICE MEDICINE OR NURSING IN THE STATE.

A LOT OF EFFORTS HAVE BEEN PUT FORTH BY THE GENERAL ASSEMBLY TO REIN THAT IN.

>> Renee: THERE HAS BEEN CONCERN BY THOSE WHO SUFFER FROM RHEUMATOID ARTHRITIS FOR WHICH OPIOID IS A RELIEF FOR THEM AND THEIR SOURCE OF PAIN MANAGEMENT.

THERE IS EVER A CONCERN ABOUT THE PENDULUM SWINGING THE OTHER DIRECTION WHERE PEOPLE CAN'T GET THE RELIEF THEY NEED NOT BECAUSE THEY'RE SUFFERING FROM AN ADDICTION BUT PAIN MANAGEMENT FOR CHRONIC ILLNESS.

>> I WAS IN THE GENERAL ASSEMBLY WHEN THAT BILL WAS PASSED.

I WAS CRITICAL OF THAT WHEN IT WAS PASSED BECAUSE I DID THINGS THE RIGHT WAY.

A LOT OF PROVIDERS I WORKED WITH DID THINGS THE RIGHT WAY.

AND IT WAS SUCH A STIFF-- I MEAN THE WAY IT WAS PASSED, A LOT OF MEDICAL PROVIDERS SAY YOU ARE THROWING THE BABY OUT WITH THE BATH WATER AND WE DID WITH A LOT OF THAT.

WE HAD TO COME BACK NINE MONTHS LATER TO FIX THE UNINTENDED CONSEQUENCES OF A LOTTED OF BILLS WE PASS BUT IT WOULDN'T HAVE ALLOWED TREATMENT FOR CANCER PATIENTS.

IT PUT RESTRICTIONS ON HOSPICE.

A LOT OF THE LAWS WERE CHANGED TO ALLOW THOSE KINDS OF USES FOR FOLKS.

BUT STILL THE PENALTIES ARE PRETTY STIFF THAT IF A PROVIDER DOESN'T DO SOMETHING APPROPRIATELY AND DOCUMENT APPROPRIATELY, YOU ARE LOOKING AT THE LOSS OF A LICENSE AND A CRIMINAL CHARGE.

YOU COULD SERVE PRISON TIME FOR THE THINGS THERE.

A LOT OF DOCTORS ARE VERY LEERY AND AS WE ARE TRAINING NEW PHYSICIANS COMING OUT, A DIFFERENT APPROACH WE ARE ENCOUNTERING BUT IT'S ON THE BACK OF EVERY PHYSICIAN'S MIND FOR THE MOST PART.

THERE ARE SOME THAT OVER PRESCRIBE ESPECIALLY POST-OP TIFF CARE.

THEY WANT PEOPLE TO BE COMFORTABLE BUT AS YOU'VE HEARD, A LOT OF DENTAL PROCEDURES, PEOPLE GET THOSE AND I CAN REMEMBER TWO PATIENTS I HAD WHO RELATED WHO CAME TO SEE ME WHO WERE DOING VERY WELL FINANCIALLY AND CAME IN AND SAID WE ARE LOSING HALF OF OUR SALARY BY BUYING OXYCONTIN AND OXYCODONE ON THE STREET.

THE SOURCE OF IT WAS A DENTAL PROCEDURE.

I TOOK IT.

I FELT GREAT WHEN I TOOK THAT.

WENT BACK FOR A REFILL.

GOT A SECOND REFILL AND THEY SAID NO, I'M NOT GOING TO GIVE YOU ANYMORE AND THEY STARTED GETTING IT ON THE STREET AND ENHANCING IT WITH ALCOHOL AND PRETTY SOON THEY WERE ON 240 MILLIGRAMS OF OXYCODONE AND SAYING CAN YOU PLEASE HELP ME GET OFF OF THIS.

THOSE STORIES ARE UNFORTUNATELY FAIRLY COMMON AND OFTEN QUIET, PEOPLE THAT ARE FUNCTIONAL WITH THOSE KINDS OF ADDICTIONS.

AND THEY GET TO THE POINT WHERE THEY REALIZE THEY CAN'T FINANCIALLY AFFORD IT OR THEY HAVE AN EVENT WHERE THEY OVERDOSE AND IT SCARES THEM AND FAMILIES HAVE NOTICED IT AND CASEY'S LAW WE PASSED FAMILIES CAN USE THAT, I HAVE A LOVED ONE WHO I THINK IS AT RISK OF DYING OR CAUSING AN INJURY TO SOMEONE ELSE AND THEY'LL STEP IN.

WE'VE PASSED THAT ACE LAW.

>> Renee: AND TWEAKED IT IN THE LAST LEGISLATIVE SESSION.

I WANT TO GO TO MIZ HALL AND Mr. ROBINSON TO TALK ABOUT THE METHODOLOGY THAT YOU USE TO HELP PEOPLE GET ON A PATH TO RECOVERY THAT IS SUCCESSFUL AND SUSTAINABLE AND WHAT DOES THAT LOOK LIKE AND WHAT IS IT A MIXTURE OF?

I'M SURE IT'S NOT JUST ONE SILVER BULLET, RIGHT; THAT THERE IS A LOT OF THINGS THAT HELP THAT PERSON AND INDIVIDUALIZED, TO THAT PERSON.

>> RIGHT.

YEAH, SO FOR US, WE ASSESS EVERYBODY THAT COMES IN.

WE USE DRIETIA-- CRITERIA, AMERICAN SOCIETY OF ADDICTION MEDICINE.

WE WERE THE FIRST IN KENTUCKY DURING A PILOT PHASE TO BE THE FIRST ADDICTION RECOVERY PROVIDER TO GET CERTIFIED IN THAT AND SO WE DETERMINE WHAT LEVEL OF CARE THEY NEED AND WE DETERMINE WITH THEM AND REALLY WITH THEIR REFERRAL SOURCE AND ALL THE PEOPLE INVOLVED IN THEIR CARE AND THAT COULD BE USUALLY A C.P.S.

WORKER, A CHILD PROTECTIVE SERVICE WORKER, OFTEN TIMES A PROBATION AND PAROLE OFFICER, SOMETIMES A FAMILY MEMBER.

WHOEVER THE CLIENT DETERMINES IS PART OF THEIR TEAM.

AND WE REALLY TRY TO COME UP WITH THE BEST TREATMENT PLAN, INTEGRATED TREATMENT PLAN POSSIBLE TO REALLY ADDRESS ALL OF THESE ISSUES.

I LIKE SAY THAT TRAUMA IS THE REAL GATEWAY DRUG, RIGHT?

WE REALLY ARE SEEING PEOPLE THROUGH THE LENS OF TRAUMA.

THEY JUST HAPPEN TO COME IN THE SUBSTANCE USE DOOR.

SO WE TREAT IT AS SUCH.

WE TRY TO REALLY GET AT THE CORE, THE STORIES THAT WE'VE HEARD ABOUT SOMEONE NOT HAVING A HISTORY AND THEN BEING PRESCRIBED SOMETHING AND LIKING THE WAY IT FEELS, TYPICALLY THAT IS TO NUMB SOMETHING THAT HAS BEEN THERE.

IT'S ALSO MORE TYPICAL FOR OUR CLIENTS, THAT THEY HAVE REALLY GENERATIONAL ADDICTION AND GENERATIONAL POVERTY.

AND THAT IS THE STORY OF OUR TYPICAL CLIENT.

AND THAT IS MORE COMPLICATED, RIGHT?

AND SO REALLY DIGGING IT INTO THE CORE ISSUES SO THAT IS THROUGH WE REALLY HAVE A HABIT APPROACH, WE HAVE A CLINICAL CREDENTIALED STAFF AND WE HAVE PEER SUPPORT SPECIALISTS.

WE BELIEVE THAT IT TAKES BOTH OF THOSE, REALLY WORKING TOGETHER TO ADDRESS SOMEONE AND HELP ADDRESS SOMEONE'S ISSUES, INCLUDING ADDRESSING THEIR CHILD'S ISSUES AS WELL.

>> Renee: MENTAL HEALTH COMPONENT, Mr. ROBINSON, WE HAVE CALLED IT CO-OCCURRING DEPENDENCIES OR DIAGNOSIS, RIGHT, THAT YOU HAVE SOMEONE WHO IS OR DEALING WITH SUBSTANCE USE SUBSTANCE USE DISORDER AND A MENTAL HEALTH CHALLENGE AT THE SAME TIME.

CAN YOU TALK ABOUT HOW THOSE OFTEN GO HAND IN HAND?

>> YOU KNOW, ONE OF THE THINGS THAT THE PANDEMIC DID WAS EXAS-- WAS EXASPERATE THAT.

THERE A FAMOUS TED TALK THAT SAID THE OPPOSITE OF ADDICTION IS CONNECTION.

AND PART OF HOW YOU HEAL FROM ADDICTION IS IN HEALTHY COMMUNITY.

AND THAT'S ONE OF THE THINGS THAT HAPPENED.

OUR A.A.

MEETINGS SHUT DOWN AND CHURCHES SHUT DOWN, RECOVERY SHUT DOWN SO THAT CREATED THAT PERFECT STORM THAT ALLOWS MENTAL HEALTH ISSUES TO JUST HAVE THEIR WAY WITH PEOPLE BECAUSE OF THE ISOLATION.

AND IT IS A BIG CHALLENGE.

AND ONE OF THE THINGS THAT WE ARE SEEING ALONG THOSE LINES IS YES, WE HAVE THIS OPIOID PROBLEM AND FENTANYL IS KILLING A LOT OF PEOPLE.

BUT IN THE NUMBERS THAT JUST COME OUT, ALMOST HALF THE PEOPLE THAT PASSED AWAY HAD METH IN THEIR SYSTEM AND MOST OF THOSE FOLKS PROBABLY THOUGHT THEY WERE TAKING METH THAT THEY ACTUALLY GOT METH LACED WITH FENTANYL.

ONE OF THE THINGS WITH METH IS TODAY WE DON'T HAVE MEDICALLY ASSIST TODAY TREATMENT FDA APPROVED FOR METH TREATMENT.

SO IN OUR CENTERS IN 2015, AND WE'LL TREAT 25,000 PLUS PEOPLE THIS YEAR.

IN 2015, 4% OF THE PEOPLE WERE USING METH.

TODAY, IN 2020 THAT NUMBER IS 35%.

SO NOW PEOPLE MAY BE THINKING THEY'RE TAKING METH AND IT'S SAFER BUT NOW IT'S LACED WITH FENTANYL AND THE PLB WITH METH IS, LONG-TERM METH USE, YOU GET IN WHAT THEY CALL METH PSYCHOS.

SO WHEN YOU COME-- SO COMPANIES IS AND SO WHEN YOU COME TO TREATMENT, YOU PRESENT AND IT'S HARD FOR PEOPLE TO SOT OUT IF YOU ARE PARANOID SCIZ SCHIZOPHRENIC OR OTHER MENTAL HEALTH DISORDERS AND WE ARE SEEING MORE AND MORE METH.

IT'S CONTINUING TO INCREASE.

THAT ADDS A WHOLE OTHER CHALLENGE TO DIAGNOSE SOMEONE.

THAT'S WHY AT ARC WE HAVE ADDED ADDICTION PSYCHIATRISTS BEHAVIORAL HEALTH PSYCHIATRIC NURSE PRACTITIONERS, IN ADDITION TO ALL THE COUNSELORS AND IT'S A HUGE PROBLEM IN OUR STATE THAT WE NEED MORE PROVIDERS BECAUSE WE ARE BLESSED WITH ACCESS TO TREATMENT.

ONE OF THE THINGS THAT VAN AND OTHERS HAVE WORKED ON FOR TWO DECADES IS GETTING US TO A PLACE WHERE WE HAVE TREATMENT ON DEMAND AND WE HAVE THAT IN KENTUCKY.

WE HAVE PHENOMENAL ACCESS.

BUT BECAUSE OF THAT WE HAVE A MENTAL HEALTH PROFESSIONAL SHORTAGE.

WE DON'T HAVE ENOUGH PSYCHIATRISTS, ESPECIALLY IN RURAL AREAS.

WE DON'T HAVE ENOUGH COUNSELORS, A LOT OF THESE PROFESSIONALS WE NEED BECAUSE WE DO HAVE ACCESS.

AND IF SOMEBODY IS OUT THERE STRUGGLING, THERE IS ACCESS IN THE STATE FOR ANYBODY THAT WANTS HELP, WE HAVE ACCESS NOW AND THERE IS ALMOST TREATMENT ON DEMAND.

>> Renee: I WANT TO YOU GET TO THAT ISSUE ABOUT METH BECAUSE WE HEARD THIS WAS AN ISSUE THAT WAS HAPPENING LOUISVILLE WEST, RIGHT?

IS THAT THE CASE?

>> NO.

IT'S STATEWIDE.

I'VE SEEN IT IN NORTHEASTERN AND SOUTH WESTERN KENTUCKY.

THE CARTELS HAVE FLOODED THE UNITED STATES WITH REALLY CHEAP POTENT METED AMPHETAMINE.

IF YOU REMEMBER WHEN I STARTED 15, 16 YEARS AGO WE WERE TALKING ABOUT METH LABS ALL OVER THE STATE.

>> Renee: THE MOBILE METH LABBED IN CARS WITH PEOPLE AND EXPLOAT EXPLODING.

>> HOW THE CARTELS ARE SELLING IT CHEAPER THAN YOU CAN BUY INGREDIENTS TO MAKE IT YOURSELF.

THE UNITED STATES IS FLOODED WITH THIS VERY POTENT DEATH.

SAM IN HIS BOOK "THE LEAST AMONG US" TALKS ABOUT HOW THIS METH IS DIFFERENCE.

IT'S MORE OF A MENTAL HEALTH CHALLENGE AS TIM ALLUDED TO.

WE SEE IT IN LAW ENFORCEMENT.

METH ADDICTS DON'T WANT TO HURT THEMSELVES.

THEY WANT TO HURT SOMEONE ELSE.

OFTEN VERY VIOLENT BECAUSE OF THE PSYCHOS IS PSYCHOSIS BECAUSE OF THE PARANOIA THE DRUG BRINGS.

PEOPLE STAYING UP FOR DAYS AND DAYS WITHOUT SLEEPING OR EATING.

IT'S REALLY TERRIBLE THAT WE ARE BACK TO THAT.

>> Renee: BACK TO THAT.

AND WORSE THAN BEFORE.

>> IT WENT AWAY FOR A WHILE AND IT WASN'T THE PROBLEM IT HAD BEEN BUT NOW IT'S BACK WITH A VENGEANCE.

>> Renee: I KNOW YOU REMEMBER THIS ISSUE VERY WELL HAVING BEEN IN THE GENERAL ASSEMBLY FOR A WHILE AND YOU REMEMBER THOSE CONVERSATIONS ABOUT METH.

BUT THIS IS NOT THE METH OF THE EARLY 2000S AND LATE 90s.

>> AND WE THOUGHT WE PASSED LEGISLATION TO LIMIT THE SUPPLY, TO MAKE THE HOME METH AND THERE FOR A WHILE IT LOOKED LIKE IT WAS DIEING OUT.

IT WAS VERY EFFECTIVE.

BUT THE FOLKS THAT WOULD POISON OUR CITIZENS ARE VERY CRAFTY AND VERY INNOVATIVE.

AND IT'S LIKE PLAYING WACK A MOLE SOMETIMES.

10 YEARS AGO WE THOUGHT HEROIN WAS THE BIGGEST PROBLEM WE WOULD EVER HAVE AND NOW IN THE REPORT IT WAS VERY, VERY LOW IN THE NUMBER OF DEATHS.

>> Renee: THAT'S RIGHT.

AND THAT'S A QUESTION, LEADER JENKINS ABOUT HOW DO YOU KEEP CHASING IT?

I REMEMBER THAT WHEN REPRESENTATIVE TILLEY, BEFORE HE WAS SECRETARY, TALKED ABOUT THAT, THAT YOU ARE ALWAYS TRYING TO, YOU KNOWER, TAKE CARE OF THE CURRENT PROBLEM AND THEN SOMEHOW MAKE POLICY THAT WILL GET YOU TO THE NEXT POINT.

BUT IT SEEMS LIKE THE DRUG JUST OUTPACES, OUTSTARTS EVERY EFFORT.

>> AND YOU WONDER SOMETIMES, ARE THERE THUNKS THAT WE ARE NOT DOING TO ADDRESS THE TRAUMA THAT OUR CITIZENS ARE EXPERIENCING?

THAT-- >> Renee: SUCH AS?

>> POVERTY, CHILD ABUSE, YOU KNOW, SUBSTANCE USE DISORDER AFFECTS OUR BUDGET ALL THE WAY ACROSS FROM EDUCATION TO CHILD SUPPORT SERVICES, CHILD PROTECTIVE SERVICES, THE AMOUNT OF PEOPLE WE DON'T HAVE IN THE WORKFORCE, BECAUSE THEY'RE NOT ABLE TO WORK.

AND WHAT WE SEE AND WHAT I HEAR FROM PROFESSIONALS ARE THAT WE HAVE HUGE AMOUNTS OF TRAUMA, MOSTLY FROM GENERATIONAL POVERTY IN OUR STATE.

NOW IF WE COULD,YOU KNOW, WAVE A MAGIC WAND AND SOLVE THE PROBLEM OF POVERTY, I THINK WE WILLIAM JEWELL DO THAT.

BUT WE HAVE TO HAVE A MIX OF TREATMENT OPPORTUNITIES PREVENTATIVE OPPORTUNITIES AND AND THERE ARE SOMETIMES.

>> OUR PUBLIC HEALTH FOLKS TALK ABOUT ACE, ADVERSE CHILDHOOD EXPERIENCES AND WHEN ACES ARE PILED ON TOP OF A CHILD: POVERTY, FEAR OF HUNGER, DOMESTIC VIOLENCE IN THE HOME, SUBSTANCE USE IN THE HOME, THEIR ODDS OF HAVING A SUBSTANCE USE CLIMB AND CLIMB AND CLIMB.

AND SO YEAH, TO WHAT REPRESENTATIVE JENKINS IS STAYING, IF WE COULD ADDRESS THAT VERY EARLY ON, WITH BEING ABLE TO IDENTIFY THESE AT A VERY EARLY AGE AND INTERVENE AT A VERY EARLY AGE, MAYBE WE COULD STOP THIS DOWN THE ROAD, THE PAIN THAT WE ARE ALWAYS TRYING TO ADDRESS.

YOU ASKED SENATOR ALVARADO ABOUT LEGISLATIVE ISSUES AND QUICKLY I WANT TO TELL YOU ABOUT TWO.

IN THE 21 SESSION, REPRESENTATIVE BOWLING HAD A BILL CALLED RECOVERY READY COMMUNITIES.

THE GOVERNOR SIGNED THAT BILL AND WE HAVE NOW, TODAY, THE VOLUNTEERS OF AMERICA ARE GOING TO PARTNER WITH ODCP IN UNPLEMENTING THAT BILL AND IT WILL HELP US SHAPE WHAT EACH COMMUNITY NEEDS TO HAVE.

>> Renee: HOW MANY COMMUNITIES ARE THERE?

>> WE ARE GOING TO BEAT THIS ADDICTION ISSUE ONE COMMUNITY AT A TIME.

THERE ARE THINGS FRANKFORT CAN DO AND WASHINGTON CAN DO AND WE ARE GOING TO DO THIS LIKE A GRASSROOTS EFFORT.

ALL MAJOR CHANGE THAT COMES COMES FROM THE GRASSROOTS EFFORT.

A LOT OF COUNTY JUDGES HAVE SHOWN A LOT OF INTEREST IN IT.

THEY WANT TO MAKE SURE THEY HAVE THE THINGS IN THEIR COMMUNITY NECESSARY TO HELP PEOPLE IF RECOVERY.

>> Renee: HOW MANY OF THESE RECOVERY COMMUNITIES AVAILABLE THAT WE WILL HAVE.

>> ONE IN EVERY COMMUNITY.

THAT'S THE GOAL.

THE OTHER THING I WANTED TO MENTION REAL QUICK, AT THE INVITATION OF THE GOVERNOR AND THE LEADERS OF THE GENERAL ASSEMBLY, THE PEW RESEARCH COMMISSION FOLKS CAME IN AND THEY IDENTIFIED A NUMBER OF THINGS THAT THEY THOUGHT KENTUCKY OUGHT TO DO.

ONE OF THE RESULTS WAS SENATOR WESTERFIELD SPONSORED THIS BILL THAT HAVE AT LEAST 10 PILOT COMMUNITIES WHEN PEOPLE COME IN ON SPECIFIC CHARGES, WITHIN 72 HOURS OF ARREST, WE ARE GOING TO MOVE THEM INTO THE PROPER TREATMENT MODALITY IF THEY HAVE A SUBSTANCE USE DISORDER RATHER THAN HAVING THE CASE LANGUAGE IN-- LANGUISH IN COURTS FOR MONTHS AND MONTHS, LET'S ADDRESS IT RIGHT OFF THE BAT.

HERE IS THE DRIVER FOR THE CRIMINAL BEHAVIOR.

LET'S ADDRESS THAT.

WE ARE EXCITED TO IMPLEMENT THAT BILL.

AT THE END OF THE PILOT PROGRAM, WE HOPE THAT WILL BE A 120 COUNTY INITIATIVE AS WITH EL.

>> Renee: DOES IT HAVE A SUNSET.

>> 2024.

>> Renee: SEVERAL GOOD QUESTIONS.

IS BEING A SUBOXONE OR METED DONE ET CETERA NOT CONSIDERED AN ADDICTION?

AND WE HAVE HAD THIS DISCUSSION MANY TIMES, ARE YOU SUBSTITUTING ONE DRUG FOR ANOTHER, Dr. ALVARADO?

>> THIS IS ALWAYS A DEBATE.

IT'S A DEBATE AMONGST PROVIDERS, LEGISLATORS.

A LOT OF THEM ARE NOT FOND OF MEDICATION ASSISTED TREATMENT.

AND THE SCIENCE IS THAT IT DOES WORK.

DOES IT WORK FOR EVERYBODY.

>> Renee: M.A.T., MEDICATION ASSISTED TREATMENT.

>> AND SUBOXONE, WE HAVE MADE IT EASIER AS A STATE.

WE PASSED A LAW BECAUSE A LOT OF THE INSURANCE COMPANIES WERE REQUIRING PRIOR AUTHORIZATION.

PERSON WOULD COME IN ON FRIDAY SAYING I NEED HELP AND YOU CAN START THEM ON TREATMENT RIGHT THEN AND THERE BUT THEN HAD YOU TO PETITION THE INSURANCE AND BY THE TIME YOU GOT THE APPROVAL ON MONDAY, THE PERSON OVERDOSE AND THEY WERE GONE.

WE GOT RID OF PRIOR AUTHORIZATION REQUIREMENTS FOR THIS.

BUT THE KEY TO THIS, SUBOXONE TREATMENTS, I KNOW SOME PEOPLE DIVERT THOSE.

THERE ARE OTHER ITERATIONS AND THERE ARE INJECTIONS AND WE ARE USING A LOT OF PEOPLE COME IN FOR INPATIENT TREATMENT, WITH AN INJECTABLE VERSION.

THEY COME OUT FOR OUTPATIENT FOLLOWUP AFTER THEY ARE DISCHARGED AND CONTINUED ON IT.

CAN'T BE DIVERTED.

THEY CAN TAKE THAT, IT KEEPS A LOT OF THEIR WITHDRAWAL SYMPTOMS AWAY EFFECTIVELY.

SO THAT THE PEOPLE ARE NOT OUT THERE CRAVING FOR IT.

IDEALLY YOU CAN WEAN THOSE PEOPLE OFF, BUT I THINK THE CURRENT STANDARD OF CARE FOR MOST IS TO GET PEOPLE ON IT.

IF THEY DO WELL, MAINTAIN THEM ON IT LONG-TERM.

IT VARIES FROM PERSON TO PERSON.

>> Renee: WHAT IS LONG-TERM.

>> IT COULD BE LIFE LONG FOR SOME PEOPLE.

IT DEPENDS AGAIN, WE DON'T DO THIS AS A GLOBAL-- EVERYBODY HAS TO FOLLOW THE SAME RECIPE.

EVERYBODY HAS VERY INDIVIDUALIZED FORM OF CARE.

WE HAVE HAD PEOPLE THAT HAVE COME IN ON METH METHADONE WHO WANT TO COME OFF OF THAT.

I WILL TALK TO A SPECIALIST WHO SAY KEEP THEM ON IT.

AND THE PERSON WANTS TO COME OFF.

YOU DEFER TO PATIENT CHOICE AND SOME OF THE DESIRES AND THINGS THEY WANT THERE.

AND THEN SOME PEOPLE JUST NEED, AGAIN THEY CAN BE ON TABLETS OR ORALLY DISSOLVABLE VERSIONS OF IT BUT IT KEEPS THE RISK OF, YOU KNOW, USING THE DRUGS LIKE FENTANYL THAT THEY'RE GOING TO OVERDOSE POTENTIALLY OR SOMETHING THAT CAN CAUSE THEM TO DIE, SUBOXONE PREVENTS THAT FROM HAPPENING.

YOU CAN TAKE AWAY YOUR WITHDRAWAL SYMPTOMS BUT YOU DON'T GET THE SAME RYE OR RISK OF DEATH AND IT WORKS VERY WELL FOR A LOT OF FOLKS.

METHADONE, YOU NEED A SPECIALIZED LICENSE TO PRESCRIBE METED DONE, ESPECIALLY FOR THIS.

I DON'T HAVE THAT LICENSE FOR METHADONE BUT CERTAIN DOCTORS DO AND THEY GO TO SPECIALIZED CLINICS AND BE MAINTAINED ON THAT BUT THE OPTIONS AND THE SCIENCE AND DATA SHOW THAT ONCE PEOPLE GET ON THAT, THEIR ODDS OF SURVIVAL, THEIR ODDS OF LIFE LONG ABILITY TO BE ABLE TO FUNCTION, TO WORK, ALL THOSE THINGS WI A LOT OF FOLKS ON SUBOXONE HAVE COME OUT AND ARE FUNCTIONAL AND BACK TO WORK AND DOING VERY WELL.

THERE IS A LOT OF STIGMA.

PHYSICIANS AND HEALTHCARE IN GENERAL IS TRYING TO DESTIGMATIZE A LOT OF THAT TO KNOW IT IS AN OPTION OF TREATMENT FOR MANY FOLKS AND HAS WORKED VERY WELL FOR A LOT OF PEOPLE.

>> CAN I FOLLOW UP ON THAT?

I'M A BIG FAN OF MEDICALLY ASSISTED TREATMENT AND ONE OF THE MOST PROFOUND THINGS I HEARD WAS ON A KET FORUM WHEN CHARLOTTE WORSTEDINGTON, THE FOUNDER OF CASEY'S LAW WHEN SHE SAID DO WE NEED HARM REDUCTION, SHE SAID ABSOLUTELY.

PEOPLE HAVE TO BE ALIVE TO RECOVER.

ONE OF THE THINGS THAT I WOULD ADD TO SENATOR ALVARADO'S STATEMENTS IS THAT ONE OF OUR REALITIES ABOUT OUR PROBLEM NOW IN KENTUCKY AS THE NUMBERS SHOWED TODAY, HALF THE PEOPLE WERE TAKING METH, IT JUST SO HAPPENS TO BE LACED WITH FENTANYL.

WE DON'T HAVE FDA APPROVED MEDICALLY ASSISTED TREATMENT FOR METH TODAY.

WE DON'T HAVE IT FOR OTHER DRUGS LIKE COMPANY COCAINE.

WE DON'T HAVE IT FOR THOSE MEDICATIONS.

IF WE KEEP JUST FOCUSING ON SUPPLY, WE ARE GOING TO KEEP PLAYING AS LEADER JENKINS SAID, WACK A MOLE.

WE HAVE TO FOCUS DEMAND AND ONE OF THE WAYS TO CHANGE DEMAND IS TO WORK ON SOME OF THE THINGS, LEADER JENKINS SAID POVERTY, AND IT'S PRETTY CLEAR THAT POVERTY IS REALLY WHAT WE ARE DEALING WITH HERE AND I'M NOT JUST TALKING ABOUT ECONOMIC POVERTY.

IT'S GENERATIONAL POVERTY AND IT'S POVERTY BEING CREATED BECAUSE SOME OF THE STUDIES ARE SHOWING THAT LOSSES IN HIGHER WAGE JOBS LIKE WHERE I'M FROM IN EASTERN KENTUCKY, THE LOSS OF $70,000 A YEAR JOBS, THOSE CREATED, THAT CREATED A SITUATION WHERE ADDICTION COULD RUN RAMPANT.

SAME THING WITH PLACES IN OHIO.

PENNSYLVANIA, OTHER PLACES THAT HAVE SEEN INCREASES IN OVERDOSES.

OHIO STATE UNIVERSITY HAS DONE A LOT OF RESEARCH IN IT AND IF YOU LOOK AT PEOPLE TODAY THAT ARE NOT IN THE WORKFORCE, HALF OF THE PRIME AGE WORKING MEN, HALF USE PAIN MEDS EVERY DAY AND TWO-THIRDS OF THOSE FOLKS THAT ARE NOT IN THE WORKFORCE USE PRESCRIPTION MEDICATION EVERY DAY.

AND SO THIS WORKFORCE PARTICIPATION, ESPECIALLY IN PLACES LIKE WHERE MY HOME IN EASTERN KENTUCKY THAT HAS LOST OUR COAL MINING INDUSTRY, THOSE THINGS HAVE TO BE ADDRESSED.

AND SO THERE IS THIS HARM REDUCTION.

THERE IS THIS WE NEED THAT TO HAPPEN.

BUT NOW WE ARE DEALING, YOU KNOW, WE ARE 25 YEARS INTO THIS CRISIS.

WE HAVE MULTIPLE GENERATIONS NOW THAT HAVE NEVER SEEN A DAD PUT ON THEIR WORK BOOTS AND GO TO THE COAL MINE OR THEY HAVE NEVER SEEN MOM GO WORK AS A SECRETARY.

AND SO ONE OF THE BIGGEST CHALLENGES THAT WE SEE IN OUR CENTERS IS PEOPLE THAT HAVE NOT HAD THE PARENTING AND THE STABILITY THAT I HAVE SO WE HAVE TO ADDRESS THIS IN A MULTIFACETED WAY THAT HAS TREATMENTED, MEDICALLY ASSISTED TREATMENT, ALL THAT, RECOVERY, HOUSING SUPPORT, CHILD CARE, TRANSPORTATION, THERE IS NO SILVER BULLET.

EVERYBODY IS WAITING ON IT.

WE DON'T HAVE A SILVER BULL OAT THIS CRISIS.

WE ARE GOING HAVE TO TAKE OUR NEIGHBORS, MANY OF THEM IN POVERTY AND HELP THEM WALK BACK TO HEALTH.

AND WHEN WOE DO THAT, EVERYTHING CHANGES.

>> AND I THINK THAT'S WHAT IS SO EXCITING TO ME ABOUT RECOVERY COMMUNITIES SO MUCH OF WHAT WE ARE DOING IS IT'S ABOUT SYSTEM CHANGE.

PEOPLE IN KENTUCKY AND WE ARE SO LUCKY BECAUSE IT'S NOT EVERY STATE THAT EVERYBODY REALIZE THIS, DECISION MAKERS REALIZE WE CAN'T JUST PLOP A TREATMENT CENTER DOWN IN A COMMUNITY AND SAY GOOD LUCK, FIGURE IT OUT.

IT'S AN ECOSYSTEM.

IT'S A RECOVERY ECOSYSTEM THAT HAS TO HAPPEN INCLUDING EMPLOYMENT, TRANSPORTATION, CHILD CARE AND ALL THE CONTINUUM OF SERVICES AND MEETING PEOPLE WHERE THEY'RE AT.

>> ONE THING I WANT TO THROW IN ALSO, TO THINK ABOUT, WHEN YOU DID M.A.T., YOU KNOW, THE BEST WAY TO DO THAT IS NOT JUST BY GIVING SOMEBODY A PRECIPITATION AND SAYING SEE YOU LATER.

YOU HAVE TO HAVE COUNSELING ALONG WITH THAT.

THAT'S VITAL.

THE STUDIES SHOW THE BEST OUTCOMES FOR PEOPLE WHO GET THE MEDICATION AND HAVE COUNSELING THAT THE HARD PART WITH IS WEEM GET STABLE, THEY FEEL GOOD, THEY'RE DOING WELL.

THEY SAY I'M GOING SKIP THE COUNSELING.

THEY NEED TO HAVE IT CONTINUED BECAUSE YOU ARE AT RISK FOR THAT AND SO WE HAVE TAKEN EFFORTS ALSO.

THERE WERE CONCERNS ABOUT PEOPLE SAYING I'M GOING TO COME INTO A CLINIC, PAY A PRESCRIPTION, PAY THE MONEY AND OFF WE G. THAT'S BEING REPORTED TO THE BOARD OF MEDICAL LICENSURE AND NURSING TO SEE WHO IS DOING THAT AND PROVIDING THE COUNSELING.

THOSE ARE WHO ARE NOT WILL BE REPORTED TO THE BOARD AND SAY THIS IS NOT ACCORDING TO THE STANDARD OF CARE AND THERE COULD BE POTENTIAL PLINNARY DISCIPLINARY TO MAKE SURE THAT THE PEOPLE GIVING OUT PRESCRIPTION WITHOUT COUNSELING WILL BE IDENTIFIED BY THE RECORDS NOW.

WE'LL START BEING ABLE TO TELL WHO IS DOING THINGS THE RIGHT WAY AND WHO IS DOING THINGS INAPPROPRIATELY TO RELIEVE THE CONCERNS THE WRITER MIGHT HAVE.

>> MASON COUNTY, THIS QUESTION, WHAT ARE PEOPLE WITH LEGITIMATE DOCUMENTED DAILY CHRONICLIC PAIN SUPPOSED TO DO?

AND THIS REVISITS THE CONVERSATION WE HAD REAL QUICKLY, CAN YOU ANSWER THAT?

>> SO A PERSON GOES IN AND HAS LEGITIMATE, THEY CAN GO TO THE PRIMARY CARE DOCTOR.

THEY HAVE TO FOLLOW WHAT THE LAW SAYS.

A LOT OF DOCUMENTATION HAS TO GO INTO IT.

THEY HAVE TO RUN A CASPER REPORT PRIOR TO MAKE SURE IF THEY HAVE NOT GOTTEN IT FROM OTHER FOLKS.

IDENTIFY RISKS TO THE INDIVIDUAL, WARN THEM OF ALL THOSE THINGS AND DOCUMENT ALL OF IT AND COME IN RUE ROUTINELY FOR DRUG SCREENS.

ANOTHER OPTION DOCTORS ARE DOING IS REFERRING PEOPLE TO PAIN CLINICS AND THEY'RE EXPERTS IN THAT.

THEY CAN IDENTIFY CONCERNS WITH ADDICTION OR OTHER PROBLEMS AND CAN PRESCRIBE IT AND DO THE SAME THING.

THOSE ARE THE TWO TYPICAL AREAS YOU SEE PEOPLE HANDLING IT.

IN A PRIMARY CARE DOCTOR IS COMFORTABLE, THEY HAVE TO FOLLOW THE LAW AND DOCUMENT IT VERY CAREFULLY.

>> Renee: FROM CAMPTON, THIS QUESTION, HOW ARE LAWMAKERS AND NON-PROFITS WORKING TO ADDRESS THE TRAUMA THAT IMPACTS CHILDREN OF THOSE STRUGGLING WITH OPIOIDS.

THIS GETS BACK TO SOMETHING Mr. INGRAM WAS TALKING ABOUT BEFORE.

THIS IS A MUCH HARDER CONVERSATION AND POLICY TO MAKE.

>> RIGHT.

AND YOU KNOW, WE HAVE DONE A LOT OF WORK OVER THE LAST COUPLE OF YEARS WITH THE KIDS THAT ARE IN STATE CUSTODY BECAUSE THAT'S WHERE WE COME IN CONTACT WITH THE.

THEM AND TRYING TO MAKE UNIFICATION OF THE BIOLOGICAL FAMILY NOT EASIER BUT MORE OBTAINABLE; THAT... >> Renee: WHEN IT'S SAFE FOR THAT CHILD.

>> WE KNOW THAT FAMILIES DO-- CHILDREN DO MUCH BETTER WHEN THEY'RE THERE THEIR BIOLOGICAL FAMILY WHEN IT'S SAFE.

SO LOOKING AT THOSE, YOU KNOW, KENTUCKY HAS A GREAT PROGRAM CALLED START.

THAT AS SOON AS YOU BECOME INVOLVED IN THE CRIMINAL JUSTICE SYSTEM, THAT THAT PROGRAM KICKS IN AND WE HAVE PEER EDUCATORS THAT WORK WITH FAMILIES ON A VERY, VERY CONTINUOUS BASIS TO GET THEM BACK TO WHERE THEY CAN TAKE GOOD CARE OF THEIR KIDS AGAIN.

>> VOA HAS A PILOT PROJECT THAT WE RECEIVED SOME FUNDING FROM STATE FROM WHERE WE ARE ABLE TO WOE CALL IT GOING UPSTREAM WHERE WE EMBED THERAPISTS IN THE CABINET, C.P.S.

OFFICE IN HARDIN COUNTY AND IN LINCOLN COUNTY AND CLAY COUNTY AND IT'S JUST BEGUN AND WE BASICALLY WORK IN TANDEM WITH THE CABINET AND WHEN THERE IS A SUBSTANCE USE DISORDER, WE TAKE, INSTEAD OF REMOVING, WHEN POSSIBLE, WE TRY TO BRING THE WHOLE FAMILY INTO CARE AND GET THEM THE CARE THEY NEED AND TRY TO PREVENT THE REMOVAL FROM HAPPENING, WHICH WE KNOW MAKES THE TRAUMA THAT MUCH MORE INTENSE.

WHEN THE REMOVAL HAPPENS.

>> AND THE FEDERAL GOVERNMENT HAS ALLOWED US NOW TO BE INVOLVED BEFORE THERE IS A COMPLAINT OR AN INVESTIGATION AND THAT EARLY HAVE INTERVENTION, I THINK, WE ARE STILL IN THE VERY BEGINNINGS OF THAT, I THINK WE ARE GOING TO SEE GOOD RESULTS FROM THAT.

BEING INVOLVED WITHOUT THAT THREAT OF WE ARE GOING TO TAKE YOUR KID AWAY.

INSTEAD SAYING WHAT DO YOU NEED TO BE SUCCESSFUL BECAUSE WHAT WE WERE SEEING VERY ON, PEOPLE WERE LOSING THEIR KID BECAUSE THEY WERE IN POVERTY AND THAT SHOULD NEVER HAPPEN.

THERE ARE OTHER SERVICES THAT WE CAN DO TO MAKE SURE THAT THOSE FAMILIES GET WHAT THEY NEED AND WE CAN KEEP THAT FAMILY TOGETHER.

>> Renee: AND SOME OF THAT IS EMBODIED IN SENATE BILL 8, THAT YOUR GOOD FRIEND SENATOR ROCKY ADAMS IS NOW LAW.

Mr. ROBINSON, I THINK WERE YOU GOING TO SAY SOMETHING.

>> ONE OF THE WORD THROWN AROUND IS PREVENTION AND IN OUR STATE, WE HAVE ONE OF THE LEADING ORGANIZATIONS IN THE NATION ON PREVENTION.

OPERATION UNITE, THAT WAS FOUNDED BY CONGRESSMAN ROGERS AND LED BY NANCY HALE, ESPECIALLY THE WORK THAT THEY HAVE DONE IN THE FIFTH CONGRESSIONAL DISTRICT.

THEY'RE A NATIONAL LEADER IN PREVENTION.

THEY HAVE GOT INTO SCHOOLS.

THEY STARTED UNITE CLUBS WHERE THEY GET KIDS TALKING ABOUT THIS.

THEY DO CAMPS, THEY DO FISHING TOURNAMENTS, ARCHERY TOURNAMENTS.

AND SO IT'S THAT GETTING INTO THE LIVES OF THOSE KIDS, MANY OF THEM IN GENERATIONAL POVERTY, AND DOING THAT INTERVENTION AND THOSE EFFORTS, IN EASTERN KENTUCKY SOME OF THOSE EFFORTS AND OTHERS WERE WORKING PRIOR TO THE PANDEMIC.

EIGHT OF THE TOP 10 COUNTIES IN THE NATION THAT HAD REDUCTIONS IN OVERDOSE DEATHS WERE IN EASTERN KENTUCKY PRE-PANDEMIC I BELIEVE A LOT OF THAT IS THE PREVENTION EFFORTS THAT UNITE HAS BEEN DOING FOR 20 YEARS.

>> Renee: WHY CANNOT THAT NOT BE STATEWIDE REPLICATED.

>> THE FEDERAL DOLLARS KENTUCKY HAS BEEN RECEIVING THE LAST FEW YEARS HAS ALLOWED US TO PUT A CURRICULUM CALLED TOO GOOD FOR DRUGS IN OVER 200 SCHOOLS.

WE PROVIDE IT FREE.

THE STATE WILL PAY FOR IT.

ANOTHER PROGRAM CALLED SOURCES OF STRENGTH.

WE HAVE TAKEN FEDERAL DOLLARS AND SPREAD THAT PROGRAM ACROSS THE STATE.

THERE WAS A PERIOD OF TIME WHERE THERE WASN'T A LOT OF MONEY TO DO THE PREVENTION PROGRAMS BUT WITH THE OPIOID RESPONSE DOLLARS FROM WASHINGTON, WE ARE ABLE TO GET BACK INTO THE PREVENTION WORK WE SHOULD HAVE BEEN ALL ALONG.

THERE IS AS GOOD OF WORK GOING AROUND KENTUCKY NOW THAN THERE HAS BEEN IN A LONG TIME.

>> Renee: WHERE DO WE GO FROM HERE.

WE LOOK AT TODAY'S REPORT, TODAY'S NUMBERS.

WHAT CHANGE NEED TO HAPPEN.

WHAT WOULD YOU RECOMMEND.

YOU MAY NOT BE THERE THE NEXT TIME BUT YOU CAN ADVISE FROM AFAR.

>> I FILED A BILL THAT GOT A LITTLE BIT OF ATTENTION AND THAT WAS HARM REDUCTION BILL THAT CALLED FOR A PILOT PROGRAM FOR SAFE CONSUMPTION.

>> Renee: WHAT DOES THAT MEAN.

>> PEOPLE CAN COME IN AND HAVE THEIR DRUGS SCREENED FOR FENTANYL OR OTHER THINGS THAT COULD HURT THEM AND WOULD USE THEIR DRUGS WITH MEDICAL PROFESSIONALS THERE.

NEW YORK STARTED THIS EARLY IN THE YEAR AND HAVE SEEN A DRAMATIC NUMBER OF OVERDOSE REVERSED.

>> Renee: HOW DO YOU GET SOMEONE ON THE PATH TO RECOVERY IF THEY'RE STILL USING?

>> IT'S THE SAME WAY THE SAME PHILOSOPHY THAT THE NEEDLE EXCHANGE HAS.

THAT YOU BRING PEOPLE IN, YOU TREAT THEM WITH COMPASSION AND CARE AND GET THEM ON THAT PATHWAY TO RECOVERY.

>> Renee: RIGHT.

I'M GOING TO ASK SENATOR ALVARADO AS CHAIRMAN OF HEALTH AND WELFARE COMMITTEE, WHAT WOULD HE THINK ABOUT THAT IDEA?

>> I MEAN SO THIS HAS BEEN A DEBATE GOING ON A LONG TIME.

THERE ARE COUNTRIES IN THE WORLD THAT HAVE, YOU KNOW, PORTUGAL IS A PRIME EXAMPLE OF A COUNTRY THAT HAS APPROACHED THIS THING, IT'S NO LONGER A CRIMINAL PROBLEM.

IT'S A MEDICAL PROBLEM AND THEY TOOK AWAY THE RESTRICTIONS, LEGALIZED A LOT OF DRUGS OUT THERE.

THAT'S GOING TO BE TOUGH TO PASS IN THE GENERAL ASSEMBLY.

TO BE PERFECTLY HONEST, BUT I'VE DISCUSSED THIS WITH MEDICAL COLLEAGUES ALL THE TIME WHERE THEY COME WITH THE APPROACH, AT ONE TIME IN THIS COUNTRY, EVERYTHING WAS ALLOWED TO BE LEGAL AND WE RESTRICTED A LOT OF THESE DRUGS BECAUSE WE HAD BAD OUTCOMES AND BATTED PROBLEMS AT THAT TIME.

THAT HAS BEEN DONE WITH ALCOHOL, DIDN'T WORK WELL, WE REPEALED ALL THOSE THINGS.

SOME COME BACK WITH THE ARGUMENT WE SHOULD ALLOW EVERYTHING TO HAPPEN AND LET IT BE A MEDICAL TREATMENT AND IF SOMEBODY HAS AN ADDICTION AND THEY SAY I WANT TO COME OFF OF THIS, AND IT'S GOING TO BE A LOT LESS EXPENSIVE TO COME FROM THAT APPROACH.

THAT SEEMS TO HAVE WORKED WELL IN PORTUGAL.

OTHER COUNTRIES HAVE TRIED IT AND IT HASN'T WORKED AS WELL.

IT WILL BE A STATE LEVEL DIFFICULT TO DO.

IT WILL HAVE TO REQUIRE A NATIONAL POLICY OF SOME SORT TO SEE HOW WE ARE GOING TO APPROACH THING.

ANY TIME YOU START INTERFERING WITH THAT COME THE CONCERNS IF SOMETHING IS FEDERALLY ILLEGAL AND LEGAL LEER, IT AFFECT FEDERAL FUNDING, ALL KIND OF DIFFERENT THINGS OUT THERE.

I THINK REALLY AGAIN, I TELL PEOPLE GOVERNMENT IS NOT GOING TO SOLVE THIS PROBLEM.

IT'S GOING TO BE ONE OF THE PEOPLE INVOLVED, WE ARE A PARTNER IN THIS, BUT IT'S GOING TO TAKE ALL LEVELS OF SOCIETY AND PEOPLE TO BE AWARE, HAVE CHURCHES IN INVOLVED, YOU KNOW, BUSINESS PARTNERS INVOLVED, SCHOOLS INVOLVED TO EDUCATE FOLKS TO START REALIZING THE DANGERS AND THE RISKS AND PROBLEMS AND WE PROBABLY HAVE TO BE VERY, VERY GRAPHIC FRANKLY WITH THE GENERATION COMING UP.

WE DID IT WITH TOB AND IT TOBACCO AND WORKED PRETTY WELL.

>> Renee: VANITY APPEAL.

>> THIS IS WHAT CAN HAPPEN TO YOU AND NOT JUST, YOU KNOW, EGGS IN A FRYING PAN LIKE WE HAVE SEEN IN THE PAST.

GRAPHIC IMAGES.

>> Renee: WE HAVE SEEN THOSE WITH THE ANTISMOKING CAMPAIGNS.

>> NEEDS TO HAPPEN SO KID SAY I DON'T WANT THAT TO HAPPEN TO ME AND IT WILL AT LEAST TAKE A PAUSE BEFORE THEY'RE OFFERED SOMETHING TO SAY I DON'T KNOW IF I WANT TO GO THERE.

AND THAT, I MEAN, AGAIN, LOTS OF DIFFERENT THINGS WE CAN DO BUT IT'S GOING TO TAKE A LOT OF DIFFERENT ANGLES TO GET THIS THING FIXED.

>> Renee: LAST TO OUR RECOVERY SPECIALIST MISS HALL, IN A MINUTE, IF YOU CAN ADVISE SENATOR ALVARADO AND HIS COLLEAGUES AND THOSE IN THE LOWER CHAMBER WHAT THEY SHOULD DO IN 2023, WHAT IS ONE THING YOU WOULD ASK THEM TO DO?

>> INVEST RESOURCES AND TIME AND SYSTEMIC CHANGES THAT SHOW EVIDENCE OF SUCCESS AND THAT PRODUCE OUTCOMES THAT ARE TRULY THAT ARE REALLY MOVING THE NEEDLE.

>> Renee: WOULD YOU ENDORSE A PLAN SUCH AS, REPEAT THAT TERM AGAIN FOR ME.

>> SAFE CONSUMPTION?

>> Renee: SAFE CONSUMPTION?

>> I'LL SAY THIS, WE KNOW WE CAN'T ARREST OUR WAY OUT OF THIS, SO WE HAVE TO FIND WAYS TO CONTINUE TO DECRIMINALIZE USE.

WE KNOW USE IS GOING TO HAPPEN AND SO THERE IS THIS OBVIOUSLY SCHOOL OF THOUGHT AROUND IT HAPPENING NOT BEHIND CLOSED DOORS AT LEAST UNDERSTAND SO ANYTHING THAT INCREASES SAFETY AND ACCESS TO RECOVERY, I'M ALWAYS OPEN TO A CONVERSATION ABOUT.

>> Renee: OKAY.

I THINK I UNDERSTAND THAT ANSWER THERE.

Mr. ROBINSON, LAST WORD.

>> I'M NOT FOR THAT.

AND I HAVE SEEN WORKING IN THIS ON THE FRONT LINES INTERVENTION WHERE WE NEED TO BE.

I CAN LOOK DOWN AT LETCHER COUNTY, ONE OF THE COUNTIES IN EASTERN KENTUCKY, A COMMUNITY, THEY GOT SERIOUS, THEY STARTED TO HEAL LETCHER COUNTY.

A.R.H.

SYSTEM, MCHC AND US, ARC, WE ALL JOINED WITH THE HEALTH DEPARTMENT AND OTHERS, THEY HAVE NOW CUT THEIR PRESCRIPTIONS PER PERSON BY 70%.

THEY'RE GOING TO BE IN SOME OF THESE STUDIES, ONE OF THE BIGGEST DECLINES IN OVERDOSES BECAUSE OF INTERVENTION.

NOW YOU CAN WALK INTO THE DOCTOR'S OFFICE AND GET HELP.

YOU CAN WALK INTO THE E.R.

AND GET HELP.

AND ALSO IN THE COURT SYSTEMS.

KEVIN MULLINS CITY SCHOOL DISTRICT JUDGE HAS COURT ORDERED 650 PEOPLE TO TREATMENT SO WHEN YOU GO INTO THE DISTRICT COURTROOM, YOU HAVE AN OPTION RIGHT THEN TO TALK TO A PEER SPECIALIST.

THAT IS WORKING THERE IN LETCHER COUNTY.

IT'S HEALING LETCHER COUNTY AND IT'S ALL ABOUT INTERVENTION.

>> Renee: WE HAVE TO LEAVE IT THERE UNLESS YOU CAN SAY IT IN 10 SECOND.

>> 838-KY-- 8338 KY HEALTH.

8338-KYHELP STATEWIDE CALL CENTER.

>> THIS HAS BEEN AN INFORMATIVE CONVERSATION.

I APPRECIATE THE WORK YOU ALL DO EACH AND EVERY ONE OF YOU TO HELP THIS ISSUE.

REMEMBER TO JOIN US WEEK NIGHTS AT 6:30 EASTERN, 5:30 CENTRAL FOR KENTUCKY EDITION.

I WILL SEE YOU TOMORROW NIGHT FOR THAT PROGRAM.

UNTIL THEN, TAKE REALLY GOOD CARE.