Kentucky editorial roundup
The Associated Press
Aug. 30, 2017
Recent editorials from Kentucky newspapers:
The Courier-Journal on halting a study on health risks for people living near strip mining sites:
People in Appalachian Kentucky are dying at rates significantly higher than national averages.
We need to better understand why, through scientific research, to begin curing the health crises in the region.
One federally funded study was working on that until the Trump administration's Interior Department turned its back on the region about a week ago when it put the brakes on a $1 million study. Officials say it was part of a budgetary review.
We're skeptical. Scientific research is under siege in this administration, especially when it calls for restrictions that cut into corporate profits.
That National Academies of Sciences, Engineering and Medicine study was looking at the potential health risks of people living near mountain strip mining sites in the coal region.
We agree with U.S. Rep. John Yarmuth, who said budget priorities are out of whack and putting lives at risk.
Kentucky's other congressional leaders must push back against the president and get this study back on track. It is morally reprehensible to claim to support bringing back coal jobs while people in those mining communities are dying at alarming rates and it's unknown whether mining is contributing to the region's health crisis.
This is a deadly smack in the face for the region that overwhelmingly voted for Trump, and it doesn't make sense.
We need to know if the dust from blasting away the mountain tops is exposing nearby residents to cancer-causing arsenic, cadmium and other dangerous elements. We need to know if the mining is contributing to lung disease, birth defects and cardiovasular disease. We need to know if polluted streams and water supplies are a factor.
What we do know is that the cancer mortality rate in Appalachian Kentucky is 35 percent higher than the national rate. And we know that the region's mortality rate from chronic obstructive pulmonary disease is 88 percent higher than the national rate.
And while smoking rates are higher in the region, one peer-reviewed study showed that does not account for increases in cancer and other health issues in mining areas.
Until we know what other factors could be contributing to the region's health problems, nothing can be off the table, including research into the effects of mountaintop strip mining.
We can't ignore earlier studies that have shown higher numbers of birth defects in communities near mountain strip mining and higher rates of kidney disease and lung cancer.
There must be wide scientific research to begin diagnosing what's killing so many in Eastern Kentucky. Anything less is malpractice.
The Lexington Herald-Leader on a trauma doctor who cut opioid prescriptions in half:
In 2013, Dr. Phillip K. Chang had what he calls an "eye-opening moment."
Chang had used his prowess as a trauma surgeon at the University of Kentucky to repair a young man's injuries from a vehicle crash, only to have the pain medicine he prescribed leave his patient addicted to opioids.
Many physicians have had that moment. Chang, who saw the pattern repeat in other patients, says it "could happen to our family, our neighbors, ourselves." The pain of withdrawal is no less real than the pain of broken bones.
Chang and his team began thinking about less risky ways to treat acute pain, and this weekend he will tell the Kentucky Medical Association how they were able to halve the amount of opiates given to trauma patients without increasing their pain levels.
KMA is dedicating its annual meeting to educating physicians about ways to combat an opioid epidemic that mutated into a heroin boom, claimed 1,404 lives from overdoses in Kentucky last year and put the state in the lead for hepatitis C.
Two developments of the 1990s spurred this crisis: Pain was added as a vital sign by the hospital accrediting commission. And the pharmaceutical industry targeted physicians with aggressive and misleading marketing of opioids, flooding Kentucky with powerful painkillers, many of which were diverted into the black market.
Medicare grades hospitals and bases reimbursements in part on what patients report about their pain control, creating a financial incentive to over-prescribe painkillers. Even among non-surgical hospital patients, half were prescribed opiates in a study of 1.14 million admissions.
Medicare should remove or revise its pain questions on patient surveys. And insurers should save themselves future costs by paying for alternatives to opioid painkillers.
Chang said KASPER, Kentucky's electronic reporting system, alerted him to his patient's doctor-shopping. (Thank you, Congressman Hal Rogers.) In four weeks, someone who had no history of drug abuse when he entered the hospital had been prescribed an alarming number of pills.
With the resources of UK Healthcare at hand, Chang called a drug counselor and they confronted the patient and offered help.
Doctors and hospitals have huge roles in preventing addiction and also avoiding relapse. After just three days of taking prescription painkillers, the risk of chronic opioid use increases and goes up rapidly after that, according to a study by the Centers for Disease Control and Prevention. Opioid prescribing has declined somewhat in this country but is still greater per capita than in 1999 and almost four times the rate in Europe.
Chang, who last year became UK's chief medical officer, says inpatients are "super receptive" when educated about the opioid risk and included in tailoring pain-control regimens, ranging from non-opioids such as Tylenol and Advil to numbing medications that don't deliver opiates to the brain. Chang and his team also are integrating art, music and touch therapies into treating acute pain.
They were able to achieve the same level of pain control with half the amount of opioids. Such success among trauma patients certainly could be replicated in other populations.
Rather than eliminating pain, Chang aims to keep pain "tolerable" — a standard that Medicare should adopt.
Kentucky's legislature this year enacted what Chang calls a "game changer" — a three-day limit on opioid prescriptions for acute (as opposed to chronic) pain. The new law creates opportunities for doctors to educate their patients about non-addictive options.
The opioid crisis demands a well-funded comprehensive plan, including a way to provide treatment on demand. Doctors have a huge role in educating patients and preventing addiction. It's good to see Kentucky's doctors talking about how to meet that responsibility to patients and public.
Richmond Register on bullying:
With summer unofficially over and children back in school, we hope their year is off to a great start. Unfortunately, bullying can ruin it.
While calls about bullying are not as frequent as they were in the past thanks to new policies and procedures, that doesn't mean it no longer exists.
And thanks to technology, it can be hard to always see bullying, especially online. However, children who are being cyberbullied are often bullied in person as well.
Children who are cyberbullied have a harder time getting away from the behavior. It can happen 24 hours a day, seven days a week, and reach a child even when he or she is alone. It can happen any time of the day or night.
Parents need to be aware. Just because you don't see it, doesn't mean it's not happening. With new social media apps appearing daily, it can be hard for parents and adults to keep up with it all.
Talk with your children about cyberbullying and other online issues regularly. Here are a few tips:
. Know the sites your children visit and their online activities. Ask where they're going, what they're doing and who they're doing it with.
. Tell your children that as a responsible parent you may review their online communications if you think there is reason for concern. Installing parental control filtering software, or monitoring programs, is one option for monitoring your child's online behavior, but do not rely solely on these tools.
. Have a sense of what they do online and in texts. Learn about the sites they like. Try out the devices they use.
. Ask for their passwords, but tell them you'll only use them in case of emergency.
. Ask to "friend" or "follow" your children on social media sites or ask another trusted adult to do so.
. Encourage your children to tell you immediately if they, or someone they know, is being cyberbullied. Explain that you will not take away their computers or cellphones if they confide in you about a problem they are having.
When cyberbullying happens, it is important to document and report the behavior so it can be addressed. Cyberbullying often violates the terms of service established by social media sites and internet service providers. Depending on the circumstances, law enforcement may need to be contacted.
We hope these tips won't be needed. However, if you need more resources, visit stopbullying.gov.
Let's make this year great and stop all forms of bullying.