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February 14, 2018

States expand authority of nurse practitioners and physicians assistants to increase health care in rural areas

Can get waiver to prescribe opioid maintenance drugs

The shortage of doctors and drug treatment in rural areas hamstrings efforts to fight the opioid epidemic. Medication-assisted therapy, which requires a prescription, is the most effective treatment. The Drug Enforcement Administration announced in late January that nurse practitioners and physician assistants can get a waiver that allows them to prescribe and dispense opioid maintenance drugs. But lawmakers in several states have gone a step further, seeking to expand the scope of practice for nurse practitioners and physician assistants in rural areas where there is often no doctor.

In Georgia, Republican Sen. Renee Unterman, chair of the Senate health committee, has introduced a bill that would give rural nurse practitioners more latitude to treat patients. Nine of the state's 159 counties have no physician, and dozens more have no pediatricians or obstetrician/gynecologists. "Proponents argue expanding the scope of practice for nurse practitioners could help fill in the health-care gaps in a growing state with increasing needs, especially with primary care. Nurse practitioners can also specialize in certain areas, such as pediatric care or mental health treatment," Jill Nolan reports for the Valdosta Daily Times.

In April 2017 the Pennsylvania Senate passed a bill to let nurse practitioners to practice on their own after fulfilling a three-year, 3,600-hour formal agreement with a physician, Jan Murphy reports for Penn Live. "There are not enough doctors willing to practice in smaller communities and as older doctors retire, fewer new doctors are coming in to replace them," said the bill's sponsor, Republican Sen. Camera Bartolotta. "Thankfully, there is a solution that holds the promise of easing this looming health care catastrophe."

Texas passed two related bills in 2017: one that allows nurse practitioners in under-served areas to see Medicaid and Children's Health Insurance Plan patients without a doctor's supervision, and one that allows APRNs and physician's assistants to sign death certificates. Nurse practitioners had protested having to pay up to six-figure contracts with doctors that would allow the nurse practitioners to treat patients and write prescriptions, Mariana Alfaro reports for The Texas Tribune.

Written by Heather Chapman Posted at 2/14/2018 


February 13, 2018

My name is Rosanne. I’m 30 years old. My sobriety date is December 13, 2016. This is my story...

I grew up in a home where my mother was the provider for me and my brother. She worked very hard to make sure we had the things we needed. My father was there but that’s about it. He didn’t help my mother provide for us and never showed us any positive attention. The only attention I received from him was physical or mental abuse. I was basically left to figure out how to feed and take care of my little brother while our mother worked. I now understand that he was doing the best he knew how to at the time. I spent most of my time with my grandmother to escape what was going on at home. When I was 10 my parents got divorced and my dad basically disappeared out of my life. The first few months I was going with him for visitation, but the visits kept getting fewer and fewer until there was no contact at all. This developed into what I now recognize as an abandonment issue in my life and created a void I would spend the next 15 years of my life trying to fill.

When I was 13 I was introduced to marijuana and began smoking it daily. I thought it was solving my problems, so to speak, because I wasn’t feeling my emotions anymore, until it wasn’t. At the age of 15 I was introduced to prescription pain pills. It numbed the pain with those for a while. At 16 I met my ex-husband and at 17 we were married. I was on top of the world. I felt like I had finally found something / someone to fill that void and everything was going to be ok, again until it wasn’t! So I gradually began using prescription pain pills again to “deal with life” I guess it’s safe to say I had developed an unhealthy habit of numbing my emotions and pretending they didn’t exist. My addiction quickly escalated and later resulted in a divorce. He was never in addiction and couldn’t understand the hold it had on my life.

After the divorce the pain pills just weren’t doing the job anymore and I began searching for something else. At this point I felt totally hopeless and like I wasn’t good enough for anyone or anything. Here I was 25 years old, my father had more or less abandoned me and I had failed terribly at being a wife. Shortly after my divorce I met husband #2. He was also in addiction and as sad as it is I thought, 'well at least I don’t have to hide getting high anymore, we can get high together and it’s all going to work out this time'. That’s the kind of hold addiction had on my life. It’s sad, but true. Not long after we were married we were introduced to methamphetamine and it didn’t take long for us to figure out how to make it. Needless to say, 6 months in we were both mentally gone and our marriage fell apart. By this time I had become an IV user and was so mentally unstable that I honestly couldn’t determine what was reality and what wasn’t. This ultimately resulted in numerous trips in and out of jail and eventually felony charges. I accepted drug court as a result of this felony charge but still couldn’t quite get a grip on my addiction.

I was put back in jail a couple of times for failing drug tests but I see now that it was all a part of God’s divine plan. My last trip back to jail resulted in drug court offering me rehab. I was hesitant at first, but knew I desperately wanted to change and wanted my life back. I arrived at Beth’s Blessing on January 3, 2017. I walked in those doors broken and hopeless but yet wanting so desperately to change. I didn’t know how, or if it was even possible, but I was willing to give it a shot. While I was completing treatment I kept hearing about how others were surrendering their lives to God and what a difference it was making in their lives. It planted a seed and got me curious, but I couldn’t help but think how could God ever forgive me? How could He ever love a mess like me?! All I kept hearing though was how much God loved me and that it didn’t matter how far I had run, He was waiting with arms wide open. All I had to do was surrender.

I’ll never forget the day that God got ahold of me in that little church in Jackson County. I hit my knees and completely surrendered everything to Him. In that moment I was set free. My life has completely changed for the better since that moment. God has restored things in my life I would have never imagined and gave me my life back! When I first walked into treatment the officer, who is actually our local jailer that transported me from jail to treatment walked me in the doors and said, “You can do this, anytime you feel like you can’t just remember,” he pointed to a verse on the wall. It was Philippians 4:13 “I can do all things through Christ who strengthens me.” That stuck with me and I still use it today to get me through things that seem impossible.

Now I have no abandonment issues. I have a heavenly Father that loves me more in one moment then any human could in one lifetime. I’ve found the most amazing fill for that void and that’s the Holy Ghost. The Bible says in 2 Corinthians 5:17 NLT, “This means that anyone who belongs to Christ has become a new person. The old life is gone; a new life has begun!” So although my past will remind me, it will never define me.

What was your aha moment?

When I was sitting back in jail after just getting released 8 days prior. At that point I was sick and tired of being sick and tired I knew it was time to change.

Feelings and emotions in active addiction:

I was emotionless, heartless, and didn’t care about anything except my next high. I was basically just existing.

The driving force that keeps me going when times get tough:

God and my family. Also looking back at where God has brought me from and how much He’s done in my life since then.

Advice for the addict still struggling?

There’s always hope! You are worth it!

What obstacles or road blocks have you faced in your recovery?

Losing my grandmother; it completely turned my world upside down.

What is something you want people who never struggled with addiction to know?

We are not bad people, although we make bad choices and sometimes do bad things. Please understand that addiction controls a person’s life in ways you couldn’t imagine. We are good hearted people fighting battles most don’t understand.

What advice do you have for family members of a person in addiction?

Don’t give up! Be careful that you’re not enabling but never give up hope! Let them know how much you love them even when it seems hard to like them.

Closing Thoughts

Nobody is ever too far gone for God’s grace and mercy. No matter what you’ve done or who you used to be He loves you so much more then you can even begin to imagine. He is always there with arms wide open.

If you or a loved one is struggling with addiction, please call Addiction Recovery Care at 606.638.0938 or visit them on the web at


There is hope. There is help.

February 10, 2018

Nearly six in 10 Kentucky adults favor raising the legal age to buy tobacco products from 18 to 21 years, according to the Kentucky Health Issues Poll.

A bill to raise the legal age to 21 was last introduced in 2016 and passed out of committee, but never made it to the floor for a vote.A bill to raise the legal age to 21 was last introduced in 2016 and passed out of committee, but never made it to the floor for a vote.

The survey, taken Oct. 24-Dec. 2, found that 58 percent of Kentucky adults favored such a law and 39 percent opposed it, with majority support from both Democrats (63 percent) and Republicans (56 percent). Support among independents was 46 percent. Support was strongest in the Louisville and Lexington areas and lowest in Northern Kentucky.

“Most smoking starts before kids turn 21, so if we can dramatically reduce purchases before that age, we have a much greater chance of preventing adult smoking,” said Ben Chandler, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsors the poll.

To date, five states — California, Hawaii, Maine, New Jersey and Oregon — have raised the age to buy tobacco to 21, along with 285 cities and counties across the nation, according to release.

Anyone 18 and older can legally buy tobacco and vapor products in Kentucky, and the state’s law doesn’t allow that age to be adjusted by “local law, ordinance or regulation,” says the release.

A bill has been introduced to eliminate that prohibition. Senate Bill 93, sponsored by Republican Sens. Julie Raque Adams of Louisville and Alice Forgy Kerr of Lexington, “would repeal that prohibition and allow cities and counties to adopt stricter tobacco display and sales regulations than enacted at the statewide level,” says the release.

A bill to raise the legal age to 21 was last introduced in 2016 and passed out of committee, but never made it to the floor for a vote.

The release notes that the recently formed Coalition for a Smoke-Free Tomorrow, chaired by Chandler, supports this legislation.

“Raising the legal age to purchase tobacco products is a research-based method to keep kids from starting, and helps protect their right to breathe smoke-free air and grow up in a tobacco-free environment,” said Chandler.

According to the 2015 Centers for Disease Control and Prevention Youth Risk Behavior Survey, 16.9 percent of high school students in Kentucky smoke, which is twice the national average rate of 8 percent for the same year. The most recent 2017 survey shows Kentucky’s teen smoking rate has dropped to 14.3 percent. However, youth use of electronic cigarettes has increased.

Approximately 90 percent of adults who are daily smokers report they first smoked before they turned 19; and 2,900 youth under the age of 18 become new daily smokers every year in Kentucky, according to the release.

The poll is funded by the foundation and Interact for Health, a Cincinnati-area foundation. It surveyed a random sample of 1,692 Kentucky adults via landlines and cell pones. The margin of error for each statewide result is plus or minus 2.4 percentage points.

From Kentucky Health News