LEXINGTON, Ky. – As Kentucky continues to face an opioid crisis longer and more severe than in most states, experts are pushing for community-generated solutions.

Approximately 350 policymakers and health advocates sold out the 15th annual Howard L. Bost Memorial Health Policy Forum Monday in Lexington.

Keynote speaker Sam Quinones, a journalist whose book Dreamland chronicles the rise of prescription opioid abuse, says addicts often face "debilitating solitude."

"It seems to me that a drug that thrives on isolation is best attacked through the community," he explains. "These are ideas that have seemed to me self-evident as I've gone through my research."

According to the state's Office of Drug Control Policy, more than 1,400 Kentuckians died of a drug overdose last year - with the introduction of the synthetic opiate fentanyl into the heroin supply, driving up the death toll.

Van Ingram, who oversees the agency, says over the next few weeks his office will channel about $3 million in government grants into community-level efforts.

Ingram acknowledges state and federal dollars alone won't do the job.

"Frankfort will not solve your drug problem here in Hopkinsville or here in name the town," he says. "Matter of fact, Washington won't solve Kentucky's drug problem. Do we need them in the mix? Absolutely."

Ben Chandler, executive director of the Foundation for a Healthy Kentucky, says society has become selfish and that's "unhealthy." He says while taxes and compromise have become "nasty" words, the reality is it's going to take more resources to reduce the drug epidemic.

"We're 'Every man for himself,' and what it's really about is community," Chandler says. "It's about us knowing each other. It's about us caring for each other. And, we've got to move more toward that."

Quinones, who has spent a lot of time in this region reporting from what he calls the epicenter of addiction in America, agrees. He's convinced despite being stifled by decades of economic decline and dope, the region can find solutions.

"It's in the DNA of this area to come together and innovate," Quinones added.


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As National Glaucoma Awareness Month comes to a close, one Nevada ophthalmologist wants to remind people to get their eyes and vision checked.

Dr. Janet Lee, an ophthalmologist with Shepherd Eye Center, said glaucoma is a group of eye diseases that affect the optic nerve and can be thought of as a cable that connects a person's eye to the brain. Damage to the optic nerve can result in partial vision loss or total blindness.

Lee said there are more than 3-million Americans in the U.S. with glaucoma, and once damage to the optic nerve has been done it cannot be reversed.

"Studies have shown that decreasing the pressure in your eyes can slow down the progression of glaucoma. Fortunately, we have many effective ways to reduce the eye pressure," Lee said.

Catching it early is key, she said, and added the pressure can be reduced, ultimately slowing the progression of glaucoma, through eye drops, laser treatment or surgery.

She said regular eyes exams and prevention are key in detecting glaucoma, which has been found to impact African American, Hispanic and Asian populations at higher rates.

Lee said glaucoma is a silent disease, and while there is no cure for most forms of glaucoma, many patients, once diagnosed, can be treated successfully. Lee said as the disease progresses, blind spots develop in one's vision and the change is so gradual that a person may not even notice a change until the glaucoma reaches an advanced stage.

"Primary opening-angle glaucoma is the most common type of glaucoma." she said. "There are no warning signs or obvious symptoms in the early stages. In fact, half the people with glaucoma don't know they have it."

Lee added it is also important to be aware of acute-angle closure glaucoma, which is a less common type of the disease but is responsible for a sudden rise in eye pressure. Symptoms include headache, nausea, vomiting and pain in the eye or brow area.

It is not a pandemic yet, but eye doctors worry the constant use of digital devices could eventually result in long-term health problems for many Texans.

Problems can include age-related macular degeneration, disrupted sleep cycles, and digital eyestrain.

Dr. Jacob Moore, president of the Texas Ophthalmological Association, said it can start with dry eyes after spending hours on digital screens.

"Probably the number one reason people have dry-eye-related symptoms when they use the computer a lot, is because is when we're actively reading, we blink less," Moore explained. "Just the fact that we're working and that our minds are active, we blink less."

He pointed out the average American logs 13 hours a day watching screens, up from between seven and 10 hours per day before the COVID-19 pandemic began.

Dr. Scott Edmonds, chief eye care officer for UnitedHealthcare Vision, said eye specialists became concerned during the pandemic about the dangers of blue light emitted by digital devices, especially because people needed them for school and work, more than ever before.

"Kids were learning remotely, using screens and laptops and cellphones; workers had moved away from the office, working from home," Edmonds recounted. "We know that the millennial generation, in addition to school and work and social media, they also play a lot of games, which emit very high levels of blue light."

In addition to dry eyes, or eyes that feel scratchy or burning, people who log excessive screen time often notice the print goes in and out of focus and complain of headaches or brain fog.

Jacobs offered tips for anyone trying to protect their eye health.

"I would recommend that people wear sunglasses when they're outside. They should wear safety glasses when they're hammering a nail or doing anything that has a risk of eye injury. People need to stay away from smoke, and secondhand smoke."

Eye specialists also recommend those who use digital screens a lot follow the 20-20-20 rule: Take a 20-second break and look at something at least 20 feet away, every 20 minutes.

A bill that would expand Medicaid coverage for some 19,000 Wyoming workers who earn too much to qualify for standard Medicaid, but can't afford private insurance, is making its way through the state Legislature.

Ana Marchese - director for the group Healthy Wyoming - said expansion would bring millions of federal tax dollars back to the state, and would largely help women working at jobs that pay low wages and offer no health benefits, including restaurant, construction, agriculture and retail.

"In Wyoming, more than half of those covered by Medicaid expansion would be low-income women," said Marchese. "Wyoming has one of the highest uninsured rates for women of childbearing age. This has big consequences for the health of mothers and infants."

Wyoming is one of just 11 states that have not expanded Medicaid coverage. The most recent American Cancer Society poll found that nearly two-thirds of Wyoming voters across the political spectrum support expansion, including 66% of Republicans.

Critics have long warned about the potential costs, and some lawmakers are leery of entering into a deal with the federal government.

House Bill 80 cleared the Joint Revenue Interim committee, but has not yet been scheduled for a hearing.

Expansion has been a lifeline for rural hospitals, according to a Families USA report, lowering the likelihood of closure by 62% - largely by reducing losses when people without insurance can't pay.

Wyoming hospitals spend $120 million a year in uncompensated care.

Marchese pointed to hospitals in Kemmerer and Rawlins that recently closed labor and delivery services due to financial struggles.

"After Montana expanded Medicaid, uncompensated care went from $143 million to $89 million in 2019," said Marchese. "And that's a big deal, that keeps hospitals open."

Marchese said expanding coverage will also boost Wyoming's economy.

People with insurance tend to be healthier, more productive workers with fewer sick days. Insurance also gives workers access to less costly preventive care.

"When people lack coverage they often seek treatment at the emergency room, which comes with a hefty price tag," said Marchese. "Having health insurance, and being able to take care of your own physical and mental health, has a positive impact on your ability to work."