Each year some 68,000 people in Colorado and across the U.S. die from opiate overdoses, largely due to lack of treatment, and federally qualified health clinics in southwestern Colorado are pioneering an effort to give people access to care at the same place they get their annual medical, dental and vision checkups.

Jeanne Marotta, a family nurse practitioner with Axis Health System in Pagosa Springs, said getting people onto alternative medications can save lives.

"Medication Assisted Treatment works," Marotta said. "We can roll it out quickly, we can get people over onto this other medication very quickly. And we can prevent those deaths that otherwise are going to continue to happen on a daily basis."

Marotta said the increased use of powerful synthetic opiates, including fentanyl, has led to a high number of unintentional overdoses. The treatment gives patients medicines that are safer than opiates as those people work to move past addiction.

Since 1999, the number of opiate-related deaths has increased every year, and overdoses have risen by 44% since the onset of the pandemic.

Taylor Miranda Thompson, a senior quality initiatives manager with Colorado Community Health Network, is working with Axis staff on clinical guidelines, policies, best practices and workflows for Medical Assisted Treatment. She said because of the health centers' unique team-based approach, patients have access to both medical and behavioral professionals throughout the process.

"A patient may get a prescription. At the start maybe it's just a couple of days," said Miranda Thompson. "They take it on a daily basis at home, and then they would come back to their primary-care provider, their treatment team, to see 'how are you doing? Is it working for you?'"

Marotta encouraged anyone struggling with addiction to check in with their primary-care provider. Even if they are not ready to quit, there are ways to prevent accidental death. Make sure you're not alone when using, and have Narcan on hand, which can reverse the effects of opiates in the event of overdose.

Narcan is available without a prescription at most pharmacies and can be administered by anyone nearby who happens to witness a potential overdose.

"Even if you decide that medication assisted treatment is not the best option for you at this time, part of harm reduction is making choices - if you are going to use opiates - to do so in the safest manner possible," Marotta said.

March is Sleep Awareness Month and health experts say Americans are not getting enough of it.

United Health Foundation data found more than 32% of those surveyed said they got fewer than seven hours of sleep, although the rate was slightly better in Oregon at about 28%.

Dr. Kimberly Hutchison, associate professor of neurology and sleep medicine at Oregon Health and Science University, said our culture devalues sleep, with the perception people who get the sleep they need are lazy or not working hard enough.

"Because we live in this accomplishment-driven culture, it results in people sacrificing sleep in order to get other things done," Hutchison explained.

Hutchison pointed out sleep is as important for our health as the food we eat or exercising. The recommended amount of sleep for adults is seven to nine hours in a 24-hour period. For teens and adolescents, it can be as much as 10 hours. For older adults, the number is closer to seven.

Dr. Ravi Johar, chief medical officer for UnitedHealthcare, said one of the best ways to ensure you are getting enough sleep is to have a regular schedule.

"That's something that's really important, just having a routine, whether it's brushing your teeth, changing into pajamas, doing some kind of activity before you go to sleep," Johar outlined. "Yoga, listening to music, reading, things of that sort, setting your alarm for the same time every day."

Johar added people should see a health professional for medical issues such as insomnia or sleep apnea.

"Sometimes there may be underlying medical problems that are making it difficult for you to sleep," Johar noted. "The other thing that's really important that people don't realize is how much stress and behavioral-health issues can factor into their sleep."

It's been 13 years since more than 156,000 West Virginians gained health insurance coverage through the Affordable Care Act.

As sweeping and sometimes controversial as the ACA has been, its longer-term effects are still being felt today at the state level.

Gary Zuckett, executive director of the West Virginia Citizen Action Group, pointed to a new West Virginia law capping insulin copays at $35 per month. The law goes into effect January 1.

"I think we now have the best insulin copay cap legislation in the country that we just helped get passed in a very 'red' legislature," Zuckett noted. "Which does show you that health care is not partisan."

Federal data shows since the launch of the federal health insurance exchange, enrollment in health insurance plans has doubled from 8 million to more than 16 million nationwide.

According to the West Virginia Center on Budget and Policy, the Medicaid expansion included in the ACA allowed more than 200,000 West Virginians to gain access to health coverage.

Zuckett cautioned when the "continuous coverage" rules enacted during the pandemic expire April 1, the state will begin re-evaluating people's eligibility, which could signal a setback in progress.

"A lot of people won't qualify or won't fill out the paperwork, and they'll lose their health insurance in West Virginia," Zuckett explained. "That could be as many as 50 or 100,000 people. So, that's going to be a step backwards."

According to America's Health Rankings, around 6% of West Virginians were uninsured in 2021, far fewer than the nearly 16% of the state's population who lacked coverage prior to the Affordable Care Act.

Beginning next year, more Kentuckians will have expanded access to biomarker testing - which helps doctors customize cancer treatment. Advocates of the new law say it will save lives and improve patients' quality of life.

Signed into law by Gov. Andy Beshear, House Bill 180 requires both private insurers and Medicaid to cover biomarker testing after a cancer diagnosis.

Doug Hogan - director of government relations for the American Cancer Society Cancer Action Network (ACS CAN) - explained that without biomarker testing, doctors typically try several rounds of chemotherapy or other treatments, without knowing which will work best for the patient.

He said biomarkers increase the odds of matching the right treatment to a specific cancer.

"We will be the fifth state in the country to adopt an enhanced access to biomarker testing law," said Hogan. "And so, we're on the cutting edge. This is the way that we can utilize technology to improve health outcomes."

The bill passed unanimously in both the House and Senate. According to the American Cancer Society, more than 30,000 Kentuckians will be diagnosed with cancer this year.

Hogan added that the new law will allow care teams to use the latest technology to make the best decisions for their patients.

"It is so important for these patients to get that right treatment at the right time," said Hogan. "It really will improve their health outcomes. It will save lives in many instances, and certainly will improve the quality of life."

Research shows biomarkers can in many cases reduce the cost of therapy, especially for lung cancer and colorectal cancer patients.

Cancer-care costs are expected to top more than $245 billion by 2030, according to the American Association for Cancer Research.





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