Fentanyl in Kentucky may be now laced with an animal tranquilizer called Xylazine, what drug officials are calling the "third wave" of the opioid epidemic. According to the Drug Enforcement Administration, in the Commonwealth, Xylazine has so far shown up at DEA labs in the Florence/Covington area and in Louisville.

Orville Greene, DEA Detroit Division Special Agent in Charge, explained Xylazine - also known as "tranq" is a powerful sedative and muscle relaxant that slows down the respiratory system and can cause severe, gaping wounds, and added Xylazine is worsening the drug crisis because it is not reversible by Naloxone, and because of the gruesome effects it has on users.

"One of the additional challenges is that people who inject drugs mixtures containing xylazine can also develop severe wounds, including necrosis, in some cases have led to to amputations," he said.

Xylazine has now been detected in street drugs in 48 states. Earlier this month The Office of National Drug Control Policy officially designated fentanyl mixed with Xylazine as an emerging threat to the United States.

Orville points out Xylazine is currently not a federally controlled substance, meaning it's easier to obtain and difficult to track.

"It allows the traffickers to reduce the amount of fentanyl or heroin for example, in the mixture and ultimately it just increases the profits. It's very cheap to obtain," he said.

A U.S. Department of Justice and DEA report found the prevalence of Xylazine in the illicit drug supply jumped by more than 193% in the South over the past two years. Xylazine-positive fatal overdoses have increased by more than 1000% in the region.

This week, Gov. Jim Justice announced five new appointments to the West Virginia First Foundation, the private foundation responsible for the statewide distribution of opioid settlement funds.

Advocates are calling for the money to be used for medication for addiction treatment and harm reduction services - such as needle exchanges, naloxone, and overdose prevention centers.

Mary Newlyn, executive director of the West Virginia Hope in Action Alliance, said expanding housing and wraparound support services for people who use drugs and people with drug-related convictions, would help stabilize communities and families.

She pointed out most substance-use disorder funding is not funneled toward those types of supports.

"Once a person has reached a state of sobriety, they need community support and access to the healthy coping techniques they obtained during treatment," Newlyn explained. "These communities are built in transitional and recovery housing."

According to the Office of Drug Control Policy there were at least 1,300 drug overdose deaths in West Virginia in 2020, a 51% increase compared to 2019. This year, there have been more than 5,000 reported EMS responses for suspected overdoses.

Tricia Christensen, director of policy for the nonprofit Community Education Group, said states should be thinking creatively about how to best use the funding to help stem the tide of substance abuse. She pointed to mental health resources, youth prevention programs and community programs focused on forging a life in recovery.

"How do we invest in our communities to really think about opportunities for kids as they're growing older?" Christensen asked. "Opportunities for those kids' parents now, right? Because we know that this is a generational issue."

The Mountain State has received an estimated $847 million from lawsuit payouts involving major pharmacy chains, drug manufacturers, drug distributors, and pharmaceutical consulting firms.This week, Gov. Jim Justice announced five new appointments to the West Virginia First Foundation, the private foundation responsible for the statewide distribution of opioid settlement funds.

Advocates are calling for the money to be used for medication for addiction treatment and harm reduction services - such as needle exchanges, naloxone, and overdose prevention centers.

Mary Newlyn, executive director of the West Virginia Hope in Action Alliance, said expanding housing and wraparound support services for people who use drugs and people with drug-related convictions, would help stabilize communities and families.

She pointed out most substance-use disorder funding is not funneled toward those types of supports.

"Once a person has reached a state of sobriety, they need community support and access to the healthy coping techniques they obtained during treatment," Newlyn explained. "These communities are built in transitional and recovery housing."

According to the Office of Drug Control Policy there were at least 1,300 drug overdose deaths in West Virginia in 2020, a 51% increase compared to 2019. This year, there have been more than 5,000 reported EMS responses for suspected overdoses.

Tricia Christensen, director of policy for the nonprofit Community Education Group, said states should be thinking creatively about how to best use the funding to help stem the tide of substance abuse. She pointed to mental health resources, youth prevention programs and community programs focused on forging a life in recovery.

"How do we invest in our communities to really think about opportunities for kids as they're growing older?" Christensen asked. "Opportunities for those kids' parents now, right? Because we know that this is a generational issue."

The Mountain State has received an estimated $847 million from lawsuit payouts involving major pharmacy chains, drug manufacturers, drug distributors, and pharmaceutical consulting firms.

More than 615,000 dollars is going to nonprofit groups in Kentucky working to end opioid addiction. According to state data, more than 2,100 Kentuckians lost their lives to a drug overdose last year - the first decline in deaths since 2018. Eligible groups include those working to raise awareness about overdose prevention, reduce the stigma around substance use disorders, and improve access to harm reduction, treatment and recovery support.

Marianne Smith Edge, chair of board of directors with the Foundation for a Healthy Kentucky said grant awardees will also receive administrative help.

"The uniqueness is not just the dollars - it's really providing that support that a lot of times nonprofits, especially smaller ones, don't have. So, that'll help them guide and ensure that the dollars really get the return on investment for those specific communities," she said.

The grant program is a partnership between the Foundation for a Healthy Kentucky and the Kentucky Cabinet for Health and Family Services.

Overdose death rates have increased by 44% for Black Americans, and by 39% for the American Indian and Alaskan Native populations, according to the CDC. The program aims to address these disparities in the Commonwealth, Smith added.

"This particular fund is really geared toward really reaching those underserved and minority populations that perhaps haven't always been the top recipients of some of the other substance abuse prevention programs," she continued.

Opioid lawsuits against pharmaceutical companies resulted in a $460 million payout to Kentucky in 2021 to provide state and local governments with funding to support opioid treatment programs.

Construction workers are more likely to die by suicide or of a drug overdose than workers in almost any other field, and a St. Louis-based peer support system and hotline wants to change it.

According to the American Addiction Centers, those who work in construction have nearly twice the rate of substance use disorders as the national average.

Don Willey, pension chairman and Trustee for Laborers Local 110, helped initiate "LEAN-STL," which stands for Laborers Escaping Addiction Now-St. Louis. He said the program's peer support specialists have lived experience, which is effective in helping others in their recovery.

"There are people that gain recovery and want to give it away and help other people attain recovery and maintain sobriety," Willey explained. "That has been the best model in dealing with people struggling with mental health issues and addiction."

Willey pointed out the construction industry is both physically and mentally taxing, and he has seen many people become addicted after being prescribed opioids for pain. He explained construction jobs have some definite benefits, but there's also the uncertainty of not knowing when the next project will come around, which can be stressful.

Willey noted LEAN STL peer support specialists are also working to help break down stigmas associated with substance use disorders, addiction and mental health. He emphasized they offer resources, not diagnoses or treatment. And he added more can still be done, not only in the construction industry, but across the board.

"We need to create an environment of free thought and speech when it comes to this topic," Willey urged. "We need to make these epidemic issues in this country as easy as talking about blood pressure, weight loss, weight gain. As easy as dealing with diabetes. It should carry no more stigma than that."

Willey stressed staying silent on the issue can be deadly. The LEAN STL program is free of charge, for Laborers' union members and their families. It's funded through the Greater St. Louis Construction Laborers Fund.