As opioid settlement money continues to flow into Kentucky, counties are having to make major decisions on how to spend it.
Half of it goes to the state's Opioid Abatement Advisory Commission, which allocates funds through a competitive grant making process.
Margaret McGladrey, assistant professor of public health at the University of Kentucky, pointed out smaller counties with fewer resources face greater challenges seeking community input on how to use the funds.
"I think there's certainly a capacity issue when we're asking each of these local governments to engage in communities in decision-making and then spend the money in accordance with that decision-making," McGladrey observed.
The Commonwealth is slated to receive around $900 million statewide across the various settlements involving companies distributing opioids, such as CVS, Walgreens, and Walmart, and pharmaceutical companies such as Purdue Pharma and the Janssen Pharmaceutical Companies of Johnson & Johnson.
According to the Appalachian Opioid Remediation tracker, the state's Opioid Abatement Advisory Commission requires local governments to submit a quarterly form certifying funds were used for their intended purposes but does not ask for specific details about expenditures.
Kate Boulton, senior legal technical adviser for the public health organization Vital Strategies, argued it important to distinguish between state spending inconsistent with the terms of the national settlements or state laws, and spending which is not evidence-based.
"In the first category, I would flag things like shooting ranges, ballistic vests, drug sniffing dogs and vehicles for law enforcement," Boulton outlined. "Those are all real life examples from various parts of the country."
McGladrey recommended to keep families intact and reduce the negative consequences of involvement in criminal legal and child welfare systems, counties should consider using funds for comprehensive medication-assisted treatment.
"Where we can have the most impact with these opioid abatement funds, is supporting our county correctional facilities in implementing medication treatment for opioid use disorder," McGladrey urged.
According to the Kentucky Youth Advocates Opioid Dashboard, in 2020, more than 30% of Kentucky children said they have lived with someone who had a problem with alcohol or drugs.
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Kentucky's latest drug overdose fatality report showed a drop in deaths and for the first time, a decline in deaths among Black Kentuckians.
Groups across the Commonwealth have been working to increase access to harm reduction services.
Latosha Perry, executive director of the Louisville-based nonprofit EmpowHer with Open Arms, said her organization provides prevention services to adolescents as well as group and individual therapy for adults who are typically required to be in therapy in order to see their children.
"Some struggling with addiction or just now coming out of incarceration, they don't have the money to cover those expenses," Perry explained. "It typically decreases the rate of them reunifying with their family."
Overdose deaths in the Commonwealth decreased for the third year in a row, with a slightly more than 30% decrease in 2024, compared with the previous year. Still, more than 1,400 Kentuckians died of a drug overdose.
Ashley Smith, founder and executive director of the nonprofit agribusiness Black Soil Kentucky, said her organization has distributed Narcan units and provided training to farmers so they are equipped to act as first responders.
"We have worked to pair education outreach and technical assistance with direct produce distributions across rural and urban communities," Smith pointed out.
Both organizations received grant funding from the Foundation for a Healthy Kentucky for their harm reduction efforts.
If you or a loved one is struggling with addiction, call 833-8KY-HELP (833-859-4357) to get assistance connecting with a treatment center. Information about treatment programs is available at FindHelpNowKy.org, and information about how to obtain naloxone is available at FindNaloxoneNowKy.org.
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With less than a week in the legislative session, Nevada lawmakers are considering a bill which would change the state's laws for driving under the influence.
Senate Bill 304 would eliminate the threshold of offenses for driving under the influence prosecutors need to charge someone with vehicular homicide. Current law mandates a person have three prior DUI offenses within a seven-year period before they can be charged with vehicular homicide on a fourth offense that results in death.
According to state data, half of deadly crashes on Nevada roads are caused by drunken drivers.
Sandy Heverly, cofounder and executive director of the nonprofit Stop DUI, said she believes the bill could help save lives.
"Why are we giving these people three chances to kill us?," Heverly asked. "We've reached a point where the penalty for the crime should, and must, outweigh the risks these drunken fools are willing to take."
The bill would not only allow charges on the first deadly DUI offense but the person could face more time behind bars. Some public defenders oppose the legislation, saying state law is already tough enough on people charged with DUI. They want more training for alcohol servers and providers to prevent incidents in the first place. The bill was heard in committee last week.
Alyssa Belle Yabut is the eldest daughter of Nevada State Police Trooper Alberto Felix. Felix and Nevada Highway Patrol Sergeant Michael Abbate were killed by an impaired driver while they assisted another driver in 2023. Yabut said DUIs not only take lives, they shatter families.
"Every holiday, every birthday and every ordinary day, we feel his absence," Yabut explained. "Unjustly, under the current Nevada law, that driver could not be charged with vehicular homicide because he didn't have three prior DUIs."
Yabut said she wants the bill to be a turning point for Nevada. Critics warned the bill could lead to steep financial implications for the state and perhaps significantly increase the state's prison population.
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As Women's Health Month winds down, public health officials in Minnesota are joining the chorus of professionals warning about the prevalence of alcohol misuse, and the added health risks for women.
Problem drinking among women is on the rise, according to the National Institutes of Health.
When compared to men, women have had larger increases in alcohol-related emergency room visits, hospitalizations, and deaths in the past two decades.
Division of Epidemiology & Community Health at the University of Minnesota Professor Toben Nelson said men still drink more, but agrees it's a pressing issue for women.
He noted the significant health consequences if they develop a problem.
"A real concern for younger women - when alcohol is involved, the risks for interpersonal violence are very significant," said Nelson. "Also, injuries related to falling, that is certainly a concern as one ages."
According to federal health agencies, frequent alcohol consumption is also linked to a greater chance of developing breast cancer.
It's recommended that adult women of legal drinking age limit their alcohol intake to one drink or fewer each day.
The NIH website Rethinking Drinking has information on signs of a problem, and how to manage and respond to these situations.
For broader prevention work, Nelson encouraged bars, restaurants, and policymakers to embrace effective strategies.
"Responsible beverage service training in places that serve alcohol," said Nelson, "and also restrictions on alcohol outlet density."
He was referring to limits on approving the number of liquor stores and similar outlets in a given area.
UnitedHealthcare's Chief Medical Officer for Women's Health Dr. Lisa Saul pointed to how alcohol is marketed toward women these days.
"Terminology," said Saul, "like 'it's wine o'clock,' or 'mommy juice,' - those sorts of things have really normalized the consumption of alcohol in ways that we didn't really see before."
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