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In Trimble County, school staff are expanding services for students and families aimed at curbing vaping, marijuana and opioid use, and increasing psychological supports.

Denise Hall, advocate for the Trimble CARES Coalition, provides one-on-one education for students who violated school drug and alcohol policies, and led the push to install vape detectors in the county's high school.

She said more recently, schools have grappled to address rising anxiety, depression and self-harm, among youths.

"We are bringing in-school mental-health counselors," Hall explained. "We are filling a lot of duties that you think would be parental; we're also offering parental classes."

According to a Centers for Disease Control and Prevention survey published last year, 37% of high school students nationwide reported their mental health was not good most or all of the time during the pandemic. Hall is a recent recipient of the Foundation for a Healthy Kentucky's 2022 Gil Friedell Award for her career serving Trimble County students.

Jessica Wilcoxson, superintendent of Trimble County Public Schools, pointed out detention or other discipline methods for students addicted to vaping do little to address the problem. She said schools have implemented counseling sessions to work at the root cause of why a child begins vaping.

"So although there are still consequences in place for when a student vapes, we are now turning more toward methods to try to help remediate," Wilcoxson noted.

Hall added the region's economic situation has played a role in students' drug use, noting many parents travel to other communities to work, leaving adolescents unsupervised for most of the day. She argued a one-size-fits-all model can't meet families' needs.

"We've learned that not one thing works, but to combine a lot of things and to have as much of the community involved really helps," Hall observed.

In addition to vaping, federal data show teenagers nationwide are now heavily misusing prescription drugs, which can impair healthy brain development and increase the risk of engaging in other harmful behaviors.


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More than 4,000 people in North Carolina died of overdoses in 2021, the highest number of overdose deaths in a single year on record in the state, according to recently released data.

Dr. Susan Kansagra, assistant secretary for public health with the North Carolina Department of Health and Human Services, said before the pandemic, the state's opioid overdose deaths had been leveling off, but now, she said they are on the rise, and communities have spent the past few years grappling with the loss of loved ones.

"We're seeing an increase in poly substance use as well," Kansaghra said. "Not just deaths caused from opioid overdose, but really we're seeing multiple substances have been used. "

She said the manufactured opioid called fentanyl is driving fatalities. In 2021, more than 77% of overdose deaths in the state likely involved fentanyl. The state's 988 Suicide and Crisis Lifeline offers 24/7 access to trained crisis counselors who can help people experiencing distress. Since the launch of 988 last summer, the call center has seen an 85% increase in people identifying substance use as their primary reason for calling.

Kansagra added health insurance is a major component of addressing the opioid epidemic. Lawmakers recently reached a bipartisan agreement that puts the state on a path to allow access to health care for an additional 600, 000 North Carolinians.

"One of the things we know in North Carolina is that we we are working on Medicaid expansion. And that's really important so that people have the ability to get high-quality care," Kansagra said.

She said the state has also expanded its mobile crisis care resources, where a person experiencing a behavioral-health or substance-use crisis can receive an assessment on the spot, whether at home, school, work or other location.


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Another Minnesota House committee has endorsed a bill that would allow sports betting within the state, but there are calls to add some provisions as the measure advances.

If approved, licenses would be provided to tribal nations around Minnesota to create sportsbooks at casinos, and Minnesotans age 21 and older could also place wagers through their phones, using online apps.

Bill sponsors have said revenue would go toward regulations and consumer protections, with another 40% used to address problem gambling. Susan Sheridan Tucker, executive director of the Minnesota Alliance on Problem Gambling, said that language is appreciated, but she asked lawmakers if information-sharing can be included, too.

"Operators and their licensees will be collecting quite a bit of data that can help answer many questions that researchers have concerning gambling behaviors," she said, "and can provide insights into whether more individuals are becoming addicted to gambling."

Tucker, whose organization is neutral on legalizing sports betting, stressed that no personal information, including a bettor's identity, would be shared. She said at least two other states have these provisions in their laws. The Minnesota Indian Gaming Association has said it needs more information before commenting on that recommendation.

Key supporters of the plan have said that with more than 30 other states already allowing sports betting, it's time for Minnesota to take something already being done on the black market and put it under the state's purview.

David Prestwood, government affairs manager for the online betting firm DraftKings, echoed that sentiment in his testimony.

"An estimated 1.17 million people in the state are making a combined total of more than $2.5 billion in illegal wagers annually," he said. "Nearly all of these wagers are placed online in the robust illegal market, where sophisticated illegal operators capitalize on the popularity of this form of entertainment."

As for the sharing of aggregated data, the bill's sponsor expressed a willingness to have more discussions about it. More broadly, the current version excludes horse tracks, potentially complicating final passage in the Legislature.

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The federal government said it is clamping down on the use of telehealth for drugs with a high risk of abuse.

Under the proposed rules, doctors will be required to see patients in person for a prescription at least once for drugs such as Adderall and Ritalin. Nearly four million people reported misusing prescription stimulants in 2021, according to data from the National Institutes of Health.

Michelle Lydenberg, senior manager of data and learning at Cincinnati-based Interact for Health, said both prescription and nonprescription drug use have had devastating effects on Ohio communities.

"So we're talking about HIV, hepatitis C. Those are extremely costly, unfortunate diseases to have to deal with," Lydenberg pointed out. "There are many ripple effects that go along with an increased rate of substance-use disorder, overdose, and overdose death in a community."

In a news release, U.S. Drug Enforcement Administration administrator Anne Milgram said the agency is committed to the expansion of telemedicine with guardrails to prevent the online overprescribing of controlled medications which can cause harm. The new rules will likely go into effect this spring.

Lydenberg noted counties could begin thinking about how to improve access to substance-use resources in rural counties, especially as opioid settlement money flows in.

"The stigma of addiction makes it harder to expand and access those services," Lydenberg acknowledged.

In Ohio, more than 5,200 people died of a drug overdose in 2020, according to the Centers for Disease Control and Prevention.

According to a new Axios-Ipsos poll, around one in four Americans said opioids and fentanyl are the nation's top public-health threat.

Reporting by Ohio News Connection in association with Media in the Public Interest and funded in part by the George Gund Foundation.

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