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.
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March Madness is in full swing, and depending on where you live, you might be able to place a bet on a college basketball tournament game. Wisconsin hasn't fully embraced the movement, but experts still advise people to avoid unhealthy habits.
A 2018 U.S. Supreme Court ruling paved the way for states to decide if they want to legalize sports betting. That helped fuel the presence of online platforms where people can place wagers through their smartphones. Wisconsin limits live bets to tribal casinos. But bettors can flock to some neighboring states for online access.
Rose Blozinski, executive director of the Wisconsin Council on Problem Gambling, said they're neutral on these laws but still have concerns.
"We know that more people are going to do it, and we also know that more people are going to become addicted to gambling," she said.
Since the legalization wave, Connecticut officials havehave reported a 200% increase in calls to gambling addiction hotlines.
To protect yourself from falling into traps, prevention experts recommend only betting what you can afford. If troubling patterns emerge, they suggest things like deleting betting apps and switching to flip phones. Nearly 40 states allow some form of sports betting, but some do have restrictions for college games.
The financial impacts of problem gambling can be obvious, but Blozinski noted that compulsive gamblers also have a higher suicide rate. And with mobile betting marketed toward young adults, she said this demographic should be considered high-risk.
"They're at a time where they're high risk-takers to start, and gambling fits right in with that, especially the sports betting. It makes them feel important; if you're winning, you can brag to all your friends," she added.
She said a big problem in helping young adults falling into addiction is that Gamblers Anonymous resources are outdated in the age groups they cater to. Industry leaders note their ads come with disclosures about problem gambling and where to seek help. But prevention experts say they're not easy to understand, and called for broader funding to carry out assistance programs.
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Communities across the Commonwealth want to minimize traumatic experiences for the state's youngest residents - as a way to help stem the drug epidemic, and prevent future generations from struggling with substance-use disorders.
According to Kentucky Youth Advocates, at least one in five Kentucky kids has had at least two Adverse Childhood Experiences or 'ACEs.'
These include physical, sexual and emotional abuse, neglect, having family members with a substance-use disorder, witnessing domestic violence, and parental incarceration.
Dr. Connie White, deputy commissioner for clinical affairs with the Kentucky Department for Public Health, said research shows ACEs can increase risky behaviors and the development of chronic diseases - and even lead to a shorter lifespan.
"All of these things contribute as that child's neural pathways are developing," said White, "as they're learning how to make choices - healthy choices, unhealthy choices - as they're chronically stressed and their cortisol levels are chronically elevated."
White added that it's becoming clear that interventions promoting safe, stable environments for kids can strengthen the building blocks for healthy coping mechanisms - and reduce their likelihood of dependence on alcohol or drugs in adolescence or adulthood.
Barry Allen is president and CEO of the Gheens Foundation. It's a member of BLOOM Kentucky, a statewide coalition pushing for policy changes to prevent ACEs.
He said increasingly, communities are recognizing the correlation between addiction and childhood trauma.
"And so, a small group of us grantmakers proceeded to seek an audience with then-Attorney General Daniel Cameron," said Allen, "to plead the case to apply at least half of the opioid abatement settlement dollars - over $400 million - to apply those to prevention."
This legislative session, Bloom Kentucky says it's advocating for sustained funding for school-based mental health providers to improve access to services, for establishing a process to automatically expunge an eviction from a family's record after a reasonable amount of time, and to prohibit minors from being named in eviction filings.
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Celebrating the holiday season can be complicated for households with a loved one dealing with an addiction.
A South Dakota expert said there are steps the individual and their family can take to avoid major problems.
Matt Walz, representative for the Keystone Treatment Center, said because alcohol is often provided at holiday gatherings, it is important for the host to provide different beverage options. The person in recovery can also plan ahead by getting a sense of the best time to leave if other guests are likely to be drinking more.
Walz stressed the approach is not "one-size-fits-all," and advised avoiding rash decisions.
"Some things that families like to try to do at family gatherings, in good faith, is they try to do, you know, guilting or shaming -- or just ignoring or doing the 'ostrich,' head in the sand -- it kind of runs the gamut," Walz explained.
He pointed out you can help the person feel supported and recognize they are dealing with an issue which can improve over time. For individuals going through a 12-step recovery process, Walz recommended talking with their sponsor before a party to determine the best approach, or whether it is appropriate to attend. He noted maintaining sobriety is more important than missing a gathering.
If a person's addiction is brought up at a holiday party, Walz suggested avoiding conversations with a large group of people. He said one-on-one chats are more manageable.
"Just asking, 'Well, how's it going? How's that working for you? Is there anything I can do to help?'" Walz recommended.
Walz added praising the person in their recovery is often viewed as an effective strategy. But he noted the stress from holiday planning might also trigger someone to drink excessively. Experts recommend taking walks or other exploring other, healthy coping mechanisms to minimize stress.
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