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.

While overdose deaths in the Commonwealth have declined, deaths among Black Kentuckians have increased by 5%, according to data from the latest Kentucky Overdose Fatality Report.

Organizations across the state are working to stem overdose deaths among residents of color. In Bowling Green, the nonprofit HOTEL INC. is focused on harm reduction.

Rebecca Troxell, HOTEL INC. lead navigator, explains the group's street teams go into homeless encampments and provide Narcan, fentanyl strips, hygiene packets and medical care.

"We have volunteer doctors, EMTs and nurses who go out with us, so we're able to provide medical care on site. We're able to provide educational components with that, as well, helping people understand what harm reduction really is," she said.

She added a recent SHIFT grant from the Foundation for a Healthy Kentucky will allow the street teams to reach more people. The program, which awards funding up to $50,000, aims to reduce disparities and other inequities worsened by the drug crisis.

In Lexington, the nonprofit agricultural organization Black Soil KY is adding Narcan boxes and educational materials to its farmers markets. They are also working to improve access to fresh food among Kentuckians in recovery.

Ashley Smith, co-founder and CEO of Black Soil, said farmers will also receive harm-reduction training: "We know having that unbarriered access to local goods, like seasonal produce, local meat within your recovery housing, just really provides an advantage for the overall outcome."

Kayla Migneron, director of the Louisville-based maternal health program Granny's Birth Initiative, said the SHIFT grant funding will help expand stigma-reduction training for doulas.

"Our main goal is that any person would be comfortable coming to get assistance from us, whether it's accessing resources using our stuff, even just asking for connections to other programming," explained Migneron.

Nationwide, overdose deaths among mostly younger Black women nearly tripled between 2015 and 2021.

In Robeson County, the opioid crisis is exposing the need for increased addiction support. The Southeastern Prevention and Addiction Recovery Resource Center is tackling the issue by bringing together more than 70 organizations into a unified recovery network.

Jackie Davis, SPARC director, says its goal is to streamline services and improve access to comprehensive support.

"Robeson County has a high rate of usage, and so one of the main challenges has been services and then organizations and agencies working in silos," Davis said.

She added that before SPARC, local agencies were isolated in their efforts. Now with funding and support in part from the Kate B. Reynolds Charitable Trusts, she said community-based initiative is fostering cooperation to better serve the people of Robeson County, with plans to secure ongoing funding and improve access to care.

Davis said SPARC provides critical resources such as training, educational support and help securing opioid settlement funds. She said these efforts have improved patient care and developed long-term recovery strategies tailored to the community's needs.

"Health disparities here, we just want to reduce or even eliminate if we can, because we know that there are major differences from rural areas to urban areas or larger cities, and we just want better for our community," she said.

She noted that future goals include addressing transportation barriers to ensure access to services and ensuring sustainability through continued funding and support for member organizations.

By Adam Pinsker for WISH-TV.
Broadcast version by Joe Ulery for Indiana News Service reporting for the WISH-TV-Free Press Indiana-Public News Service Collaboration

THC retailers across Indiana are being warned they could be violating Indiana law by selling cannabis products containing more than 0.3% of the chemical Delta-9, which can have an intoxicating effect and may cause some side effects.

Although no Indiana law regulates Delta-9, the Indiana Attorney General's Office issued an opinion in 2023 defining Delta-8 and Delta-10 as Schedule I drugs.

Vigo County Prosecutor Terry Modesitt says violators could be charged with a high-level felony.

"I personally felt the fair way to deal with this was to send a letter to all the businesses and advise them of the attorney general's ruling, and to give them some time to get these products off their shelves," the prosecutor based in Terre Haute said.

Modesitt estimates from 30 to 40 retailers in the county along I-70 on the Illinois border - many of them gas station convenience stores - are in violation.

"We've actually had our drug task force, since I've sent this letter, going around checking businesses," he said.

Modesitt said until state lawmakers pass legislation clearly defining how much cannabis can be sold in Indiana, he'll have to enforce the laws based on the attorney general's opinion.

Indiana State Police investigators secretly bought THC products and found some of them were mislabeled. In other cases, they found Delta-9 products had more than the 0.3% of THC allowable under a federal law passed in 2018.

State officials and CBD retailers have also expressed concerns that some THC products may have chemicals added to them.

Scott Hughes, co-owner of WildEye Lounge dab bar in Indianapolis, said he and his business partner, Nick Brown, test all of their cannabis products. "To show there is no heavy metals, to show there is no pesticides in the product, which we do regularly with all of our products before we release them."

Hughes urges customers to do their homework before purchasing any CBD product.

"You're not going to go to your mechanic to ask why your knee hurts. You're not going to go to your doctor to ask what is wrong with your car," Hughes said.


Adam Pinsker wrote this article for WISH-TV.


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