New marijuana product called 'wax' often smoked in e-cigarettes

A new marijuana product on the market called Wax (also called Butter and Honeycomb) that is easily disguised and used in e-cigarettes has found its way to Kentucky, Erica Coghill reports for WLKY-TV in Louisville.

It is called "wax" because its yellow color and waxy texture makes it look like earwax, and that makes it easy to conceal because it looks and feels like lip balm, Raychelle Cassada Lohmann writes for Psychology Today.

"Wax" is made from the oils of marijuana plants and has a high level of THC, the ingredient in marijuana that makes a user high, and while it is easy to make, the ingredients are "highly flammable and dangerous," Lohmann reports.

"What they do is they take marijuana, then take the THC out of it, put it in wax form, stick it in an e-cig, which heats it up, melts it, and you smoke it just like an e-cig, but you get the high off the marijuana," Tim Gividen, Carrollton police officer told Coghill.

"Wax" is much stronger than marijuana,. and can be eaten or smoked. "What's super-scary is that this new substance is equal to smoking 15 to 20 joints and can give a buzz that may last a full day," Lohmann reports.

E-cigarettes are composed of water vapor, flavoring and nicotine.  "You're not going to get the marijuana smell off the smoke, because it is going to be disguised with flavoring, "Gividen told Coghill. Heroin is also being smoked with e-cigs, Coghill said.

Gividen, who patrols schools in Carroll County, learned about "wax" when he confiscated an e-cigarette from a student at Carroll County High School and started asking questions. He found out that it had been popular on the West Coast, but had worked its way across the country.

"Actually, in Trimble County, it has been an issue within their high school, so we know it is something that is surrounding us and a problem," Hayley Franklin, director of Champions For A Drug Free Carroll County, told Coghill.

Gividen and Franklin reminded parents to "keep an eye on their kids and who they're hanging out with, and educate them about the dangers of drugs."

Lohmann suggests that parents keep an eye out for items used in the making of "wax": butane containers, glass/metal tubes, glass baking dishes, isopropyl alcohol and coffee filters.

AMA president-elect, from Lexington, talks with KET host about the myriad issues facing his profession and its patients

Steven J. Stack

The new president-elect of the American Medical Association, Dr. Steven J. Stack of Lexington, covered a range of topics with Bill Goodman on KET's "One to One" in December, including the AMA's advocacy role, health information technology, improving health disparities in Kentucky and medical liability reform.

Stack, an emergency physician in Lexington, told Goodman that his experience as an emergency room physician would bring a unique perspective to his role as AMA president because he has seen first-hand how many people don't have health insurance and therefore a lack of access to routine care.

"As an emergency-room physician, it has been for me a personal hope and aspiration and a great joy to see that we are making strides finally to improve American's access to care because we know that those without access to health insurance and support live sicker and die younger," Stack said. "And that's a tragedy that we should not stomach easily or tolerate in this nation."

Not only is Stack the first board-certified emergency physician elected president, when he takes office in June he will be the youngest person to lead the AMA, the nation's largest organization for physicians. He is a longtime member of the organization and has held many leadership positions. He is the second Lexington doctor in three years to hold the office. AMA's immediate past president is Dr. Ardis Dee Hoven, an infectious disease specialist at the University of Kentucky.

Stack said the AMA as an association is non-partisan and works with people in both partie "to advance policies that we hope will improve patient care and the practice of medicine." That being said, he then said he fully recognized the role of politics in health policy and said he will, "have to advocate strenuously at times for those policies that we think will be helpful."

He talked about the privilege of being an advocate before Congress, federal agencies and the state legislature. "It is an incredible privilege and it is one that I take very seriously," he said.

Stack headed the AMA’s Health Information Technology Advisory Group from 2007 to 2013 and is a member of the federal advisory groups for the Office of the National Coordinator for Health Information Technology.

"Healthcare is one of the last big sectors in the U.S. economy to go digital in its management of information. And there are good reasons for that delay," Stack said. He listed several reasons: the complexity of health care, the varying needs of different types of health-care facilities, maintaining patient privacy, continuing technological barriers, and politics.

Asked why it is taking so long to make advancements with electronic health records, Stack blamed "policy issues, differences in opinion, protecting privacy, a variation across all 50 states and layering on top of that different federal requirements." But he added, "We will get there."

Stack suggested that focusing on improving health outcomes, which is part of the AMA strategic plan, would ultimately help improve many of the health disparities that face so many Kentuckians.

Asked about the continued calls by some to repeal the Patient Protection and Affordable Care Act, Stack said the time to quit arguing about it is long past, it is "the law of the land" and recent polls show that the many people who have received insurance through the PPACA are happy with it.

"It is here to stay and we need to  get to work on fixing the things that have to be fixed," he said.

At the same time, the AMA firmly supports medical liability reform, which was not included in the reform law. Stack told Goodman that this reform is not only important for physicians, but also patients. "Only one in 100 cases actually prevail against the physician at trial," he said, and "Nearly 90 percent of cases are either dismissed or dropped, closed or settled with no payment from the physician to the plaintiff. It is clearly not helping the patients."

He called for "a rational system" that appropriately compensates patients who are "inappropriately harmed" and treats physicians fairly, while not making a "small number" of lawyers rich.

Asked what his overarching goal as president of the AMA would be, Stack said, "I would really like to see all Americans have access to high quality, reliable health care that is affordable and within their means. So the AMA and I will work diligently to that end and it is a great privilege to do that."

Click here to view the program.

Kentucky has recorded 26 flu-related deaths, mostly seniors, and 64 outbreaks at long-term-care facilities; get vaccinated!

Kentucky has reported 26 influenza-related deaths and 64 flu outbreaks in long-term care facilities as of Jan. 8 after five consecutive weeks of widespread flu activity, and is only halfway through the flu season, which runs from October through May, a top state health official said Thursday, Jan. 8.

And with the flu season in full swing and not expected to improve any time soon, Deputy Health Commissioner Kraig Humbaugh said it's not too late to get a flu shot and "Practically everyone 6 months and older should get a flu vaccine." He added, "Even though this year's flu vaccine is not as well matched to covering the circulating strains as we would like to see, it is still the best way to prevent the flu."

"The types of people that are likely to experience severe illness are the young, the elderly, pregnant women and people with chronic illness," Humbaugh said. "That is why we especially want those folks to receive a flu vaccine each year."

Last flu season, there were approximately 50 flu-related deaths. "All areas of the state have been affected by flu deaths and have been affected by the circulating flu this year," Humbaugh said.

He noted that 19 of the 26 reported deaths were among people 65 and older. He encouraged seniors to get vaccinated because they have the highest risk of complications from the flu and are most likely to be hospitalized because of it. Typically,70 percent of seniors are vaccinated. Among the other reported deaths, two were children and five were aged 18 to 64.

Humbaugh also suggested that "the old advice that your mother gave you still applies" to stay healthy: Wash your hands well and often, don't touch your mouth and nose unnecessarily, and avoid large crowds and contact with sick people. He reminded those who are sick to stay home from work or school and to sneeze into their elbow to avoid spreading the flu.

The Centers for Disease Control and Prevention are urging doctors to prescribe more antiviral medication to help patients heal faster, saying in a news release, "Evidence from the current and previous influenza seasons suggests that they are severely underutilized."

Humbaugh said, "People who are sick with the flu can potentially benefit from an anti-viral medication, such as Tamiflu or Rolenza." He noted that the drugs must be prescribed by a health provider and work best if taken during within the first two days of illness. No widespread shortages of these antiviral medications have been reported.

Long-term care facilities across the state have reported 64 flu outbreaks, meaning they have one or more cases of flu in their facility, this flu season. Facilities are working with the state to determine how to control outbreaks, Humbaugh said. He encouraged those with the flu to stay away from these facilities and for the public to respect the rules put in place at these facilities to protect this most vulnerable population from the flu.

Belief in bogus studies and stories undermines use of vaccines that have been proven safe, resulting in spread of diseases

UPDATE: Jan. 16, 2014 4:50  Kentucky has not had any reports of measles in the past three years. It has had two cases of mumps in 2013 and two cases of mumps in 2014. Kentucky continues to have a large number of  pertussis, or whooping cough, cases with 666 in 2012; 383 in 2013; and 292 in 2014. The 2014 reports have not been finalized at this time.

The United States has recently seen a significant rise in the number of cases of vaccine-preventable diseases such as measles, mumps and pertussis, commonly called whooping cough.

A recent report blames this on an anti-vaccine movement caused by widespread misinformation about the safety of immunizations, John Wihbey reports for Harvard University's Shorenstein Center on Media, Politics and Public Policy.

"Over the past two decades, a combination of fraudulent scientific studies, irresponsible reporting, and well-meaning but misinformed citizen activists has led to a steady increase in the proportion of parents who have concerns about the recommended childhood vaccine schedule," says a 2014 report from the American Academy of Arts and Sciences.

Many young parents in the United States have no memory of  the time before vaccines and don't realize how important successful vaccination programs are to prevent the reemergence of the diseases they protect us from. In 2014, the United States had 610 confirmed cases of measles and 20 outbreaks, the highest number of cases since measles elimination was documented in the U.S. in 2000, according to the federal Centers for Disease Control and Prevention.

Chart provided by the federal Centers for Disease Control and Prevention

The origin of much of this misinformation is a "fraudulent" 1998 study, published in a well-respected British medical journal, that linked the measles-mumps-rubella (MMR) vaccine to autism. And while the study never claimed a definite link between the vaccine and autism, "sensational media reports ignited a public panic and MMR vaccinations fell dramatically," WebMD reports.

The study has since been discredited and retracted from the journal because it "was proven entirely false and even labeled "fraudulent,"" Wihbey writes. A new study, that updated this 1998 fraudulent study, has also shown that the MMR vaccine is not the cause of autism, Daniel J. DeNoon reports for WebMD.

"We are convinced there is no link between MMR vaccination and autism," study leader W. Ian Lipkin, MD, director of the center for infection and immunity at Columbia University in New York City, said at a news conference, DeNoon reports. Lipkin noted that this study did not address the theory that the mercury-containing preservative thimerosal might cause autism. The MMR vaccine does not contain thimerosal.

As for thimerosal, "A very large number of scientific studies have been carried out, and extensive scientific reviews, that have concluded there is no causal connection between vaccines or the preservative thimerosal and autism," Anne Schuchat, director of the CDC's National Center for Immunization and Respiratory Diseases, told DeNoon in a different article for WebMD.

The rate of vaccination in the United States is 92 percent for measles, mumps and rubella, which is relatively high, Wihbey reports.And only 1 percent of children in the United States do not receive any vaccines, according to the CDC..

But, "if we stop vaccinating, even the few cases we have in this country could very quickly become tens or hundreds of thousands of cases," says the CDC website.

How "herd immunity" protects us all.

National Institute of Allergy and Infectious Diseases

One concern is that as the vaccination rate drops, the United States will loose its "herd immunity," which offers a level of protection across an entire community that protects even the un-vaccinated. This type of noncompliance occurred in 2011, when 15 states saw MMR vaccination levels below the target level of 90 percent, Wihbey reports. Adding to misinformation about immunizations is media coverage of activists and celebrities with anti-vaccine positions.

In an in-depth article about the media's role in spreading misinformation that childhood vaccines cause autism, Curtis Brainard, for Columbia Jouralism Review, writes: "The consequences of this coverage go beyond squandering journalistic resources on a bogus story. There is evidence that fear of a link between vaccines and autism, stoked by press coverage, caused some parents to either delay vaccinations for their children or decline them altogether."

And it looks like many choose to believe unsubstantiated stories rather than public-health campaigns that attempt to address this misinformation, according to a recent study published in the peer-reviewed medical journal Pediatrics.

“None of the pro-vaccine messages created by public health authorities increased intent to vaccinate with MMR among a nationally representative sample of parents who have children age 17 years or younger at home," the study concluded.

The researchers said there should be more careful testing of public health campaign messages, suggesting that pediatricians, rated by parents in the study as the most trusted source of vaccine safety information, could be an "especially persuasive source" for this information.

The vast majority of Kentucky's children have been immunized, possibly because state law requires immunizations for admission to school, with exemptions made only for medical or religious purposes.  The CDC reported that less than 1 percent of Kentucky kindergarten children were exempted from one or more vaccine during the 2013-14 school year.

Beshear: Improving health means progress on other issues

Gov. Steve Beshear gave his eighth and final State of the Commonwealth address Wednesday night touting the many accomplishments Kentucky has made in the past seven years under his leadership, but he also said there is work to do, including improving the health of Kentuckians, which is related to so many of the state's problems.

Associated Press photo by David Stephenson

While Kentucky has led the way on many health fronts with the implementation of electronic health records, expansion of Medicaid under federal health reform and a "nation-leading health benefit exchange," Beshear said, it still ranks "among the worst, if not the worst, in almost every major health category."

He said those issues are broader than people think: "There is a direct line from poor health to almost every core challenge Kentucky faces, whether that's poverty, unemployment, low education attainment, substance abuse or crime."

Almost 30 percent of the governor's speech was spent talking about health related issues and the success of the Affordable Care Act in Kentucky.

Beshear reiterated his support for a comprehensive,statewide smoke-free ban and encouraged lawmakers to pass this ban about mid-way through the speech, spending a little over two minutes giving facts about the ill effects of smoking to our state. He noted that the state leads the nation in smoking "and when it comes to preventable illnesses and deaths, every single study concludes that nothing is as devastating to Kentucky as smoking and tobacco use."

A new poll shows that 66 percent of Kentucky adults favor a statewide smoking ban and 29 percent oppose it, but it has never come to a vote on the floor of either chamber of the legislature. However, on Monday, House Speaker Greg Stumbo said the time had come for a floor vote in the House.

Terry Brooks, executive director of  Kentucky Youth Advocates said in a prepared statement after the speech, "A comprehensive statewide smoke-free law will protect children today and, by protecting pregnant women from secondhand smoke, that law will protect unborn babies as well."

Another big health issue in Kentucky is heroin,"and it's getting worse every day," Beshear said.

"In 2011, 5 percent of people who died from drug overdoses in Kentucky had heroin in their bloodstream. In 2013, that had risen to 32 percent," he said. He also cited that the number of heroin cases sent to the Kentucky State Police crime lab for analysis had increased by 340 percent in the last five years.

In response to this epidemic, Beshear asked for legislation to expand access to drugs that immediately reverse the effects of overdoses, saying that such drugs will protect law enforcement and health care workers from needle sticks and will expand access to treatment.

He also asked for legislation that will enhance penalties for major traffickers and will protect users from minor drug charges when they call 911 to help an overdose victim. "No single change in the law is enough," he said. An anti-heroin bill failed last year because each chamber wanted the measure to do something the other chamber didn't want.

On other issues related to health, Beshear asked for legislation to increase the age and weight requirement for booster seats and to create an expansion of court protective orders for dating partners.

Beshear closed by asking the lawmakers to put aside things like "partisan bickering, pending elections and Twitter-feed rhetoric" and to ""Join with me in continuing to improve our health, our workforce, our families and our economy."