A Friday summit at Marshall University will explore critical interventions against the use of the drug xylazine as part of the opioid crisis.
A Friday summit at Marshall University will explore critical interventions against the use of the drug xylazine as part of the opioid crisis.
Xylazine is a tranquilizer increasingly linked to overdose-related deaths across the United States, but most notably in the southern states, according to the CDC.
“Xylazine is actually an animal tranquilizer that is now being used with opioids, particularly fentanyl, and it’s not ever been used [for human consumption], it’s not meant to be, it’s not intended for human consumption. Essentially, it lowers your blood pressure and makes you more sedated,” said Oscar Morgan, project director of the Central East Addiction Technology Transfer Center Network, an Opioid Response Network partner organization.
There has been an alarming increase of fentanyl mixed with xylazine and in April 2023, the White House designated the drug as an emerging threat within the ongoing opioid crisis.
“While the training center typically focuses on the behavioral health workforce, specifically, for this summit, we’re kind of expanding to also include other health care professions, emergency medical services, quick response teams,” Mika-Lude said. “Because all of those professions are certainly relevant when we’re talking about xylazine.”
The summit aims to bring communities together to discuss and strategize interventions in outreach, harm reduction, symptom treatment, overdose prevention and withdrawal management.
Dr. Matthew Christiansen is the state health officer and commissioner of the DHHR’s Bureau for Public Health.
“It’s something that we’re dealing with across the state,” Christiansen said. “And so to give public health practitioners more information about xylazine help them counsel patients or individuals that might be using this substance to inform them of the of the dangers of illicit substances broadly, but also the unique characteristics of xylazine, which predisposes individuals for difficult to treat skin wounds, and also the low blood pressure and sedative effects.”
Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.
**Editor’s Note: A previous version of this story incorrectly indicated that Oscar Morgan is the executive director of the Opioid Response Network. He is the project director of the Central East ATTC, an ORN partner organization. This story has been updated to reflect the correct title.
In a weekly update, the West Virginia Department of Health and Human Resources (DHHR) reported six additional deaths attributed to the virus in the past week bringing the total number to 8,155.
Since the end of the Public Health Emergency on May 11, West Virginia has continued to lose lives to COVID-19.
In this week’s update, the West Virginia Department of Health and Human Resources (DHHR) reported six additional deaths attributed to the virus in the past week bringing the total number to 8,155.
In the past week, 99 new cases of COVID-19 were reported in the state, according to the Coronavirus Disease Dashboard. This places West Virginia’s incidence rate at 3.74 percent, a nearly 2 percent drop in infections since the previous update. An incidence rate is used to measure the frequency of occurrence of new cases of infection within a defined population during a specified time frame.
According to the DHHR,West Virginians ages six months and older are recommended to stay up-to-date with COVID-19 vaccination.
Those 65 years and older, and those who are moderately to severely immunocompromised, are eligible for at least one additional Omicron COVID-19 shot for updated protection.
Since March of this year, the average age of persons testing positive for COVID-19 is above 50 years of age. Persons 71 years of age and older account for 40 percent of all positive cases reported in the past seven days.
According to the Centers for Disease Control and Prevention (CDC), as of June 11, there were 14 cases of COVID-19 in long-term care facilities in West Virginia with an infection rate of 1.6 percent.
In the West Virginia Division of Corrections and Rehabilitation, there are 34 inmates who have tested positive and one staff member.
While Candida auris is resistant to antibiotics, physicians have a set of medicines to treat the fungal infection. The difficult part is identifying the infection and prescribing the correct medication.
A drug-resistant fungal infection first found in the U.S. in 2015 has been detected in West Virginia.
The fungi, Candida auris, is part of a class of fungi well-known to researchers. While its classification is known, physicians are working to learn how to identify it in their patients.
Dr. Matthew Christiansen is the West Virginia state health officer and commissioner of the Department of Health and Human Resources Bureau of Public Health.
“It’s been something that we’ve been monitoring here at the bureau for a few years now,” Christiansen said. “We’ve been lucky here in West Virginia to not have a case until recently.”
Christiansen said the fungal infection predominantly affects people who are already immunocompromised, putting long-term care facility patients at risk.
“Candida is a yeast or fungus that is present in the environment,” Christiansen said. “Its presence is almost ubiquitous in our lives that we just that we don’t notice. And so when we see Candida in a sample that we’ve collected from a patient, sometimes that can be chalked up to a naturally occurring or not pathologic form of that disease or of that infection that’s causing the disease.”
While Candida auris is resistant to antibiotics, physicians have a set of medicines to treat the fungal infection. The difficult part is identifying the infection and prescribing the correct medication.
“It’s just that we need to make sure that providers are aware that this is present, make sure they do their specific tests to confirm that, that they’re dealing with this specific type of drug-resistant candidal infection, and then use the appropriate antibiotic,” Christiansen said. “And so there are options. It’s just that it is resistant to some of the more common medicines that we use.”
Those worried about Candida auris being the next pandemic need not worry, according to Christiansen, the fungus is treatable if identified correctly.
“This certainly is not as infectious as COVID-19, for example, in the sense that the infections that we’ve seen with this infection are isolated to people that are immunocompromised in long-term care facilities,” Christiansen said. “And we do have known medications that can treat it as long as we identify it early and get the antibiotics on board quickly enough.”
Christiansen also praised West Virginia’s health facilities for keeping Candida auris away from their patients for the eight years it has been found on American soil.
“The fact that we haven’t had infections yet speaks to the quality of our hospital systems, or our long-term care facilities of prevention and, and in early intervention, regarding the spread of infectious diseases and appropriate use of antibiotics,” Christiansen said. “Those are all things that can prevent the spread of antibiotic-resistant bacteria and funguses.”
That number is higher than the population of eight counties in the state, according to U.S. Census data. That includes Wirt, Pendleton, Calhoun, Tucker, Gilmour, Pleasants, Doddridge and Pocahontas counties. CDC data indicates more than 2,600 people in the state have died from the virus on average per year.
More than 8,000 West Virginians have now died from COVID-19.
Twenty-nine deaths were announced statewide Wednesday morning by the Department of Health and Human Resources’ COVID-19 dashboard. That brings the total number of deaths to 8,005.
That number is higher than the population of eight counties in the state, according to U.S. Census data. That includes Wirt, Pendleton, Calhoun, Tucker, Gilmer, Pleasants, Doddridge and Pocahontas counties. CDC data indicates more than 2,600 people in the state have died from the virus on average per year.
For comparison, the CDC said there were 1,330 drug overdose deaths in the state in 2020. There were 1,485 fatal overdoses from March 2021 to March 2022, according to the state Office of Drug Control Policy.
Reported cases have dropped significantly since last week’s update, with 165 cases statewide compared to last week’s 707. More than a quarter of the reported cases are people older than 70.
“We still want our vulnerable population to remember today that about 90 percent of people who die of COVID-19 are over 65 years old and over 70 percent of people that died of COVID-19 are over 75 years old,” state Coronavirus Czar Clay Marsh said during Gov. Jim Justice’s regular media briefing Wednesday.
“We still want our most vulnerable population and our immunocompromised population to pay particular attention and care to make sure that you stay up to date with your vaccinations, that if you develop symptoms and you’re around somebody who is infected, that you get tested, so that you can call your care provider.”
The DHHR recently switched to weekly COVID-19 updates, keeping in line with the response at the federal level. The federal public health emergency is set to end May 11.
Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.
The CDC’s National Institute for Occupational Safety and Health (NIOSH) is building the Underground Mine Safety and Health Research Program facility to primarily research mine explosions.
The Centers for Disease Control and Prevention has acquired land in Pocahontas County to construct a facility for mine safety research.
The CDC’s National Institute for Occupational Safety and Health (NIOSH) is building the Underground Mine Safety and Health Research Program facility to primarily research mine explosions, alongside work on mine seals, escape and rescue protocols, refuge alternatives and ventilation, among other projects like automation technology.
It will be built in Mace, replacing a similar facility in Lake Lynn, Pennsylvania, which opened in 1982 and closed in 2012. Negotiations between NIOSH and the previous property owner for the agency to purchase the land, as well as an environmental impact statement, began in 2018. The purchased property is 465 acres.
“The surface development is anticipated to take about 12 acres, so 453 acres will be left undisturbed, but it will contain some of our underground workings within a limestone bed,” NIOSH Deputy Associate Director for Mining George Luxbacher said.
Parts of the underground facility are designed to mimic the geometry of “room and pillar” and longwall coal mines, with the mine openings constructed in limestone. Other facilities that would emulate limestone mines and metal mines are also planned for construction.
“By constructing these mine openings in limestone, we don’t have to worry about the issues that we would have if we were to conduct these explosion testings in coal,” Luxbacher said.
Despite mine safety improvements brought on in part by the 2006 Sago, Alma and Darby mine disasters, Luxbacher says the industry still has issues that require research in unique facilities.
“This isn’t the kind of thing that you can do primarily in the laboratory, you have to be able to do it in a field environment that’s similar in conditions as to a working mine,” Luxbacher said.
The facility is expected to be completed within five years once construction begins. Design of the facility is expected to take around one year.
With toxic “forever chemicals” being detected in waterways statewide, the pollutants have caught the attention of both the public eye and state legislators.
With toxic “forever chemicals” being detected in waterways statewide, the pollutants have caught the attention of both the public eye and state legislators.
PFAS are a group of around 10,000 manmade chemicals that have been used to manufacture both industrial and consumer products for around 80 years. More commonly known as “forever chemicals,” they’re known to cause health problems like liver damage, higher cholesterol, cancer and a weakened immune system, among others.
Most famously, PFAS chemicals have been used to create industrial-grade firefighting foam and have been used by companies like Chemours and Dupont to create Teflon. But they’re also found in products like food packaging and water-resistant jackets.
“These products end up in landfills, many of them can have leachate that gets into the groundwater and percolates through the soil,” Jenna Dodson, staff scientist at the West Virginia Rivers Coalition, said.
Dodson was among the panelists at a public conference addressing PFAS earlier this month in Shepherdstown, located in the Eastern Panhandle.
Levels of PFAS chemicals above the federal EPA’s health advisories have been found in 130 raw water supplies statewide, with the state’s Departments of Environmental Protection and Health and Human Resources currently testing the state’s treated water systems as well.
In 2019, the CDC reported that state residents living near the Shepherd Field Air National Guard Base in Martinsburg had blood concentrations of PFAS higher than the national average. Bases like that use the PFAS firefighting foam, and it is believed the chemicals contaminated much of the local waterways. Martinsburg’s Big Springs water filtration plant was temporarily shut down in 2016 after high levels of the chemicals were found.
“They’re in our waterways, it’s in our soil, it’s in our air because it also travels via air deposition,” Dodson said. “And so that’s why they’re so ubiquitous and again, localized contamination can occur.”
In the region alone, there are 36 raw water supplies that have been identified as having unsafe amounts of the chemicals. That area, along with the Ohio River Valley, is considered a “PFAS hot zone” in West Virginia, though they’ve been found in water supplies statewide.
A map depicting the locations of raw water systems statewide where PFAS were detected at higher levels than current federal health advisories. (West Virginia Rivers Coalition)
Dodson was joined by Brent Walls of the Potomac Riverkeeper Network. He’s studying PFAS’ effects on the Potomac River’s aquatic ecosystem by surveying small-range fish species in the area. He discovered some fish in the nearby Antietam Creek in Maryland had elevated amounts of the chemicals in their tissue.
“That was extremely alarming because smallmouth bass is a popular recreational fish species, not only for catch and release, but also for families and communities to take home to eat,” Walls said.
Health advisory guidelines released by the EPA in 2022 say anything above 0.004 parts per trillion for PFOA or 0.02 parts per trillion for PFOS are considered unsafe. PFOA and PFOS are two common PFAS subgroups.
“That would be one drop of PFOS in 20 Olympic sized pools,” Walls said. “That’s the kind of visualization of how small the amount of this pollutant has an impact.”
Walls is worried state and local agencies wouldn’t be able to properly measure and treat PFAS because of how little amounts are needed to infiltrate waterways to contaminate them.
“Those tests are expensive,” Walls said. “And even if the facilities are able to find the lab to provide the analysis for their influent or effluent (river systems), or even for the drinking water that goes out to the public, then they have to find the resources to address the situation, to implement some level of protection, some kind of a water treatment to remove the PFAS down to those levels. And that’s going to cost some money.”
That’s a concern echoed by John Bresland, one of the local citizens in attendance at the Shepherdstown conference Walls and Dodson spoke at. He’s also a member of the town’s water board.
EPA Senior Advisor Rod Snyder speaks at a community panel at Shepherd University’s Robert C. Byrd Center for Congressional Education and History as fellow panelists Jenna Dodson and Brent Walls look on. (Shepherd Snyder/WV Public Broadcasting)
“I know that the current wastewater plant that we have will not be able to remove PFAS,” Bresland said. “So we need to get some guidance from the EPA if, and when, the time comes.”
The EPA is set to propose a national drinking water standard regulating PFOA and PFOS by the end of this year. That could come as early as this Spring, according to EPA senior advisor Rod Snyder, who also spoke at the conference.
Other locals in attendance, like David Lillard, were concerned about both his health as well as the health of the local environment.
“We’re a headwater state,” Lillard said. “So water that flows from our mountains is not only our drinking water, it is a drinking water for people in the Ohio Valley. And in the Potomac River Basin. It’s 5 million people just in the Washington, DC area.”
In the state legislature, bills have been introduced in both the House and Senate that would require the state Department of Environmental Protection to create an action plan to address PFAS chemicals, have state manufacturing facilities monitor and self-report PFAS discharge and would enforce a limit on said discharges statewide.
Senate Bill 485 passed through the Senate Agriculture and Natural Resource Committee and is currently in the Finance Committee. The House of Delegates’ equivalent bill, HB 3189, passed the House as of Friday. It’s now on its way to the Senate.
