Tag: The Ohio Valley ReSource

A Centers for Disease Control and Prevention panel has recommended the Pfizer COVID-19 vaccine for use in children as young as 12. The decision follows the Food and Drug Administration’s extension of the vaccine’s emergency use authorization for children 12 to 15 years old on May 10.

West Virginia announced the state will be offering the vaccine to this group of young Appalachians shortly after the recommendation.

The Ohio Valley ReSource asked Vince Venditto, an expert in vaccine design, about the Pfizer study data collected in participants ages 12 to 15. Venditto previously responded to listener questions about the safety and efficacy of the Pfizer and Moderna vaccines.

ReSource: The FDA press release said that (the Pfizer vaccine) shouldn’t be given to anyone with a known history of severe allergic reaction, including anaphylaxis. Has that changed?

Venditto: It’s really out of an abundance of caution. There are other options. So the allergic response to the Moderna and Pfizer vaccines — we think it’s due to a response to a specific component of the vaccine. So because the Johnson & Johnson vaccine is also available, people who have the anaphylactic response to Pfizer and Moderna would very likely not have the allergic response to Johnson and Johnson. I think it’s really out of an abundance of caution to make sure there’s not that risk there. I’m not aware of a change in the standards based on the FDA and the CDC.

ReSource: In this latest trial of kids 12 to 15, were there any other risks associated with getting the vaccine?

Venditto: No. They are reporting about the same reactogenicity, so the same response that you get when you feel a little achy after the vaccine. So in children ages 12-15, they are reporting about the same response that way. They have a slightly better antibody response, so their immune system looks a little bit stronger compared to the 16 to 25 year-olds, but not really any major difference. And otherwise safe. Now this was only done in about a little more than 2,000 individuals and about 1,100 individuals got the vaccine. It’s smaller than the large-scale study that was done for the initial approval that had 40,000 people in it. So it is smaller, but everything looks like it’s working about the same in the 12 to 15 year-olds as it is in the older population.

ReSource: This study seems small. But obviously it was large enough for the FDA to extend that emergency (use) authorization. Do you know why the study was this size?

Venditto: It has to do with the number of adults in the original study. And then based on the same safety profile, you’re basically running a smaller study just to determine if there’s anything coming up that is unexpected in a younger population. And you should see that in a thousand subjects, if something came up. But you know we have this safety profile in however many millions of adults that have received the vaccine — minus a few examples of anaphylaxis as the most common, rare side effect. The fact that we didn’t see anything in any of the children, it’s really just a continuation. There’s no reason to expect there to be any difference. But they are continuing to monitor the children long term, and so as they monitor the children long term, they’ll be able to still continue to assess safety just like they are in the adults as well.

ReSource: And how long will they follow the children long term?

Venditto: They are following them for an additional two years after their second dose.

ReSource: The FDA release said the vaccine was 100% percent effective in preventing COVID-19. Does that mean the vaccine is more effective in children than it is in adults?

Venditto: That’s a really difficult comparison to make. With the different size of the study, you’re comparing the 20,000 people who got the vaccine in the adult study compared to the 1,100 or so in this one. In the whole trial, which had 2,260 subjects, there were 18 cases of COVID-19. All of them were in the placebo group. And so that’s where this hundred percent comes from. Now, if you expand this number to 40,000, it’s very likely you’re going to have some number of cases in the vaccinated group. The only way to actually compare those is to do an equally sized trial. And so I suspect that after this is approved and after they start administering this to children on a large scale, we will probably see more information about the number of people who are vaccinated who are also getting infected.

ReSource: The CDC also says that in general vaccine breakthrough cases are expected, and no vaccines are 100% effective at preventing illness. So should we expect breakthrough cases in the 12-15 year old age group?

Venditto: We should expect them the same way that we expect them in the adult population. I don’t think that there’s anything different about the 12 to 15 year olds. There’s nothing that I would anticipate that would say there was a difference. Just like in adults who have been vaccinated, some adults have been infected, and I think we should just be expecting the same thing to happen in children.

ReSource: Do we know anything yet about the study in children under the age of 12.

Venditto: I’m not aware of any data yet. I know that those studies are ongoing from both Pfizer and Moderna — they both have studies in younger children.

The Pfizer COVID-19 vaccine study in children younger than 12 is ongoing. To find Pfizer vaccine, visit vaccine.gov.

This conversation has been shortened and edited for clarity.

Terrance D. is the father of two daughters and lives in Lexington. He’s a carpenter and owns a small construction company.

More than 15 years ago, Terrance walked into his first Narcotics Anonymous meeting at age 27.

He spoke to the Ohio Valley ReSource about addiction, sobriety and how the COVID-19 pandemic has affected him. He uses a pseudonym when speaking publicly about his involvement with Narcotic Anonymous.

Terrance first joined NA because he feared he would die from his addiction.

“I started using socially as a kid in my early teens, and by the time it got into my 20s, it got worse and worse,” Terrance said. “And I had tried drugs that I never set out to try and did things that I never said I would do.”

Overdose deaths in the U.S. were on the rise even before the pandemic hit. Now, government data show that fatalities have sharply increased during the pandemic. From June 2019 through June 2020 more than 81,000 people died from drug overdoses — the most deaths recorded in a single year.

To ensure that NA meetings were available during the pandemic, Terrance and some of his fellow NA members held training sessions to help other NA groups get online. He discussed how meetings have changed and why they’ve been crucial to the recovery community.

The conversation has been edited for length and clarity.

Ohio Valley ReSource: Would you want to talk a little bit about what it’s like going to NA meetings being in a recovery group during the pandemic?

Terrance D.: It’s changed drastically what the landscape looks like inside a face to face meeting is much different than what many of us have known. Our entire recoveries, the rooms are set up generally differently, people are trying as best they can to adhere to social distancing. People have masks on … a little bit harder to hear when people are sharing and talking. But we’re doing the best we can. So some meetings are much smaller, because they have to be.

Ohio Valley ReSource: So there was already some form of online meeting starting in 2018?

Terrance D: We use the Zoom platform, the hybrid meetings are held on multiple platforms. But the one that we chose was zoom. And we quickly became a pretty much a nationwide meeting. Usually we have about 20 to 30 in attendance ranging from Australia to the United Kingdom. And all of the Americas, the English speaking Americas.

Ohio Valley ReSource: How was the decision, I guess made then to start doing those online.

Terrance D: I think the decision then was that we wanted more. We knew that the world has more to offer as far as recovery, different ways that people work the 12 steps. What’s it like in their local cultures where they live? We knew that we have a lot to learn from one another and Kentucky is a tough nut to crack. Kentucky has a very vast geography. It’s flat out in the west, the foothills are in the central, the mountains are in the south and the east. And people are segregated, not necessarily by color, but by geography. And Kentucky’s always been that way. And we wanted those of us that were serving together in these different service bodies that span the whole state wanted to recover together in recovery meetings as well. And so we decided that we would try that and See what happened. And it turned out that we had a lot of people in other places that wanted to try it with us.

Ohio Valley ReSource: So it sounds like, since these meetings, these online meetings had started before the pandemic that maybe it wasn’t too big of a change, but I’m guessing that not being able to be in person and see other people that you’re in recovery with an imagined that was that was a really tough change.

Terrance D.: Well, yeah, and I think there’s two answers to that question. It was a huge change for Central Kentucky, because and let me give you a little bit of scope in the first week of March, let’s say March 6 2020. There were over 76,000 weekly NA meetings globally in a multitude of languages. Those stopped almost immediately, in the next week. You know, in central Kentucky, we had one online meeting. But we had two, we have one here and we have one based out of Louisville. And we had both been meeting like I said for about a year. And what did happen, to kind of get to the second part of your question is because the recovery community in NA had been exposed to online meetings, and they had maybe come once or twice, they had been to a couple of different events that we put on, special events, where they could hear a speaker from some other part of the world. They had that basic understanding. And so within that next week, everybody was online. And I mean, everyone. Central Kentucky, southern Kentucky, eastern Kentucky, Louisville area, Indiana, across the rivers from Louisville, down in Bowling Green, western Kentucky, everybody was online within a week. And that was because we had spent a little bit of time with some minimal training. It was a lot different for the rest of the world. And we spent the next month probably training people on every continent, how to get online, how to do the basic ins and outs of a normal NA recovery meeting that was relevant to their culture, because each culture might do it a little bit differently, their order of operations and things like that. So it was a really interesting time. It was a very stressful time as well.

Ohio Valley ReSource: And then since then, have different chapters of NA continued to host those zoom meetings? How popular I guess are those?

Terrance: The communities are doing well. They’re doing better than any of us expected. And to give you an idea, we had what we would call a kind of a virtual service community of some of these virtual communities around the world came together to create a meeting list. And so that people could find one another for online meetings. And they created a website, virtual-NA.org. I think that’s been most difficult on our older population. The younger population are used to looking at screens, they’re used to being on their phones, you know, they’re, they’re on social media. That’s not the case for our members that are 50, 60, 70, 80 years old. And also being the portion of the population that is most vulnerable to catching COVID-19. And it, I think it’s been the hardest on them. And I’ve seen some really wonderful things. And then I’ve seen some really sad things. And the wonderful things being people that are open and willing to try something new and the sad things, the people that are not, and people who are still isolated, even to this day. And they’ve chosen to stay isolated that way. That’s been difficult as well.

Ohio Valley ReSource: So people who may have once shown up to meetings in person have just decided that maybe online meeting is not for them.

Terrance D.: And it’s unfortunate, but they have that right to make that decision. As someone who was a champion for, for online recovery, even after, attending meetings for 13, 14 years in person, which I still do when I can. I understand that, that everybody’s not the same, they don’t communicate the same, their brains don’t work the same. I get that. I was thinking about this earlier today…what was the last group of people that have been through a change that’s this abrupt? That’s changed life so drastically, and the only couple things I can think of are, are people that are still alive and experienced World War II. And, and maybe maybe some of the people who remember things going on during the Cuban Missile Crisis.

Ohio Valley ReSource: What has the pandemic been like for you? And if you’d want to talk a little bit about maybe, if it has impacted you, personally, financially, emotionally or in any other way?

Terrance D.: It’s all the above. It’s impacted me personally, financially, and emotionally. I’m a small business owner, and having to be on unemployment for a while was difficult, and I won’t go too far into all that. But yeah, I mean, it affected me, like it did everyone, not being able to go to work was difficult, and work is sporadic for me right now because I’m a contractor. Personally and emotionally, it’s had a huge impact on me. I’m a very social individual. In NA it’s not uncommon for members to hug one another. That’s kind of a cultural thing in our fellowship, that’s a greeting that people are used to, and I haven’t hugged many of my friends and in a year. There’s men that I’ve sponsored for over 10 years that I’ve had phone contact with, and that’s it. We’re not out watching the game. We’re sports fans, we go to games, and we go to UK games. I have two men that I sponsor that just lift a couple blocks away from me. And we’ve been able to kind of see each other from a distance, and we talk a lot on the phone. But we used to go eat a lot and do all these other things. And that that’s hard. It’s hard not seeing my family. My mother is very high risk. That’s been difficult. I have two children that are, they’re basically grown. I mean, they were two and four, when I got clean, I have daughters. And now I have one who is 20 and she’s a college basketball player at a local college, and I don’t get to go see her games. I have to watch the game streaming. My youngest is a cheerleader. And sorry, got a little emotional. Her senior year we had walked out on the field for the football season. And it was, it was difficult, you know, to be socially distanced, and have my mom in a wheelchair with a mask on and my finance. It was a different experience than what we were used to, because her sister will when our sister was a senior, volleyball and basketball and walked her out on the courts there were 10 people. This experience was much different than this, the senior year has been much different. It is what it is, you know, we persevere. But yeah, that’ll affect you emotionally.

Ohio Valley ReSource: Do you think that people, and we’ve been talking a lot about how, you know, you just talked about how everyone’s been impacted by the pandemic? It’s been hard, emotionally and financially. But do you think that people understand how the pandemic affects people in recovery?

Terrance D.: I think that’s, that’s a really interesting question, because I kind of think there’s two levels to that. I think, you know, people in recovery are, we’re human beings like everyone else. And I do think that on some level, the general public can understand what it’s like to all of a sudden be isolated from family, friends, co workers, you know, spiritual companions, if you are a member of a religious community or something like that, you know, I think they can understand that, but for, for people in recovery, those kind of connections, and that social interaction can also mean life and death. You know, meeting meeting attendance is crucial to survival, in regain recovery. And in 12 step recovery. It’s paramount, because it’s where we say, the therapeutic value of one out of one addict helping another. And, and so I don’t know if, if everyone can understand that, looking at it, if they haven’t experienced it. That with the drugs that are available today, to our communities that one use can kill you. You know, that one bad decision to use one time can kill you. I don’t know if the general public understands that it’s that serious. And that and that it has to be that serious, because that one’s use can kill you.

Ohio Valley ReSource: And what do you think has been the hardest part about all of this for you?

Terrance D.: Isolation has been the hardest part. Undoubtedly. And what I mean by that is that, there’s a sharing process for us, as humans and as people in recovery. When we are more in a physical space together we’re able to pick up on one another’s body language. We can tell, how one another are doing this by looking at how we’re interacting and some of that gets lost online. Not all of it. Those are just the kind of things that I miss the most, Just the little short conversations I get to have with people. We’re kind of, we’re an entire society within the larger society. We recover meetings together with our families, we’ve raised our families together, our kids know one another, we generally go to eat after meetings, or coffee or other things we socialize together and all that changed. And it was an abrupt change. You know, I think if it’s a little bit easier to handle, when it’s gradual, because this happens a lot. When we grow and recover, we get a new job, or we start school, we maybe buy a home in a new location. There’s these things that happen that are kind of gradual changes, but all of the changes at once, really difficult to handle. And we have lost some people. We’ve had people decide that they couldn’t handle it and use, which is very sad. That’s the hardest part is accepting that. That’s life today. And there’s nothing that I can do about it. I can try, and I can do all this stuff. But other people have to make the decisions that they want to stay clean and wouldn’t take the actions necessary to stay clean.

Ohio Valley ReSource: And then, what has it been like participating and contributing to a recovery community. Has a lot of that been done online as well, like you said through social media?

Terrance D.: Yeah, and that’s a, that’s a great question, and there’s a lot to unpack in it. So I want to address a couple of different things as to, you know, contributing to a recovery community from a service perspective. We have in a group, and so the groups are the primary place that we contribute, we share our personal recoveries together, but we have other services, that local geographies provide, and multiple groups come together and they form an area, multiple areas come together, and they form a region, which might be a state or a half of state, and so there is no getting together, right? The services that we used to provide in groups, like going into a rehabilitation facility, or going into a jail are almost nonexistent in person, A lot of that stuff we have started to do online.

Terrance D.: I want to tell a story about one of our new members. So, the online meeting that I had talked about, that we had formed a couple years ago, it had about 12 people come into it consistently, in March last year. And within four days of the governor’s stay at home order, we were up to 400 people. And so we had a guy who was in Tampa, come to our meetings in Tampa, Florida. And he came to the meeting. While he was in rehab, on his phone, they let him do it. And then he came for a couple of weeks before he got released. And when he was released, he went back to his home, everybody was still in lockdown. And he kept going to the meeting every day. And now he’s got a home here. He contributes the same way he would as if he were going to in person meetings where he lives. He’s got other friends that go to his meeting that he sees all the time. Virtually he gets to go to facilities and talk to people about NA, and he gets a chance to be a part of all kinds of stuff. We’ve got a guy who got out of treatment, he’s from South Florida. He’s never been to an NA meeting in person. He’s a truck driver. We were one of the first meetings, he’s found. He’s become a member. And he’s sponsored by the man who’s in Oklahoma. He found his sponsor with us. And he’s actually driven to meet his sponsor, because he’s been in that part of the country. I mean, this time in our life is full of stories like that. That just never would have happened if we weren’t, if we kind of had no other choice but to come together the way that we have. It’s been difficult, but it’s not been all bad.

If you are struggling with addiction, the Substance Abuse and Mental Health Services helpline operates year round. 1-800-662-HELP (4357).

Narcotics Anonymous hosts online meetings year round.

This interview is part of a series of stories examining the addiction crisis during the COVID-19 pandemic.

The Ohio Valley ReSource gets support from the Corporation for Public Broadcasting and our partner stations.

Terrance D. has been sober for more than 15 years and Narcotics Anonymous has been a big part of his recovery. He uses a pseudonym when speaking publicly about addiction and his work with NA.

Terrance said the bonds the group has formed are very important, and they were forged through regular social gatherings.

“We recover in meetings together, we’ve raised our families together, our kids know one another,” he said. “We generally go to eat after meetings, or coffee or other things. We socialize together.”

But last March as the coronavirus pandemic forced businesses and public places to close, the regular face-to-face contact that Terrance and his group depended on was gone.

“All that’s changed, and it was an abrupt change,” he said.

As a small business owner, the pandemic has affected him financially, but Terrance said isolation has been the hardest.

Health experts have repeatedly warned about the pandemic’s impact on mental health. In a region long plagued by the opioid epidemic, alarm rippled through the Ohio Valley’s addiction treatment community as people realized that the pandemic’s sudden disruption and isolation could lead to relapses and overdoses.

As 2020 came to an end, the Centers for Disease Control and Prevention published overdose death data from June 2019 through June 2020, and the report was grim. At least 81,000 people had died from drug overdoses, a 21% jump, making it the deadliest year for U.S. overdoses.

The statistics for parts of the Ohio Valley were even worse, mirroring trends pointed out by health experts in the region. West Virginia — which already had some of the nation’s highest rates of overdose fatalities — saw a 32% increase in overdose deaths for that time period compared to the previous year. In Kentucky, deaths climbed by 27%, and in Ohio the deaths from overdose rose by 16%.

This crisis within a crisis is especially profound for the Ohio Valley. In addition to being ground zero for the opioid epidemic, the region also suffers from some of the nation’s poorest health outcomes. Public health efforts that once focused on opioid use disorder treatment have been eclipsed by the need to address COVID-19, just as the additional stress and isolation from the pandemic both limits usual treatment options and threatens to push more people into active addiction.

But ongoing regional efforts have helped some remain in treatment, offering some solutions for substance use disorder even in the face of the pandemic.

Online Sobriety

Terrance D. is also part of the public information subcommittee for the Kentucky Survivors Area of Narcotics Anonymous. Shortly after the declaration of the coronavirus pandemic, approximately 76,000 in-person NA meetings held worldwide stopped and then moved online.

“There’s a sharing process for us, as humans and as people in recovery when we are more in a physical space together, we’re able to pick up on one another’s body language,” he said. “We can tell how one another is doing just by looking at how we’re interacting and some of that gets lost online.”

But Terrance said not all of that communication is lost. Video calls have played a significant role in keeping people in recovery connected. The NorthStar Online NA group he is part of has hosted an online meeting since 2018, so many members already had experience with a virtual setup before the pandemic.

Terrance and other NA members also hosted multiple training sessions to ensure other groups knew how to get online and host meetings.

“And I mean, everyone,” he said, listing locations all across Kentucky and into surrounding states. “Everybody was online within a week.”

Although online meetings have helped many people in recovery stay connected, Terrance says online meetings aren’t for everyone — especially for older members who are used to meeting in person.

“The younger population are used to looking at screens, they’re used to being on their phones,” he said. “That’s not the case for our members that are 50, 60, 70, 80 years old and also being the portion of the population that is most vulnerable to catching COVID-19.”

“I think it’s been the hardest on them,” he said.

Emergency Indicator

Well before the CDC updated its overdose data, a disturbing trend began emerging in the Ohio Valley last spring — a sharp increase in the number of emergency responses to drug overdoses.

Fifty-two days before and after the pandemic was declared, Kentucky EMS saw a “17% increase in the number of opioid overdose runs” and “a 50% increase in runs for suspected opioid overdoses with deaths at the scene,” according to an article published in the journal Drug and Alcohol Dependence.

One of the article’s authors, Sharon Walsh, directs the Center on Drug and Alcohol Research at the University of Kentucky. Walsh said the increased EMS runs were happening throughout the state.

“As the overdose death data became available through vital statistics, unfortunately, we had the highest number of cases of overdose deaths ever in the state of Kentucky this past May,” Walsh said. “So that was not unexpected, based on what we’re seeing with the early data from EMS. But nonetheless, it was incredibly sad.”

Walsh said some research will examine the possible reasons behind the increase in overdoses.One possible factor: isolated users are more vulnerable in an overdose situation.

“The risk when someone uses opioids alone of dying is greater than if they are using with somebody else. And that person, if somebody overdoses, they can call 911 or if they have Naloxone, they can use it,” Walsh said.

Powerful synthetic opioids such as fentanyl are involved in most of the overdose deaths, according to the CDC report. The potency of the drug also varies, which makes it dangerous.

“It’s very easy to overdose on,” Walsh said. “The other thing is that it’s finding its way into other parts of the drug market. So people are overdosing unintentionally, when they use methamphetamine or cocaine because it’s also laced with fentanyl.”

Another factor could be the availability of treatment programs.

“Whether or not people who are in treatment had their treatment discontinued because of the structural changes once the pandemic hit, or whether or not they wanted to start treatment, but they weren’t able to,” Walsh said.

Dana Quesinberry is a coauthor of the article on EMS responses. Quesinberry is a professor at UK’s College of Public Health and works on drug overdose prevention research with the Kentucky Injury Prevention Research Center. Quesinberry and her team monitor fatal and non-fatal overdose data.

She said Kentucky EMS data is used to spot trends and KIPRC receives those numbers every week.

“As far as pre-COVID, we were already on an increasing trend. During COVID, we have seen the rate go up, we’ve had a couple of different spikes throughout the period,” Quesinberry said.

Since the pandemic began, EMS data has also shown a 71% increase of instances in which a person refused to be transported to an emergency department after being treated for a suspected overdose. Quesinberry said there could be a number of reasons behind refusals, and coronavirus fear could be a contributing factor.

“In the data that we look at, understanding why they refused is not possible,” she said. “But it makes sense that some of the issues that have been identified in other jurisdictions about, fear of arrest, fear of COVID and being taken to the hospital and getting exposed to COVID.”

Treatment Changes

The pandemic has also strained the overall public health system, with likely impacts on harm reduction services such as needle exchange programs, which are critical for people who are not in treatment.

“They had to deploy all of their effort, staff, money to addressing COVID, first — which took the priority away from the opioid crisis,” Walsh said. “They also had to figure out how to convert syringe services to something that is more remote or safe.”

Walsh is also the principal investigator for the HEALing Communities Study at the University of Kentucky. The $87 million dollar research study aims to reduce opioid overdose deaths by 40% in 16 participating counties. The HEALing Communities study also includes counties in Massachusetts, New York and Ohio.

Franklin County, Kentucky, is part of the study. Health workers there are finding ways to keep a syringe exchange service going during the pandemic by moving operations outdoors. They asked Walsh’s team for some help during winter: a tent and heaters will allow them to continue offering the service through cold weather.

The HEALing Communities Study is collecting a wide variety of data on overdose deaths, the numbers of people enrolling in treatment programs and to look for other factors that have contributed to the rise of overdoses. Walsh said a change in public policy may offer one explanation.

“Our state and also the federal government worked very quickly to change some of those regulations that had been in place, some of them for more than 50 years, that were limiting access to care,” Walsh said.

If you are struggling with addiction, the Substance Abuse and Mental Health Services helpline operates year round. 1-800-662-HELP (4357).

Narcotics Anonymous hosts online meetings year round.

This is the first of three stories examining the addiction crisis during the COVID-19 pandemic. Upcoming stories explore federally funded efforts underway to better treat addiction and reduce overdose deaths, and the effects on those in recovery.

The Ohio Valley ReSource gets support from the Corporation for Public Broadcasting and our partner stations.