Pages

Wednesday, December 19, 2012

Managed-care doctor creates process to steer pregnant Medicaid recipients who are using dangerous drugs into treatment

When Dr. Jeremy Corbett of Lexington found that "nearly one in five pregnant women enrolled in the Medicaid managed-care program where he works were using narcotics or other harmful drugs," he tackled the problem. As medical director of the Kentucky Spirit Health Plan, "He designed a new program combining high-tech health information with case management to tackle the problem of addicted babies, which is exploding statewide," reports Laura Ungar of The Courier-Journal. (C-J photo by Tim Webb)

Ungar describes how Corbett's program works: "Employees examine patient records for pregnant Kentucky Spirit members. The pharmacy department uses an analytics report, coupled with the Kentucky All Schedule Prescription Electronic Reporting System, or KASPER, to cross-check for drugs that could be dangerous during pregnancy, including narcotics. Department employees also look at the pattern of prescriptions, which could point toward doctor-shopping for pills. . . . Kentucky Spirit sends letters to the prescribing doctor and the obstetrician the woman is seeing, letting them know she is pregnant and has received a prescription for dangerous drugs. Corbett said sometimes the prescribing doctor doesn’t know the woman is pregnant, and the obstetrician doesn’t know she’s taking narcotics. Corbett said they also send letters outlining the dangers of taking certain drugs during pregnancy, and case managers reach out to women at risk of giving birth to addicted babies."

The program started three weeks ago. Corbett said two women have asked to get substance-abuse treatment, for which Kentucky Spirit pays — "even residential treatment, which is not required by Kentucky law — because it saves money in the long run," Ungar reports. "Kentucky has seen its hospitalizations for addicted newborns climb from 29 in 2000 to 730 last year — a 2,400 percent increase that far outpaces the national increase." Corbett told her, “When these babies wind up in the neonatal intensive care unit, it’s a huge loss, emotionally, and it’s also a huge loss of state dollars.” (Read more)
When Dr. Jeremy Corbett of Lexington found that "nearly one in five pregnant women enrolled in the Medicaid managed-care program where he works were using narcotics or other harmful drugs," he tackled the problem. As medical director of the Kentucky Spirit Health Plan, "He designed a new program combining high-tech health information with case management to tackle the problem of addicted babies, which is exploding statewide," reports Laura Ungar of The Courier-Journal. (C-J photo by Tim Webb)

Ungar describes how Corbett's program works: "Employees examine patient records for pregnant Kentucky Spirit members. The pharmacy department uses an analytics report, coupled with the Kentucky All Schedule Prescription Electronic Reporting System, or KASPER, to cross-check for drugs that could be dangerous during pregnancy, including narcotics. Department employees also look at the pattern of prescriptions, which could point toward doctor-shopping for pills. . . . Kentucky Spirit sends letters to the prescribing doctor and the obstetrician the woman is seeing, letting them know she is pregnant and has received a prescription for dangerous drugs. Corbett said sometimes the prescribing doctor doesn’t know the woman is pregnant, and the obstetrician doesn’t know she’s taking narcotics. Corbett said they also send letters outlining the dangers of taking certain drugs during pregnancy, and case managers reach out to women at risk of giving birth to addicted babies."

The program started three weeks ago. Corbett said two women have asked to get substance-abuse treatment, for which Kentucky Spirit pays — "even residential treatment, which is not required by Kentucky law — because it saves money in the long run," Ungar reports. "Kentucky has seen its hospitalizations for addicted newborns climb from 29 in 2000 to 730 last year — a 2,400 percent increase that far outpaces the national increase." Corbett told her, “When these babies wind up in the neonatal intensive care unit, it’s a huge loss, emotionally, and it’s also a huge loss of state dollars.” (Read more)
Read More


Tuesday, December 18, 2012

Animals from industrial farms are giving rise to diseases in human beings


 

Today, a lot of animals are reared all over the world in order to serve the ever increasing human demands of meat and milk. But apart from providing victuals, these animals also serve the human population in another way. Natural News reports that these industrial farm animals are the main origin of increased diseases in humans. Continuous and over-consumption of meats that come fresh from farms may lead to severe diseases in humans. This is why many health conscious people have totally renounced animal flesh from their daily diets.

 

Animal right activists have been pointing out the deplorable condition of animal farming for quite some time now. Though, previously, it largely went unheard and unheeded, now the issue is gaining some importance.  Pew Commission on industrial Farm Animal Production made it clear in its 2008 report that animal farms are the cradle of germs and bacteria that may give rise to severe diseases in the human body. The commission carried out an extensive research work of one and a half years prior to the publication of the report. The uncontrolled use of antibiotics on the animals is giving rise to antibiotic resistant superbugs that can annihilate a large population from the face of earth. 


 

Natural News also reports that the Food and Drug Administration, or FDA, has quietly increased the level of radiation allowed in foods. It is needless to mention that radiated foods can usher serious illness in human beings, but the FDA does not seem to be moved by the gravity of the situation. Keeping all these things in mind, it can be said that the slow poisoning of U.S.citizens continues unchecked with big pharmaceuticals and food giants earning millions out of the volatile situations.

 



 



 

 

 

Today, a lot of animals are reared all over the world in order to serve the ever increasing human demands of meat and milk. But apart from providing victuals, these animals also serve the human population in another way. Natural News reports that these industrial farm animals are the main origin of increased diseases in humans. Continuous and over-consumption of meats that come fresh from farms may lead to severe diseases in humans. This is why many health conscious people have totally renounced animal flesh from their daily diets.

 

Animal right activists have been pointing out the deplorable condition of animal farming for quite some time now. Though, previously, it largely went unheard and unheeded, now the issue is gaining some importance.  Pew Commission on industrial Farm Animal Production made it clear in its 2008 report that animal farms are the cradle of germs and bacteria that may give rise to severe diseases in the human body. The commission carried out an extensive research work of one and a half years prior to the publication of the report. The uncontrolled use of antibiotics on the animals is giving rise to antibiotic resistant superbugs that can annihilate a large population from the face of earth. 


 

Natural News also reports that the Food and Drug Administration, or FDA, has quietly increased the level of radiation allowed in foods. It is needless to mention that radiated foods can usher serious illness in human beings, but the FDA does not seem to be moved by the gravity of the situation. Keeping all these things in mind, it can be said that the slow poisoning of U.S.citizens continues unchecked with big pharmaceuticals and food giants earning millions out of the volatile situations.

 



 



 

 
Read More


Many Ky. parents don't realize children are overweight, or won't acknowledge it, but many report kids' poor health behavior

By Al Cross
Kentucky Health News

Many Kentucky parents don't realize that their children are obese or overweight, or at least aren't willing to acknowledge it. That is the obvious conclusion to draw from the latest results of the Kentucky Parent Survey, released Tuesday by the Foundation for a Healthy Kentucky.

The poll found that only 14 percent of Kentucky parents say their child weighs too much, but the National Survey of Children's Health found that 37 percent of Kentucky children are overweight or obese. Conversely, 76 percent of parents in the poll think their child's weight is about right, but the national survey found that only 58 percent of Kentucky kids have healthy weight.

The Kentucky Parent survey, taken by land-line and cell telephone from July 19 to Aug. 22 by the Center for Survey Research at the University of Virginia, interviewed 1,006 Kentucky parents, step-parents, grandparents, foster parents or other legal guardians of children in Kentucky selected at random. The statistical margin of error for that sample size is plus or minus 3 percentage points.

The poll also found that 56 percent of Kentucky children are watching more than the maximum daily recommended amount of “screen time” – watching television, playing video games or using the Internet – and that 59 percent drink sugar-sweetened beverages every day. Both are major factors in childhood obesity, research has found, and experts recommend no more than two hours of screen time a day and no sugar-sweetened drinks at all.

“Parents can help reduce this risk by encouraging healthy behaviors for their children,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky.“Our children’s habits and behaviors impact their health today and shape their quality of life as they grow. When kids eat poorly and don’t get enough physical activity, it increases their risk for obesity, diabetes, heart disease and other chronic diseases. This poll data helps us understand what parents think about the behaviors that are so critical to health.”

The Kentucky Parent Survey also found that only 56 percent of Kentucky parents said their child got "enough" fruits and vegetables every day during the preceding week, and 66 percent of parents reported their child got "enough" physical activity every day during the preceding week. It also found that elementary and high-school students often get less than the recommended amount of sleep per day (chart).

The survey did not define "enough." The foundation noted that one strategy to reduce childhood obesity in Kentucky is "5-2-1-0," reflecting experts' recommendations that each day, children should eat at least five servings of fruits and vegetables, have no more than two hours of screen time, engage in one hour of physical activity, and drink zero sugar-sweetened beverages. For the foundation's press release, click here.
By Al Cross
Kentucky Health News

Many Kentucky parents don't realize that their children are obese or overweight, or at least aren't willing to acknowledge it. That is the obvious conclusion to draw from the latest results of the Kentucky Parent Survey, released Tuesday by the Foundation for a Healthy Kentucky.

The poll found that only 14 percent of Kentucky parents say their child weighs too much, but the National Survey of Children's Health found that 37 percent of Kentucky children are overweight or obese. Conversely, 76 percent of parents in the poll think their child's weight is about right, but the national survey found that only 58 percent of Kentucky kids have healthy weight.

The Kentucky Parent survey, taken by land-line and cell telephone from July 19 to Aug. 22 by the Center for Survey Research at the University of Virginia, interviewed 1,006 Kentucky parents, step-parents, grandparents, foster parents or other legal guardians of children in Kentucky selected at random. The statistical margin of error for that sample size is plus or minus 3 percentage points.

The poll also found that 56 percent of Kentucky children are watching more than the maximum daily recommended amount of “screen time” – watching television, playing video games or using the Internet – and that 59 percent drink sugar-sweetened beverages every day. Both are major factors in childhood obesity, research has found, and experts recommend no more than two hours of screen time a day and no sugar-sweetened drinks at all.

“Parents can help reduce this risk by encouraging healthy behaviors for their children,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky.“Our children’s habits and behaviors impact their health today and shape their quality of life as they grow. When kids eat poorly and don’t get enough physical activity, it increases their risk for obesity, diabetes, heart disease and other chronic diseases. This poll data helps us understand what parents think about the behaviors that are so critical to health.”

The Kentucky Parent Survey also found that only 56 percent of Kentucky parents said their child got "enough" fruits and vegetables every day during the preceding week, and 66 percent of parents reported their child got "enough" physical activity every day during the preceding week. It also found that elementary and high-school students often get less than the recommended amount of sleep per day (chart).

The survey did not define "enough." The foundation noted that one strategy to reduce childhood obesity in Kentucky is "5-2-1-0," reflecting experts' recommendations that each day, children should eat at least five servings of fruits and vegetables, have no more than two hours of screen time, engage in one hour of physical activity, and drink zero sugar-sweetened beverages. For the foundation's press release, click here.
Read More


Oregon may show the way for Kentucky in drug treatment

In facing up to its need for more drug-treatment facilities, Kentucky could learn some lessons from Oregon, Courier-Journal reporter Laura Ungar writes in the third and last part of her package of stories about drug treatment, or lack of it, in our state: "Oregon, like Kentucky, is a largely rural state with about 4 million people — and a substantial prescription-drug abuse problem. But Oregon has acted more quickly and aggressively to tackle treatment." She cites examples:

• Oregon is spending about $51 million annually on substance abuse treatment, $11 million more than six years ago. "Kentucky’s Department of Behavioral Health, Developmental and Intellectual Disabilities spends $29 million a year , and hasn’t increased that amount in more than a decade."

• Medicaid, the federally subsidized health-insurance program for the poor and disabled, covers substance abuse treatment in Oregon, "while Kentucky, with a few exceptions, does not."
• Oregon admits more than twice as many addicts for treatment, and "Oregonians are much more likely to receive intensive treatment: "10 percent of treatment admissions were to long-term, residential facilities, compared with 1.1 percent in Kentucky."
• Kentucky had a much higher rate of deaths from drug overdoses in 2008, the most recent year available — 17.9 per 100,000 compared with 11.7. "Health experts say effective treatment leads to fewer overdoses." (Read more)
In facing up to its need for more drug-treatment facilities, Kentucky could learn some lessons from Oregon, Courier-Journal reporter Laura Ungar writes in the third and last part of her package of stories about drug treatment, or lack of it, in our state: "Oregon, like Kentucky, is a largely rural state with about 4 million people — and a substantial prescription-drug abuse problem. But Oregon has acted more quickly and aggressively to tackle treatment." She cites examples:

• Oregon is spending about $51 million annually on substance abuse treatment, $11 million more than six years ago. "Kentucky’s Department of Behavioral Health, Developmental and Intellectual Disabilities spends $29 million a year , and hasn’t increased that amount in more than a decade."

• Medicaid, the federally subsidized health-insurance program for the poor and disabled, covers substance abuse treatment in Oregon, "while Kentucky, with a few exceptions, does not."
• Oregon admits more than twice as many addicts for treatment, and "Oregonians are much more likely to receive intensive treatment: "10 percent of treatment admissions were to long-term, residential facilities, compared with 1.1 percent in Kentucky."
• Kentucky had a much higher rate of deaths from drug overdoses in 2008, the most recent year available — 17.9 per 100,000 compared with 11.7. "Health experts say effective treatment leads to fewer overdoses." (Read more)
Read More


Monday, December 17, 2012

Treatment for insecticide toxicosis in cats

Haworth MD and Smart L. Use of intravenous lipid therapy in three cases of feline permethrin toxicosis. J Vet Emerg Crit Care. 2012; 22: 697-702.

Permethrin is a synthetic pyrethroid insecticide and acaricide commonly used for flea and tick control in dogs. Permethrin toxicosis in cats usually occurs when owners inadvertently apply over-the-counter spot-on flea insecticides intended for dogs to their cats or when cats are exposed secondarily to the product used on dogs that share the same environment. Permethrin exerts its toxic effect on ectoparasite and host by modulating sodium ion channels, causing them to remain open longer, resulting in repetitive excitable cell discharge. While this leads to paralysis and death of the parasite, toxicosis in the host manifests primarily as central nervous system effects including tremors, hyperesthesia, ataxia, mydriasis, pyrexia, seizures, and possibly death. Cats are highly susceptible to permethrin toxicity possibly due to their innate deficiency in glucoronyl transferase and slower hepatic detoxification of the compound.
 
No antidote exists for permethrin toxicosis, therefore treatment is aimed at decontamination and control of neurological symptoms while allowing time for the toxin to be metabolized and excreted. Clinical signs typically last from 1 to 3 days. Mortality rates vary from 5-45%. Lengthy hospitalization times and cost often contribute to an owner’s decision for euthanasia.

Intravenous lipid emulsion (IVLE) has shown promise as an emerging adjuvant treatment for certain lipophilic toxicants such as ivermectin, local anesthetics, and permethrin. Although the exact mechanism of action of IVLE is unknown, it has been postulated that the lipid creates a “sink” for fat-soluble drugs, decreasing their tissue availability. This report describes treatment of 3 cats with permethrin toxicosis with IVLE administration in addition to standard treatment. All 3 cats appeared to show accelerated resolution of clinical signs following lipid administration. The authors suggest that lipid administration may also reduce hospitalization time and cost, and possibly prevent the decision to euthanize. A prospective, controlled clinical trial to confirm these findings is warranted. In circumstances where euthanasia, or death is imminent, the use of IVLE is justified. [GO]

See also: Bruckner M and Schwedes CS. Successful treatment of permethrin toxicosis in two cats with an intravenous lipid administration. Tierarztl Prax Ausg K Kleintiere Heimtiere. 2012; 40: 129-34

Malik R, Ward MP, Seavers A, et al. Permethrin spot-on intoxication of cats: Literature review and survey of veterinary practitioners in Australia. J Feline Med Surg. 2010; 12: 5-14.

Related blog articles:
Feline permethrin toxicity (March 2010)
Cats and permethrin toxicity (February 2009)
Feline permethrin spot-on toxicity (May 2008)


More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Haworth MD and Smart L. Use of intravenous lipid therapy in three cases of feline permethrin toxicosis. J Vet Emerg Crit Care. 2012; 22: 697-702.

Permethrin is a synthetic pyrethroid insecticide and acaricide commonly used for flea and tick control in dogs. Permethrin toxicosis in cats usually occurs when owners inadvertently apply over-the-counter spot-on flea insecticides intended for dogs to their cats or when cats are exposed secondarily to the product used on dogs that share the same environment. Permethrin exerts its toxic effect on ectoparasite and host by modulating sodium ion channels, causing them to remain open longer, resulting in repetitive excitable cell discharge. While this leads to paralysis and death of the parasite, toxicosis in the host manifests primarily as central nervous system effects including tremors, hyperesthesia, ataxia, mydriasis, pyrexia, seizures, and possibly death. Cats are highly susceptible to permethrin toxicity possibly due to their innate deficiency in glucoronyl transferase and slower hepatic detoxification of the compound.
 
No antidote exists for permethrin toxicosis, therefore treatment is aimed at decontamination and control of neurological symptoms while allowing time for the toxin to be metabolized and excreted. Clinical signs typically last from 1 to 3 days. Mortality rates vary from 5-45%. Lengthy hospitalization times and cost often contribute to an owner’s decision for euthanasia.

Intravenous lipid emulsion (IVLE) has shown promise as an emerging adjuvant treatment for certain lipophilic toxicants such as ivermectin, local anesthetics, and permethrin. Although the exact mechanism of action of IVLE is unknown, it has been postulated that the lipid creates a “sink” for fat-soluble drugs, decreasing their tissue availability. This report describes treatment of 3 cats with permethrin toxicosis with IVLE administration in addition to standard treatment. All 3 cats appeared to show accelerated resolution of clinical signs following lipid administration. The authors suggest that lipid administration may also reduce hospitalization time and cost, and possibly prevent the decision to euthanize. A prospective, controlled clinical trial to confirm these findings is warranted. In circumstances where euthanasia, or death is imminent, the use of IVLE is justified. [GO]

See also: Bruckner M and Schwedes CS. Successful treatment of permethrin toxicosis in two cats with an intravenous lipid administration. Tierarztl Prax Ausg K Kleintiere Heimtiere. 2012; 40: 129-34

Malik R, Ward MP, Seavers A, et al. Permethrin spot-on intoxication of cats: Literature review and survey of veterinary practitioners in Australia. J Feline Med Surg. 2010; 12: 5-14.

Related blog articles:
Feline permethrin toxicity (March 2010)
Cats and permethrin toxicity (February 2009)
Feline permethrin spot-on toxicity (May 2008)


More on cat health:
Winn Feline Foundation Library
Find us on Facebook
Follow us on Twitter
Join us on Google+

Read More


Sunday, December 16, 2012

What You Need to Know About Vitamin K2, D and Calcium


By Dr. Mercola
Vitamin K is a fat-soluble vitamin most well known for the important role it plays in blood clotting. However, many do not realize that there are different kinds of vitamin K, and they are completely different.
The health benefits of vitamin K2 go far beyond blood clotting, which is done by vitamin K1, and vitamin K2 also works synergistically with a number of other nutrients, including calcium and vitamin D.
Dr. Kate Rheaume-Bleue, a naturopathic physician with a keen interest in nutrition, has authored what I believe is one of the most comprehensive books on this important topic, titled: Vitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life
"I tuned in to the emerging research about K2 early in 2007," she says. "Not long before, I had read Nutrition and Physical Degeneration by Weston A. Price. When I learned about vitamin K2, I thought:
"Hey, you know what? I'm sure Price talked all about this in his book." I went to the book, looked through it, and didn't find any reference to vitamin K2. I was really stumped.
A little bit later in 2007, I read a brilliant article by Chris Masterjohn that links vitamin K2 to Prices' work on Activator X.
Once I realized that link, the light bulb went on about how important this nutrient is, and how overlooked it's been for so long. It really provides the missing piece to the puzzle of so many health conditions, and yet it was being completely overlooked, despite the overwhelming amounts of modern-day research."

What's So Special About Vitamin K2?

Vitamin K is actually a group of fat-soluble vitamins. Of the two main ones, K1 and K2, the one receiving the most attention is K1, which is found in green leafy vegetables and is very easy to get through your diet. This lack of distinction has created a lot of confusion, and it's one of the reasons why vitamin K2 has been overlooked for so long.
The three types of vitamin K are:
  1. Vitamin K1, or phylloquinone, is found naturally in plants, especially green vegetables; K1 goes directly to your liver and helps you maintain healthy blood clotting
  2. Vitamin K2, also called menaquinone, is made by the bacteria that line your gastrointestinal tract; K2 goes straight to your blood vessel walls, bones, and tissues other than your liver
  3. Vitamin K3, or menadione, is a synthetic form I do not recommend; it's important to note that toxicity has occurred in infants injected with this synthetic vitamin K3
Vitamin K1 exclusively participates in blood clotting — that's sole purpose. K2 on the other hand comes from a whole different set of food sources, and its biological role is to help move calcium into the proper areas in your body, such as your bones and teeth. It also plays a role in removing calcium from areas where it shouldn't be, such as in your arteries and soft tissues.
"K2 is really critical for keeping your bones strong and your arteries clear," Rheaume-Bleue says.
Now, vitamin K2 can be broken into two additional categories, called:
  1. MK-4 (menaquinone-4), a short-chain form of vitamin K2 found in butter, egg yolks, and animal-based foods
  2. MK-7 (menaquinone-7), longer-chain forms found in fermented foods. There's a variety of these long-chain forms but the most common one is MK-7. This is the one you'll want to look for in supplements, because in a supplement form, the MK-4 products are actually synthetic. They are not derived from natural food products containing MK-4.
    The MK-7 – these long-chain, natural bacterial-derived vitamin K2 – is from a fermentation process, which offers a number of health advantages:
    1. It stays in your body longer, and
    2. It has a longer half-life, which means you can just take it once a day in very convenient dosing

How Much Vitamin K2 Do You Need?

The optimal amounts of vitamin K2 are still under investigation, but it seems likely that 180 to 200 micrograms of vitamin K2 should be enough to activate your body's K2-dependent proteins to shuttle the calcium where it needs to be, and remove it from the places where it shouldn't.
"The most recent clinical trials used around those amounts of K2," Rheaume-Bleue says. "The average person is getting a lot less than that. That's for sure. In the North American diet, you can see as little as maybe 10 percent of that or less. Certainly, not near enough to be able to optimize bone density and improve heart health."
She estimates that about 80 percent of Americans do not get enough vitamin K2 in their diet to activate their K2 proteins, which is similar to the deficiency rate of vitamin D. Vitamin K2 deficiency leaves you vulnerable for a number of chronic diseases, including:
OsteoporosisHeart diseaseHeart attack and stroke
Inappropriate calcification, from heel spurs to kidney stonesBrain diseaseCancer
"I talked about vitamin K2 moving calcium around the body. Its other main role is to activate proteins that control cell growth. That means K2 has a very important role to play in cancer protection," Rheaume-Bleue says.
"When we're lacking K2, we're at much greater risk for osteoporosis, heart disease, and cancer. And these are three concerns that used to be relatively rare. Over the last 100 years, as we've changed the way we produced our food and the way we eat, they have become very common."
Researchers are also looking into other health benefits. For example, one recent study published in the journal Modern Rheumatology1 found that vitamin K2 has the potential to improve disease activity besides osteoporosis in those with rheumatoid arthritis (RA). Another, published in the journal Science2, found that vitamin K2 serves as a mitochondrial electron carrier, thereby helping maintain normal ATP production in mitochondrial dysfunction, such as that found in Parkinson's Disease.
According to the authors:
"We identified Drosophila UBIAD1/Heix as a modifier of pink1, a gene mutated in Parkinson's disease that affects mitochondrial function. We found that vitamin K(2) was necessary and sufficient to transfer electrons in Drosophila mitochondria. Heix mutants showed severe mitochondrial defects that were rescued by vitamin K(2), and, similar to ubiquinone, vitamin K(2) transferred electrons in Drosophila mitochondria, resulting in more efficient adenosine triphosphate (ATP) production. Thus, mitochondrial dysfunction was rescued by vitamin K(2) that serves as a mitochondrial electron carrier, helping to maintain normal ATP production."

The Interplay Between Vitamin K2, Vitamin D, and Calcium

As I've discussed on numerous occasions, vitamin D is a critical nutrient for optimal health and is best obtained from sun exposure or a safe tanning bed. However, many are taking oral vitamin D, which may become problematic unless you're also getting sufficient amounts of vitamin K2. Dr. Rheaume-Bleue explains:
"When you take vitamin D, your body creates more of these vitamin K2-dependent proteins, the proteins that will move the calcium around. They have a lot of potential health benefits. But until the K2 comes in to activate those proteins, those benefits aren't realized. So, really, if you're taking vitamin D, you're creating an increased demand for K2. And vitamin D and K2 work together to strengthen your bones and improve your heart health.
... For so long, we've been told to take calcium for osteoporosis... and vitamin D, which we know is helpful. But then, more studies are coming out showing that increased calcium intake is causing more heart attacks and strokes. That created a lot of confusion around whether calcium is safe or not. But that's the wrong question to be asking, because we'll never properly understand the health benefits of calcium or vitamin D, unless we take into consideration K2. That's what keeps the calcium in its right place."

IMPORTANT: If You Take Vitamin D, You Need K2

This is a really crucial point: If you opt for oral vitamin D, you need to also consume in your food or take supplemental vitamin K2.
"There are so many people on the vitamin-D-mega-dose bandwagon, taking more and more of vitamin D. And it could absolutely be causing harm if you are lacking the K2 to complete the job to get the calcium where it's supposed to be,"Rheaume-Bleue warns.
"We don't see symptoms of vitamin D toxicity very often. But when we do, those symptoms are inappropriate calcification. That's the symptom of vitamin D toxicity. And it is actually a lack of vitamin K2 that can cause that..."
While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Rheume-Bleue suggests that for every 1,000 IU's of vitamin D you take, you may benefit from about 100 micrograms of K2, and perhaps as much as 150-200 micrograms (mcg).
The latest vitamin D dosing recommendations, which call for about 8,000 IU's of vitamin D3 per day if you're an adult, means you'd need in the neighborhood of 800 to 1,000 micrograms (0.8 to 1 milligram/mg) of vitamin K2.
"My earlier recommendation was not taking into account people who were doing high dose of vitamin D supplementation," Rheaume-Bleue says. "That's where it gets a little bit more technical. It seems that for the average person, around 200 to 280 micrograms will activate your K2 proteins and do a lot of good for your bones and your heart. If you're taking high levels of vitamin D... then I would recommend taking more K2."
The good news is that vitamin K2 has no toxicity. No toxic effects have ever been demonstrated in the medical literature.
"The reason why K2 doesn't have potential toxic effect is that all vitamin K2 does is activate K2 proteins. It will activate all the K2 proteins it finds. And if they're all activated and you take extra K2, it simply won't do that. That's why we don't see a potential for toxicity the way we do with vitamin A or D," she says.

If You Need Calcium, Aim for Calcium-Rich Foods First

For those who are calcium deficient, Rheaume-Bleue recommends looking to food sources high in calcium, before opting for a supplement. This is because many high calcium foods also contain naturally high amounts of, you guessed it, vitamin K2! Nature cleverly gives us these two nutrients in combination, so they work optimally. Good sources of calcium include dairy, especially cheeses, and vegetables, although veggies aren't high in K2.
Additionally, magnesium is far more important than calcium if you are going to consider supplementing. Magnesium will also help keep magnesium in the cell to do its job far better. In many ways it serves as nutritional version of the highly effective class of drugs called calcium channel blockers. If you do chose to supplement with calcium, for whatever reason, it's important to maintain the proper balance between your intake of calcium and other nutrients such as:
  • Vitamin K2
  • Vitamin D
  • Magnesium

The Importance of Magnesium

As mentioned previously, magnesium is another important player to allow for proper function of calcium. As with vitamin D and K2, magnesium deficiency is also common, and when you are lacking in magnesium and take calcium, you may exacerbate the situation. Vitamin K2 and magnesium complement each other, as magnesium helps lower blood pressure, which is an important component of heart disease.
Dietary sources of magnesium include sea vegetables, such as kelp, dulse, and nori. Few people eat these on a regular basis however, if at all. Vegetables can also be a good source, along with whole grains. However, grains MUST be prepared properly to remove phytates and anti-nutrients that can otherwise block your absorption of magnesium. As for supplements, Rheaume-Bleue recommends using magnesium citrate. Another emerging one is magnesium threonate, which appears promising primarily due to its superior ability to penetrate the mitochondrial membrane.

How Can You Tell if You're Lacking in Vitamin K2?

There's no way to test for vitamin K2 deficiency. But by assessing your diet and lifestyle, you can get an idea of whether or not you may be lacking in this critical nutrient. If you have any of the following health conditions, you're likely deficient in vitamin K2 as they are all connected to K2:
  • Do you have osteoporosis?
  • Do you have heart disease?
  • Do you have diabetes?
If you do not have any of those health conditions, but do NOT regularly eat high amounts of the following foods, then your likelihood of being vitamin K2 deficient is still very high:
  • Grass-fed organic animal products (i.e. eggs, butter, dairy)
  • Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria. Please note that most fermented vegetables are not really high in vitamin K2 and come in at about 50 mcg per serving. However, if specific starter cultures are used they can have ten times as much, or 500 mcg per serving.
  • Goose liver pâté
  • Certain cheeses such as Brie and Gouda (these two are particularly high in K2, containing about 75 mcg per ounce)
  • "An important thing to mention when it comes to cheese (because this becomes an area of confusion), [is that] because cheese is a bacterial derived form of vitamin K2, it actually doesn't matter if the cheese came from grass-fed milk. That would be nice, but it's not the milk that went into the cheese that makes the K2. It's the bacteria making the cheese, which means it doesn't matter if you're importing your brie from France or getting it domestically. Brie cheese, the bacteria that makes brie cheese, will make vitamin K2," she says.
Fermented vegetables, which are one of my new passions, primarily for supplying beneficial bacteria back into our gut, can be a great source of vitamin K if you ferment your own using the proper starter culture. We recently had samples of high-quality fermented organic vegetables made with our specific starter culture tested, and were shocked to discover that not only does a typical serving of about two to three ounces contain about 10 trillion beneficial bacteria, but it also contained 500 mcg of vitamin K2.
Note that not every strain of bacteria makes K2. For example, most yoghurts have almost no vitamin K2. Certain types of cheeses are very high in K2, and others are not. It really depends on the specific bacteria. You can't assume that any fermented food will be high in K2, but some fermented foods are very high in K2, such as natto. Others, such as miso and tempeh, are not high n K2.

Pregnant? Make Sure You're Getting Enough Vitamin K2

Last but not least, while vitamin K2 is critical for the prevention of a number of chronic diseases listed above, it's also vital for women who are trying to conceive, who are pregnant, and for growing healthy children. "K2 plays a very important role throughout pregnancy (for the development of teeth for both primary and adult teeth, the development of proper facial form, healthy facial form, as well as strong bones), then again throughout childhood to prevent cavities, and through adolescence as the skeleton is growing," Rheaume-Bleue says.
Vitamin K2 is needed throughout pregnancy, and later while breastfeeding. It may be particularly important during the third trimester, as most women's levels tend to drop at that time, indicating there's an additional drain on the system toward the end of the pregnancy. Since vitamin K2 has no toxicity issues, it may be prudent to double or even triple — which is what Rheaume-Bleue did during her own recent pregnancy — your intake while pregnant.



About Dr Kevin Lau


Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.

By Dr. Mercola
Vitamin K is a fat-soluble vitamin most well known for the important role it plays in blood clotting. However, many do not realize that there are different kinds of vitamin K, and they are completely different.
The health benefits of vitamin K2 go far beyond blood clotting, which is done by vitamin K1, and vitamin K2 also works synergistically with a number of other nutrients, including calcium and vitamin D.
Dr. Kate Rheaume-Bleue, a naturopathic physician with a keen interest in nutrition, has authored what I believe is one of the most comprehensive books on this important topic, titled: Vitamin K2 and the Calcium Paradox: How a Little Known Vitamin Could Save Your Life
"I tuned in to the emerging research about K2 early in 2007," she says. "Not long before, I had read Nutrition and Physical Degeneration by Weston A. Price. When I learned about vitamin K2, I thought:
"Hey, you know what? I'm sure Price talked all about this in his book." I went to the book, looked through it, and didn't find any reference to vitamin K2. I was really stumped.
A little bit later in 2007, I read a brilliant article by Chris Masterjohn that links vitamin K2 to Prices' work on Activator X.
Once I realized that link, the light bulb went on about how important this nutrient is, and how overlooked it's been for so long. It really provides the missing piece to the puzzle of so many health conditions, and yet it was being completely overlooked, despite the overwhelming amounts of modern-day research."

What's So Special About Vitamin K2?

Vitamin K is actually a group of fat-soluble vitamins. Of the two main ones, K1 and K2, the one receiving the most attention is K1, which is found in green leafy vegetables and is very easy to get through your diet. This lack of distinction has created a lot of confusion, and it's one of the reasons why vitamin K2 has been overlooked for so long.
The three types of vitamin K are:
  1. Vitamin K1, or phylloquinone, is found naturally in plants, especially green vegetables; K1 goes directly to your liver and helps you maintain healthy blood clotting
  2. Vitamin K2, also called menaquinone, is made by the bacteria that line your gastrointestinal tract; K2 goes straight to your blood vessel walls, bones, and tissues other than your liver
  3. Vitamin K3, or menadione, is a synthetic form I do not recommend; it's important to note that toxicity has occurred in infants injected with this synthetic vitamin K3
Vitamin K1 exclusively participates in blood clotting — that's sole purpose. K2 on the other hand comes from a whole different set of food sources, and its biological role is to help move calcium into the proper areas in your body, such as your bones and teeth. It also plays a role in removing calcium from areas where it shouldn't be, such as in your arteries and soft tissues.
"K2 is really critical for keeping your bones strong and your arteries clear," Rheaume-Bleue says.
Now, vitamin K2 can be broken into two additional categories, called:
  1. MK-4 (menaquinone-4), a short-chain form of vitamin K2 found in butter, egg yolks, and animal-based foods
  2. MK-7 (menaquinone-7), longer-chain forms found in fermented foods. There's a variety of these long-chain forms but the most common one is MK-7. This is the one you'll want to look for in supplements, because in a supplement form, the MK-4 products are actually synthetic. They are not derived from natural food products containing MK-4.
    The MK-7 – these long-chain, natural bacterial-derived vitamin K2 – is from a fermentation process, which offers a number of health advantages:
    1. It stays in your body longer, and
    2. It has a longer half-life, which means you can just take it once a day in very convenient dosing

How Much Vitamin K2 Do You Need?

The optimal amounts of vitamin K2 are still under investigation, but it seems likely that 180 to 200 micrograms of vitamin K2 should be enough to activate your body's K2-dependent proteins to shuttle the calcium where it needs to be, and remove it from the places where it shouldn't.
"The most recent clinical trials used around those amounts of K2," Rheaume-Bleue says. "The average person is getting a lot less than that. That's for sure. In the North American diet, you can see as little as maybe 10 percent of that or less. Certainly, not near enough to be able to optimize bone density and improve heart health."
She estimates that about 80 percent of Americans do not get enough vitamin K2 in their diet to activate their K2 proteins, which is similar to the deficiency rate of vitamin D. Vitamin K2 deficiency leaves you vulnerable for a number of chronic diseases, including:
OsteoporosisHeart diseaseHeart attack and stroke
Inappropriate calcification, from heel spurs to kidney stonesBrain diseaseCancer
"I talked about vitamin K2 moving calcium around the body. Its other main role is to activate proteins that control cell growth. That means K2 has a very important role to play in cancer protection," Rheaume-Bleue says.
"When we're lacking K2, we're at much greater risk for osteoporosis, heart disease, and cancer. And these are three concerns that used to be relatively rare. Over the last 100 years, as we've changed the way we produced our food and the way we eat, they have become very common."
Researchers are also looking into other health benefits. For example, one recent study published in the journal Modern Rheumatology1 found that vitamin K2 has the potential to improve disease activity besides osteoporosis in those with rheumatoid arthritis (RA). Another, published in the journal Science2, found that vitamin K2 serves as a mitochondrial electron carrier, thereby helping maintain normal ATP production in mitochondrial dysfunction, such as that found in Parkinson's Disease.
According to the authors:
"We identified Drosophila UBIAD1/Heix as a modifier of pink1, a gene mutated in Parkinson's disease that affects mitochondrial function. We found that vitamin K(2) was necessary and sufficient to transfer electrons in Drosophila mitochondria. Heix mutants showed severe mitochondrial defects that were rescued by vitamin K(2), and, similar to ubiquinone, vitamin K(2) transferred electrons in Drosophila mitochondria, resulting in more efficient adenosine triphosphate (ATP) production. Thus, mitochondrial dysfunction was rescued by vitamin K(2) that serves as a mitochondrial electron carrier, helping to maintain normal ATP production."

The Interplay Between Vitamin K2, Vitamin D, and Calcium

As I've discussed on numerous occasions, vitamin D is a critical nutrient for optimal health and is best obtained from sun exposure or a safe tanning bed. However, many are taking oral vitamin D, which may become problematic unless you're also getting sufficient amounts of vitamin K2. Dr. Rheaume-Bleue explains:
"When you take vitamin D, your body creates more of these vitamin K2-dependent proteins, the proteins that will move the calcium around. They have a lot of potential health benefits. But until the K2 comes in to activate those proteins, those benefits aren't realized. So, really, if you're taking vitamin D, you're creating an increased demand for K2. And vitamin D and K2 work together to strengthen your bones and improve your heart health.
... For so long, we've been told to take calcium for osteoporosis... and vitamin D, which we know is helpful. But then, more studies are coming out showing that increased calcium intake is causing more heart attacks and strokes. That created a lot of confusion around whether calcium is safe or not. But that's the wrong question to be asking, because we'll never properly understand the health benefits of calcium or vitamin D, unless we take into consideration K2. That's what keeps the calcium in its right place."

IMPORTANT: If You Take Vitamin D, You Need K2

This is a really crucial point: If you opt for oral vitamin D, you need to also consume in your food or take supplemental vitamin K2.
"There are so many people on the vitamin-D-mega-dose bandwagon, taking more and more of vitamin D. And it could absolutely be causing harm if you are lacking the K2 to complete the job to get the calcium where it's supposed to be,"Rheaume-Bleue warns.
"We don't see symptoms of vitamin D toxicity very often. But when we do, those symptoms are inappropriate calcification. That's the symptom of vitamin D toxicity. And it is actually a lack of vitamin K2 that can cause that..."
While the ideal or optimal ratios between vitamin D and vitamin K2 have yet to be elucidated, Rheume-Bleue suggests that for every 1,000 IU's of vitamin D you take, you may benefit from about 100 micrograms of K2, and perhaps as much as 150-200 micrograms (mcg).
The latest vitamin D dosing recommendations, which call for about 8,000 IU's of vitamin D3 per day if you're an adult, means you'd need in the neighborhood of 800 to 1,000 micrograms (0.8 to 1 milligram/mg) of vitamin K2.
"My earlier recommendation was not taking into account people who were doing high dose of vitamin D supplementation," Rheaume-Bleue says. "That's where it gets a little bit more technical. It seems that for the average person, around 200 to 280 micrograms will activate your K2 proteins and do a lot of good for your bones and your heart. If you're taking high levels of vitamin D... then I would recommend taking more K2."
The good news is that vitamin K2 has no toxicity. No toxic effects have ever been demonstrated in the medical literature.
"The reason why K2 doesn't have potential toxic effect is that all vitamin K2 does is activate K2 proteins. It will activate all the K2 proteins it finds. And if they're all activated and you take extra K2, it simply won't do that. That's why we don't see a potential for toxicity the way we do with vitamin A or D," she says.

If You Need Calcium, Aim for Calcium-Rich Foods First

For those who are calcium deficient, Rheaume-Bleue recommends looking to food sources high in calcium, before opting for a supplement. This is because many high calcium foods also contain naturally high amounts of, you guessed it, vitamin K2! Nature cleverly gives us these two nutrients in combination, so they work optimally. Good sources of calcium include dairy, especially cheeses, and vegetables, although veggies aren't high in K2.
Additionally, magnesium is far more important than calcium if you are going to consider supplementing. Magnesium will also help keep magnesium in the cell to do its job far better. In many ways it serves as nutritional version of the highly effective class of drugs called calcium channel blockers. If you do chose to supplement with calcium, for whatever reason, it's important to maintain the proper balance between your intake of calcium and other nutrients such as:
  • Vitamin K2
  • Vitamin D
  • Magnesium

The Importance of Magnesium

As mentioned previously, magnesium is another important player to allow for proper function of calcium. As with vitamin D and K2, magnesium deficiency is also common, and when you are lacking in magnesium and take calcium, you may exacerbate the situation. Vitamin K2 and magnesium complement each other, as magnesium helps lower blood pressure, which is an important component of heart disease.
Dietary sources of magnesium include sea vegetables, such as kelp, dulse, and nori. Few people eat these on a regular basis however, if at all. Vegetables can also be a good source, along with whole grains. However, grains MUST be prepared properly to remove phytates and anti-nutrients that can otherwise block your absorption of magnesium. As for supplements, Rheaume-Bleue recommends using magnesium citrate. Another emerging one is magnesium threonate, which appears promising primarily due to its superior ability to penetrate the mitochondrial membrane.

How Can You Tell if You're Lacking in Vitamin K2?

There's no way to test for vitamin K2 deficiency. But by assessing your diet and lifestyle, you can get an idea of whether or not you may be lacking in this critical nutrient. If you have any of the following health conditions, you're likely deficient in vitamin K2 as they are all connected to K2:
  • Do you have osteoporosis?
  • Do you have heart disease?
  • Do you have diabetes?
If you do not have any of those health conditions, but do NOT regularly eat high amounts of the following foods, then your likelihood of being vitamin K2 deficient is still very high:
  • Grass-fed organic animal products (i.e. eggs, butter, dairy)
  • Certain fermented foods such as natto, or vegetables fermented using a starter culture of vitamin K2-producing bacteria. Please note that most fermented vegetables are not really high in vitamin K2 and come in at about 50 mcg per serving. However, if specific starter cultures are used they can have ten times as much, or 500 mcg per serving.
  • Goose liver pâté
  • Certain cheeses such as Brie and Gouda (these two are particularly high in K2, containing about 75 mcg per ounce)
  • "An important thing to mention when it comes to cheese (because this becomes an area of confusion), [is that] because cheese is a bacterial derived form of vitamin K2, it actually doesn't matter if the cheese came from grass-fed milk. That would be nice, but it's not the milk that went into the cheese that makes the K2. It's the bacteria making the cheese, which means it doesn't matter if you're importing your brie from France or getting it domestically. Brie cheese, the bacteria that makes brie cheese, will make vitamin K2," she says.
Fermented vegetables, which are one of my new passions, primarily for supplying beneficial bacteria back into our gut, can be a great source of vitamin K if you ferment your own using the proper starter culture. We recently had samples of high-quality fermented organic vegetables made with our specific starter culture tested, and were shocked to discover that not only does a typical serving of about two to three ounces contain about 10 trillion beneficial bacteria, but it also contained 500 mcg of vitamin K2.
Note that not every strain of bacteria makes K2. For example, most yoghurts have almost no vitamin K2. Certain types of cheeses are very high in K2, and others are not. It really depends on the specific bacteria. You can't assume that any fermented food will be high in K2, but some fermented foods are very high in K2, such as natto. Others, such as miso and tempeh, are not high n K2.

Pregnant? Make Sure You're Getting Enough Vitamin K2

Last but not least, while vitamin K2 is critical for the prevention of a number of chronic diseases listed above, it's also vital for women who are trying to conceive, who are pregnant, and for growing healthy children. "K2 plays a very important role throughout pregnancy (for the development of teeth for both primary and adult teeth, the development of proper facial form, healthy facial form, as well as strong bones), then again throughout childhood to prevent cavities, and through adolescence as the skeleton is growing," Rheaume-Bleue says.
Vitamin K2 is needed throughout pregnancy, and later while breastfeeding. It may be particularly important during the third trimester, as most women's levels tend to drop at that time, indicating there's an additional drain on the system toward the end of the pregnancy. Since vitamin K2 has no toxicity issues, it may be prudent to double or even triple — which is what Rheaume-Bleue did during her own recent pregnancy — your intake while pregnant.



About Dr Kevin Lau


Dr Kevin Lau DC is the founder of Health In Your Hands, a series of tools for Scoliosis prevention and treatment. The set includes his book Your Plan for Natural Scoliosis Prevention and Treatment, a companion Scoliosis Exercises for Prevention and Correction DVD and the innovative new iPhone application ScolioTrack. Dr Kevin Lau is a graduate in Doctor of Chiropractic from RMIT University in Melbourne Australia and Masters in Holistic Nutrition. He is a member of International Society On Scoliosis Orthopaedic and Rehabilitation Treatment (SOSORT), the leading international society on conservative treatment of spinal deformities. In 2006 I was awarded the "Best Health-care Provider Awards" by the largest Newspaper publication in Singapore on October 18 2006 as well as being interviewed on Primetime Channel News Asia as well as other TV and Radio. For more information on Dr Kevin Lau, watch his interviews or get a free sneak peek of his book, go to:

Website - http://www.hiyh.info.
ScolioTrack Website - http://www.ScolioTrack.com.
Facebook - https://www.facebook.com/HealthInYourHands.
Youtube - http://www.youtube.com/user/DrKevinLau.
Twitter - http://www.Twitter.com/DrKevinLau.
Read More


In starting its sixth package in series on prescription drug abuse, The Courier-Journal shows treatment programs fall short of need

Brittany Crouch suffers through withdrawal in Frenchburg
before leaving for treatment in Lexington, as daughter
Kaylee Adams, 3, cries. (C-J photo by Alton Strupp)
"In a state plagued by one of the worst prescription-drug abuse problems in the nation . . . treatment options are woefully limited, especially for hard-core addicts in need of the most intense care, Laura Ungar reports for The Courier-Journal in the opening story of its sixth package in the series called "Prescription for Tragedy."

"Only 40 of Kentucky’s 301 treatment and recovery sites offer 24-hour residential care, which experts say may be the only hope for the most severely addicted. And those 40 centers are concentrated in just 19 of the state’s 120 counties, mostly in urban areas, meaning addicts in rural counties often must travel hours for help, Ungar writes, noting that almost 80 percent of the sites "are for outpatients only, typically offering one hour of care a week."

That is the type of care received by two-thirds of Kentuckians admitted for treatment, but by 46 percent nationwide in 2009, the last year for which comparative figures are available. Fewer than 5 percent "entered residential care, compared with 17 percent nationally," Ungar writes. "Treatment shortages are most severe in Appalachian counties with the state’s highest overdose rates. Six Kentucky counties that rank among the 10 highest for overdose deaths have just one outpatient center or no center at all." (Read more)

Today's package includes a map of treatment centers in the state; in the print version, it is overlaid on a county map showing rates of death from prescription drugs, with the highest in Appalachian Kentucky. The dots in green, yellow and red on the Google-based map below indicate centers that provide care more intensive than outpatient.

Brittany Crouch suffers through withdrawal in Frenchburg
before leaving for treatment in Lexington, as daughter
Kaylee Adams, 3, cries. (C-J photo by Alton Strupp)
"In a state plagued by one of the worst prescription-drug abuse problems in the nation . . . treatment options are woefully limited, especially for hard-core addicts in need of the most intense care, Laura Ungar reports for The Courier-Journal in the opening story of its sixth package in the series called "Prescription for Tragedy."

"Only 40 of Kentucky’s 301 treatment and recovery sites offer 24-hour residential care, which experts say may be the only hope for the most severely addicted. And those 40 centers are concentrated in just 19 of the state’s 120 counties, mostly in urban areas, meaning addicts in rural counties often must travel hours for help, Ungar writes, noting that almost 80 percent of the sites "are for outpatients only, typically offering one hour of care a week."

That is the type of care received by two-thirds of Kentuckians admitted for treatment, but by 46 percent nationwide in 2009, the last year for which comparative figures are available. Fewer than 5 percent "entered residential care, compared with 17 percent nationally," Ungar writes. "Treatment shortages are most severe in Appalachian counties with the state’s highest overdose rates. Six Kentucky counties that rank among the 10 highest for overdose deaths have just one outpatient center or no center at all." (Read more)

Today's package includes a map of treatment centers in the state; in the print version, it is overlaid on a county map showing rates of death from prescription drugs, with the highest in Appalachian Kentucky. The dots in green, yellow and red on the Google-based map below indicate centers that provide care more intensive than outpatient.

Read More