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Rossville, Fort Oglethorpe convenience store owners busted for selling pot

Lookout Mountain Judicial Circuit Drug Task Force agents recently completed the initial stages of an investigation into reports that convenience stores within the four-county circuit were distributing suspected marijuana.

"This is absolutely marijuana being sold as 'hemp flower' in at least one store in each county," Task Force Commander Patrick Doyle said.

Doyle said an ongoing investigation revealed a number of convenience stores were indeed selling marijuana, leading agents to apply for arrest warrants for area store owners.

These stores were located in Chattooga, Dade, Walker, and Catoosa counties.

The Task Force operates in Catoosa, Chattooga, Dade and Walker counties with officers currently assigned from the LaFayette and Fort Oglethorpe police departments and deputies from the Walker, Dade and Chattooga sheriff's offices.

The illegal substances were packaged with misleading labels indicating the contents were "Legal in all Fifty States," contained "CBD," and had been "Lab Tested."

The first store owners arrested and booked on July 31, are Risilkumar Patel, 26, Cross Street. Rossville, who was booked into the Chattooga County jail, and Tanjot Bajwa, 41, Honeysuckle Trail, Fort Oglethorpe, who was booked into the Catoosa County Jail.

Additional arrest warrants — as many as five — have been obtained and more arrests are pending in this ongoing investigation, Commander Doyle said.

* WARNING TO RETAILERS/PARENTS/CONSUMERS

These products claiming to have "No THC", "CBD", or "Hemp Flower" may contain marijuana. These products may be ILLEGAL to distribute, purchase, or possess.

"This is absolutely marijuana being sold as 'hemp flower' in at least one store in each county.

— Task Force Commander Patrick Doyle


These pills could be next U.S. drug epidemic, public health officials say

The growing use of anti-anxiety pills reminds some doctors of the early days of the opioid crisis.

Considered relatively safe and non-addictive by the general public and many doctors, Xanax, Valium, Ativan and Klonopin have been prescribed to millions of Americans for decades to calm jittery nerves and promote a good night's sleep.

But the number of people taking the sedatives and the average length of time they're taking them have shot up since the 1990s, when doctors also started liberally prescribing opioid painkillers.

As a result, some state and federal officials are now warning that excessive prescribing of a class of drugs known as benzodiazepines or "benzos" is putting more people at risk of dependence on the pills and is exacerbating the fatal overdose toll of painkillers and heroin. Some local governments are beginning to restrict benzo prescriptions.

When taken in combination with painkillers or illicit narcotics, benzodiazepines can increase the likelihood of a fatal overdose as much as tenfold, according to the National Institute on Drug Abuse. On their own, the medications can cause debilitating withdrawal symptoms that last for months or years.

Public health officials also warn that people who abruptly stop taking benzodiazepines risk seizures or even death.

With heightened public awareness of the nation's opioid epidemic, some state and local officials are insisting that these anti-anxiety medications start sharing some of the scrutiny.

"We have this whole infrastructure set up now to prevent overprescribing of opioids and address the need for addiction treatment," said Dr. Anna Lembke, a researcher and addiction specialist at Stanford University. "We need to start making benzos part of that."

"What we're seeing is just like what happened with opioids in the 1990s," she said. "It really does begin with overprescribing. Liberal therapeutic use of drugs in a medical setting tends to normalize their use. People start to think they're safe and, because they make them feel good, it doesn't matter where they get them or how many they use."

The number of adults filling a benzodiazepine prescription increased by two-thirds between 1996 and 2013, from 8 million to nearly 14 million, according to a review of market data by Lembke and others in the New England Journal of Medicine. Despite the known dangers of co-prescribing painkillers and anti-anxiety medications, the rate of combined prescriptions nearly doubled between 2001 and 2013.

Since then, prescriptions for benzodiazepines may have leveled off or declined slightly, according to recent data from a market research firm that tracks prescription drug sales, the IQVIA Institute for Human Data Science. At the same time, opioid prescribing has dropped by more than a fifth.

Still, Lembke said, the level of prescribing is much higher than it was in the mid-1990s and benzo dependence appears to be rising based on her own clinical observations.

First marketed in the early 1960s, benzodiazepines have been cyclically abused throughout their history. What's notable now, Lembke said, is that overuse of benzos is coinciding with overuse of opioids.

But a newly formed group of researchers and pharmacologists, the International Task Force on Benzodiazepines, wrote in an editorial that recent negative publicity has made it difficult for many doctors around the world to prescribe medications they consider essential.

Some scientific articles "achieved a common goal that negative propaganda frequently reaches: they aroused suspicion of benzodiazepines and suggested difficulties in using them, while overlooking their benefits," the pharmacologists said. (Three of the 17 co-authors reported having consulted for or received support from drug companies.)

Psychiatrists, including Lembke, agree that relatively inexpensive benzodiazepines can be effective at relieving acute cases of anxiety and sleeplessness.

Physicians agree that benzos should not be used long term to solve psychiatric problems. Research indicates that use of the drugs for more than a few weeks can cause tolerance, including withdrawal symptoms between doses, and physical and psychological dependence.

To raise awareness of benzodiazepines' dangers, Hawaii, Pennsylvania and New York City have issued prescribing guidelines that limit the duration of Xanax, Valium and other benzo prescriptions, similar to many state guidelines for opioids.

In addition, the Massachusetts Legislature this month passed a wide-ranging opioid bill that included benzodiazepines as a class of restricted drugs.

Nationwide, most states require doctors and pharmacists to track opioid prescribing through online databases that monitor patients who receive them and doctors who prescribe them. Benzodiazepines are not included in half of the states, according to an analysis of state laws by The Pew Charitable Trusts, which also supports Stateline.

Mounting Dangers

As prescriptions for benzodiazepines have grown since the late 1990s, so have deaths, according to a study at Montefiore Medical Center in New York. The National Institute on Drug Abuse reports that overdose deaths involving benzodiazepines quadrupled from 2002 to 2015.

New highly potent forms of benzodiazepines that are illicitly traded are also causing overdose deaths, addiction doctors say. Adding to the dangers, the Drug Enforcement Administration has reported that the deadly synthetic drug fentanyl has been found in counterfeit forms of Xanax.

Xanax and Valium were involved in more than 30 percent of opioid overdose deaths between 2010 and 2014, far more than cocaine and methamphetamines, according to the Centers for Disease Control and Prevention. In some parts of the country, the prevalence of Xanax in drug overdose autopsy reports was even higher.

Xanax for the past several years has been found in more overdose autopsies in Kentucky than any specific opioid, according to Dr. Kelly Clark, president of the American Society of Addiction Medicine and an addiction doctor who lives in the state. "In fact, community mental health centers in Louisville stopped prescribing Xanax because it is such a common drug of abuse and so dangerous in combination with alcohol and opioids," she said in an interview with Stateline.

Better Information

Researchers and patient advocates argue more needs to be done to educate medical students and inform doctors and patients about the drugs' dangers.

Dr. Christy Huff, who is in recovery from dependence on Xanax, co-directs the Utah-based Benzodiazepine Information Coalition. The nonprofit advocates for stronger warnings for patients who take Xanax and other benzos, as well as better education for prescribing physicians.

"Our population of patients is experiencing extremely difficult withdrawals, and they have neurological injuries because of unsafe prescribing," Huff said. "Doctors need to be informed that the medications should be prescribed for no more than two to four weeks. They were always meant to be short term."

In 2016, the Food and Drug Administration issued a warning about the dangers of combining opioids and benzodiazepines. That prompted many doctors to force patients to choose one drug over the other without warning them about the potential symptoms of withdrawal such as seizures or even death, Huff said.

"Patients who are on the medications should be given the choice of how and when they are tapered off," she said. "Too many doctors are taking people off their prescriptions too rapidly."

The benzo task force wrote in its editorial that it was developing research that it hoped would support preserving the drugs as a valuable part of the medical arsenal.


Feds report serious RN shor tages at many Georgia nursing homes

"The current methodology underreports staffing," said Devon Barill, an association spokeswoman. "For example, for employees who are salaried and work more than 40 hours in a week, [Medicare] does not count hours beyond 40 per week unless the salaried employee is paid an additional amount above their usual salary, even when it is widely known that many nurses work extra shifts and thus extra time.''

She added that Georgia nursing homes face a statewide shortage of RNs, so they keep higher levels of licensed practical nurses (LPNs) on staff. But the federal Centers for Medicare & Medicaid Services (CMS) does not count some of those LPN hours worked, such as supervisory hours, Barill said.

"Collectively, this results in fewer hours of patient care being reported today than actually delivered and certainly less than previously reported. As such, we don't feel that the new ratings provide an accurate reflection of the care being provided in Georgia's centers."

"We also believe that judging the quality of a nursing home based solely on staffing is misguided,'' Barill added. "There are centers with high staffing levels and poor outcomes and numerous deficiencies and there are centers with low staffing with good inspection reports and good

quality outcomes."

Nearly 1.4 million people are cared for in skilled nursing facilities in the United States. When nursing homes are short-staffed, nurses and aides scramble to deliver meals, transport bedbound residents to bathrooms and answer calls for pain medication, KHN reported. Essential tasks such as repositioning a patient to avert bedsores can be overlooked when workers are overburdened, sometimes leading to avoidable hospitalizations

"We've just begun to leverage this new information to strengthen transparency and enforcement with the goals of improved patient safety and health outcomes," the CMS said in a statement to KHN.

Kathy Floyd of the Georgia Council on Aging said last week that ''the lack of RNs has caused some homes to give more duties and responsibilities to LPNs. But you have to make sure they have the necessary training and, of course, that [instruction] takes time away from direct care."

Overall staffing levels are low, Floyd added. "Advocates and providers are talking about possible solutions to Georgia's lower staffing levels. I hope our next governor will look at provider reimbursement rates and please, please tie increases to quality measures."

The new payroll data, analyzed by Kaiser Health News, showed that for-profit nursing homes averaged 16 percent fewer staff than did nonprofits, even after accounting for differences in the needs of residents. The biggest difference was in the number of registered nurses: At the average nonprofit, there was one RN for every 28 residents, but at the average for-profit, there was only one RN for every 43 residents.

The data also revealed that nursing homes have large fluctuations in staffing. The average nursing home had one licensed nurse caring for as few as 17 residents or as many as 33, depending on the day. On the best-staffed days, each certified nursing assistant or other aide cared for nine residents, but on the worst-staffed days, each aide was responsible for 16 residents, KHN reported.

Weekend staffing was particularly sparse. On weekends on average, there were 11 percent fewer nurses providing direct care and 8 percent fewer aides, according to the KHN report.

McNeil, the long-term care ombudsman, said that including the nurse staffing information in the nursing home ratings "is helpful for individuals to consider when choosing a nursing home.''

The Georgia Health Care Association cited consumer satisfaction surveys conducted by NRC Health, in which the trade group said 93 percent of nursing center residents and their families indicated they would recommend Georgia skilled nursing care centers to friends or relatives in 2017.

"The cost of direct care staffing for Georgia's skilled nursing centers still exceeds what Medicaid currently reimburses, so centers are unable to compete with the wages and benefits packages of other health care provider groups and non-health care employers,'' Barill added. The Georgia Health Care Association, she said, "continues to work with legislators and other stakeholders to address these issues and develop methods to enhance the ability of Georgia's nursing centers to recruit and retain a skilled, competent workforce."

GHN intern Naomi Thomas contributed to this article.


Are you a good citizen?

To begin with, the headline should read: "Are you a good resident?" To put it in the words of Wikipedia, "Citizenship is the status of a person recognized under the custom or law as being a legal member of a sovereign state or belonging to a nation."

We're going to say citizen anyway, but keep in mind that you are not truly a citizen of Walker County or LaFayette or Rossville or Chickamauga or Lookout Mountain. You're a resident that we're calling a citizen. But resident is just as important as citizen.

At any rate, here's a good-citizen bucket list, some things every good citizen should try at least once. Why not write them down or print them up and get to checking them off? If you have children or grandchildren, this would make a great civics project.

• Visit your city or county website and search around on it. You'll learn all manner of things.

• Vote. Don't be one of thousands who pass. There's early voting, absentee voting, 12 hours on final election day.

• Attend a city council or county commissioner meeting. Meet your elected officials (somebody elected them).

• Write a letter or email to an elected official about anything at all — your concerns or hopes, a bit of praise or a well-founded complaint.

• Visit your animal shelter. Pet a lonely dog or cat or adopt one.

• Visit your public library. Get a library card. Check out a book or a movie or some music.

• Visit your police and fire departments. Ask for a tour or some advice.

• Find out which departments have Facebook pages and follow them.

• Find out what recreation options your municipality offers and try something (disc golf, anyone•).

• Walk on a city or county trail and pick up a piece of litter.

• Watch government meetings online when you can't attend (you can wear your PJs).

And how about some preventive habits?

• Don't throw trash on the ground of your city or county.

• Get your pets spayed or neutered. Stop animal homelessness.

• Drive safely – within the speed limits, without distraction, the way you want other people to.

• Treat your fellow citizens with respect. Help create the kind of city or county you want to live in.

Where to start your new take on citizen-residentship: walkercountyga.gov, mycityoflafayettega.org, rossvillegagov.us, cityofchickamauga.org, lookoutmtnga.com.