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Mississippi pharmacies fall short in providing opioid-reversal drug, study shows

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Almost half of Mississippi pharmacists are not readily storing and selling naloxone, according to a study conducted by researchers at the University of Mississippi.

More than 40% of Mississippi pharmacies do not carry naloxone, despite a 2017 standing order from the state that allows pharmacists to dispense naloxone with or without a prescription at a patient’s request.

This is the first study since the passage of the order to investigate the accessibility of naloxone, commonly known as Narcan – a drug that can reverse the effects of an opioid overdose.

Emily Gravlee, a fourth-year University of Mississippi doctoral student in pharmacy administration Credit: Courtesy of Emily Gravlee

Emily Gravlee, a fourth-year University of Mississippi doctoral student in pharmacy administration and creator of the study for her master’s thesis, said it’s important to have naloxone available at community pharmacies because they are access points for many people.

“If we don’t have naloxone available at community pharmacies, then that could potentially represent a missed opportunity for a patient to receive a life-saving medication,” Gravlee told Mississippi Today.

Using a secret shopper method, volunteers cold-called 591 community pharmacies to request the drug: 328 were independent pharmacies, 147 were chain pharmacies and 116 were grocery store pharmacies.

The report showed that only 25% of independent pharmacies had naloxone available for same-day pickup, resulting in the lowest proportion out of the three groups. Fifty-six percent of grocery store pharmacies offered naloxone.

Mona Arnold-McBride, executive director of the Mississippi Pharmacists Association, did not make herself available for an interview with Mississippi Today for the story.

Sujith Ramachandran, associate professor of the Department of Pharmacy Administration at the University of Mississippi and one of the paper’s coauthors, said there could be multiple reasons that independent pharmacies fall short among community pharmacies.

Standardized corporate policies may be in place throughout chain pharmacies to stock and dispense naloxone, while independent pharmacies’ policies vary from business to business.

“I personally know some independent pharmacies that took an initiative to make sure they stock naloxone and are engaging in harm reduction services where possible, but that sort of proactiveness is not consistent across all independent pharmacies,” Ramachandran told Mississippi Today.

Robert Hugh Dozier, executive director of Mississippi Independent Pharmacies Association (MIPA), said the association sees naloxone availability as a positive because it can keep people safe, but ultimately, independent pharmacies will each decide whether or not to stock naloxone.

“If the product is priced too high, and the pharmacy cost is high, they might not be able to stock that product in their pharmacy,” Dozier told Mississippi Today. “There also may not be a market need for it in their surrounding area.”

According to the Mississippi Opioid and Heroin Data Collaborative, 78% of overdosing deaths in the state were caused by opioids in 2022, compared to 72% in 2021.

The University of Mississippi study noted how naloxone was least available in the western part of the state.

Naloxone Same-Day Availability Under a Standing Order in Mississippi by County
Credit: Naloxone Accessibility Under the State Standing Order Across Mississippi. JAMA Netw Open. July 6, 2023. Page 6. Copyright © 2023. American Medical Association. All rights reserved.

Gravlee said broadly speaking, educational interventions about the accessibility of naloxone could be a useful approach for both pharmacies and people.

“Maybe, more than we realize, it’s a two-piece problem,” Gravlee said. “Pharmacies may not know about the standing order or understand the standing order, but also patients, people, in the community may not know that they can receive this drug under the standing order.”

Under the Health’s Opioid and Substance Use Disorder Program through the Mississippi State Department of Health, Mississippians can receive free naloxone kits, which cost about $100 without insurance coverage.

The naloxone kits include two doses of naloxone, an index card on how to recognize an overdose, the signs and symptoms a person may experience and how to administer naloxone.

For every person who requests naloxone, a pharmacist transcribes the prescription, and the order is then labeled and shipped to the individual’s mailing address.

There have been roughly 7,000 kits shipped directly to individuals as of early September, according to the state Department of Health.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

Mississippi Today

Health Department cuts clinical services at some county clinics following insufficient funding from Legislature

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mississippitoday.org – Gwen Dilworth – 2025-02-05 11:21:00

After the Legislature failed to give the state health department the funding it needed to fully staff county health departments, some no longer offer clinical services and the agency may close others. 

County health departments now offer one of three levels of care as a part of a plan to ensure their sustainability in the face of limited and unpredictable funding. 

Eight county health departments no longer offer the clinical services they have traditionally provided, like immunizations, preventive screening and reproductive health services. Instead, they serve as a connection point to other health departments with higher levels of care. 

The reorganization is the county health departments’ “pathway for survival,” State Health Officer Dr. Daniel Edney told Mississippi Today. 

Previously, clinicians rotated between county health departments, he said. The new system establishes consistent levels of care.

“That didn’t work,” he said. “But this is working.”

Health departments are now classified into three levels:

  • Level 3 clinics, or “super clinics,” have a doctor or nurse practitioner on staff. They offer a full range of services, including family planning, immunizations, disease screenings and programming for mothers and children.
  • Level 2 clinics have a nurse on staff and offer limited family planning services, immunization, disease screenings, programming for mothers and children and telehealth appointments. 
  • Level 1 clinics do not have a clinician on staff, and offer referrals, record services, federal programming for women and children and help people schedule rides to higher level clinics.

Some clinics offer Level 2 services on some days of the week and Level 3 services on others.

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The new system aims to concentrate resources and ensure that every region of Mississippi has access to needed health services, said Dr. Renia Dotson, Mississippi’s state epidemiologist and the director of the recently created Center for Public Health Transformation, the health department division responsible for overseeing the changes. 

It utilizes telehealth and transportation services – like the department’s partnership with Uber – to ensure that patients can access a doctor or nurse practitioner even in health department locations without one on staff. 

In just over one year, the health department doubled the number of nurse practitioners it employs to over 30 and increased the number of Level 3 clinics to 15, said Dotson. She said the health department aims to continue expanding the number of Level 3 clinics. 

Drastic budget cuts in 2017 forced the agency to shutter county health departments and lay off staff. The agency has spent the last eight years rebounding from the cuts. 

In 2023, the Legislature denied the health department’s $9 million budget request to hire the nurses needed to fully staff county health departments and a program that puts nurses in the homes of low-income pregnant women with high-risk pregnancies. 

The Mississippi State Department of Health began implementing a tiered approach to county health departments’ level of care not long afterwards. The agency has been making the changes for the past 18 months, said Edney. 

No county health departments have yet been closed as a result of the changes, said Dotson, but there may be some areas where it is not possible to continue operating a county health department. The agency is currently in the process of evaluating the level of care that is needed and that the department is able to support in each county, and considering other health services offered in an area when making determinations on need. 

“We’ll make an effort to maintain a presence in every county if that is feasible,” she said. 

The agency’s website does not currently include information about the reorganization or provide information about which level of care each county health department provides. 

The Department of Health made a meager budget request this year of just $4.8 million to train early-career doctors and help Mississippians enroll in health insurance. It did not include any specific requests for county health department funding or funding positions for doctors or nurses. 

The agency is working to create margins in a tight budget by reducing its overhead, Edney told Mississippi Today. 

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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On this day in 1994

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mississippitoday.org – Jerry Mitchell – 2025-02-05 07:00:00

Feb. 5, 1994

Myrlie Evers and her daughter, Reena Evers-Everette, cheer the guilty verdict. Credit: AP/Rogelio Solis

A jury convicted Byron De La Beckwith for the 1963 murder of Medgar Evers after seeing evidence that included Beckwith’s fingerprint on the murder weapon and hearing six witnesses share how he had bragged about killing Evers. The judge sentenced Beckwith to life in prison. 

Evers’ widow, Myrlie Evers, had prayed for this day, and now that it had come, she could hardly believe it. “All I want to say is, ‘Yay, Medgar, yay!’” 

She wiped away tears. “My God, I don’t have to say accused assassin anymore. I can say convicted assassin, who laughed and said, ‘He’s dead, isn’t he? That’s one n—– who isn’t going to come back.’ But what he failed to realize was that Medgar was still alive in spirit and through each and every one of us who wanted to see justice done.”

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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Sending taxpayer money to private schools advances in Mississippi House

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mississippitoday.org – Michael Goldberg – 2025-02-04 17:31:00

A House committee advanced a bill Tuesday that would send taxpayer money from public to private schools,

The move keeps alive a yearslong push from private school advocates and prompted concern among Democrats that the legislation could undermine public schools serving some of the state’s neediest students.

House Education Chairman Rob Roberson’s bill passed after an hour of debate. Roberson advanced the bill by voice vote and denied Democrats’ request for a roll call where each member’s vote could be recorded. Roberson acknowledged the bill faces a tough road ahead in the Legislature before it would have a chance of becoming law. But he said lawmakers needed to discuss solutions for students in disadvantaged areas who aren’t getting a quality education.

“The purpose of this is for us to continue having a conversation about how we help the poorest of the poor (students),” Roberon said. “I do realize that you all are getting a lot of pressure to push back on this, but we’ve got to keep talking about these things. Even if it makes you uncomfortable, even if you’re getting a million phone calls, these kids deserve to have us talking about this.”

Roberson’s bill would allow students who have been enrolled in a district rated D or F within the past five years to use the state portion of their base student cost — money that would normally go to their local public school — and use it to pay for private school tuition.

Students could only use the money at a private school if there is not an A- or B-rated district willing to accept them within 30 miles of their home. The legislation does not cover transportation costs for students, an omission that Democrats on the committee said would exacerbate the economic strain on poor families.

The money from each child’s base student cost would be placed in an education savings account, a provision designed to protect the legislation from a legal challenge.

The constitutionality of education savings accounts in Mississippi remains a subject of debate. Skeptics say ESAs are unconstitutional because they allow public money to be used to support private schools. Supporters say the accounts do not directly fund private schools, but instead allow families to make their own decisions about where to educate their children.

The legislation creates an initial appropriation of $5 million in public money. The Legislature would then need to appropriate funds for the program based on the state Department of Education’s estimation of students attending private schools that are currently receiving public money and the projected number of eligible students who opt to attend a private school.

Students in families that make less than 138% of the federal poverty level would have first access to the money. After that, funds would be disbursed on a first-come, first-served basis.

Students would need to obtain approval from the receiving district in order to transfer to another public school. The district could decline to accept the student if school officials say they don’t have enough room.

Proponents of such “school choice” measures argue that parents should have greater autonomy to customize their children’s education and that students shouldn’t be trapped in low-performing schools. Opponents argue these measures starve already under-resourced public schools of funds they would otherwise receive.

Rep. Cheikh Taylor, D-Starkville, said the bill and similar measures sending taxpayer funds to private schools would widen the “separation of school systems” between rich and poor areas. He also said the bill would be struck down by either a state or federal court if it became law.

“There will be an educational gap that will be furthered by this bill and the constitutionality has not been vetted,” Taylor said. “The intent has always been to divert money to charter schools and private schools. For years we’ve pushed back against it. Now we’re seeing again that this ugly head of the separation of education, those who are afforded more access and those who are not.”

Roberson said that divide already exists in Mississippi and that wealthy families find ways to send their children to the schools of their choosing, either public or private.

“Frankly it comes down to, the rich people can take kids can take their kids and go anywhere they want to. The poor kids, whether transportation is attached or not, end up going to what’s left over,” Roberson said. “If you’re a wealthy person, you have school choice.”

The school choice debate has been intertwined with debates over race and class in education. Those against school choice say the policies could effectively re-segregate schools. School choice supporters say some high-performing school districts fight school choice measures to avoid accepting students from poor and minority backgrounds.

Roberson said he did not believe the Legislature was ready to support “full-blown school choice.” Lt. Gov. Delbert Hosemann and senators with sway over education policy have not said they support sending public money to private schools. Senate Education Chairman Dennis DeBar, R-Leakesville, said this week that he is skeptical that even a measure to ease transfers between public schools could pass.

The bill has already drawn fierce opposition from public education groups, who said the measure could lay the groundwork for an unconstitutional voucher program impacting all public schools in the state

“Just because it is being passed through the parents’ hands before it goes to the private school, doesn’t make the action any less unconstitutional, in our opinion,” said Erica Jones, Executive Director of the Mississippi Association of Educators.

The proposal now awaits a vote on the House floor.

This article first appeared on Mississippi Today and is republished here under a Creative Commons license.

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