September 1, 2021 Issue, Page 4 of 26

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Agricutlure September 1, 2021 Rapid increase in Ivermectin prescriptions and reports of severe illness associated with use of products Containing Ivermectin to prevent or treat COVID-19 Ivermectin is a U.S. Food prevention or treatment of The Centers for Disease Ivermectin is also used in vet- on the role of ivermectin in the crease from the pre-pandemic and Drug Administration COVID-19. The National In- Control and Prevention (CDC) erinary applications to prevent treatment of COVID-19. baseline. (Figure) (EDA)-approved _ prescription stitutes of Health’s (NIH) CO- confirmed with the American or treat internal and external A recent study examin- Figure: Estimated num- medication used to treat cer- VID-19 Treatment Guidelines Association of Poison Control parasitic infections in animals. ing trends in ivermectin dis- ber of outpatient ivermectin tain infections caused by in- Panel has also determined that ‘When used in appropriate dos- Centers (AAPCC) that human pensing from outpatient re- prescriptions dispensed from ternal and external parasites. there are currently insufficient es for approved indications, exposures and adverse effects tail pharmacies in the United retail pharmacies — United When used as prescribed for data to recommend ivermectin associated with ivermectin re- ivermectin is generally well tol- States during the COVID-19 States, March 16, 2019-Au- approved indications, it is gen- for treatment of COVID-19. ported to poison control cen- erated. pandemic showed an increase gust 13, 2021* erally safe and well tolerated. ClinicalTrials.gov has listings ters have increased in 2021 Clinical trials and obser- from an average of 3,600 pre- “Data are from the IQVIA During the COVID-19 of ongoing clinical trials that compared to the pre-pandemic vational studies to evaluate scriptions per week at the pre- National Prescription Audit pandemic, ivermectin dis- might provide more informa- baseline. These reports include the use of ivermectin to pre- pandemic baseline (March 16, Weekly (NPA Weekly) data- pensing by retail pharmacies tion about these hypothesized increased use of veterinary vent and treat COVID-19 in 2019-March 13, 2020) to a base. NPA Weekly collects has increased, as has use of uses in the future. products not meant for human humans have yielded insuf- peak of 39,000 prescriptions in data from a sample of approxi- veterinary formulations avail- Adverse effects associated consumption. ficient evidence for the NIH the week ending on January 8, mately 48,900 U.S. retail phar- able over the counter but not with ivermectin misuse and Ivermectin is a medication COVID-19 Treatment Guide- 2021.1 Since early July 2021, macies, representing 92% of intended for human use. FDA overdose are increasing, as that is approved by FDA in lines Panel to recommend its outpatient ivermectin dispens- all retail prescription activity. has cautioned about the poten- shown by a rise in calls to poi- oral formulations to treat on- use. Data from adequately ing has again begun to rapidly Ivermectin dispensed by mail tial risks of use for prevention son control centers reporting chocerciasis (river blindness) sized, well-designed, and well- increase, reaching more than order and long-term care phar- or treatment of COVID-19. overdoses and more people ex- and intestinal strongyloidiasis. conducted clinical trials are 88,000 prescriptions in the macies, prescriptions by veter- Ivermectin is not autho- periencing adverse effects. Topical formulations are used needed to provide more spe- week ending August 13, 2021. inarians, and non-oral formu- rized or approved by FDA for Background to treat head lice and rosacea. cific, evidence-based guidance This represents a 24-fold in- lations were not included. TSET Board of Fall isn’t just for pumpkin spice Directors Approve anting trees, too Resolutions Covering TSET Independence, Emerging Tobacco Products and Local Autonomy ‘The Tobacco Settlement Endowment Trust (TSET) Board of Directors passed three resolutions Thursday affirming TSET’s mission and structure and calling for action on emerging nicotine products and tobacco control laws. The unanimous votes came at the Board’s regular meeting on August 26. In one resolution, the TSET Board resolved to continue its commitment to act in accordance with the will of Oklahoma vot- ers, who reaffirmed their support of TSET’s mission and indepen- dence by an overwhelming majority in November 2020. “Twenty years ago, Oklahomans had the foresight to under- stand that smoking and obesity are public health crises that have enormous impact on our state and require consistent, sustained investment to address,” said Michelle Stephens, chair of the TSET Board of Directors. “There are no easy fixes and real change must come from a collaborative and comprehensive approach over the long-term, including investment in research, commu- nity programs and state policy. Voters understood that then and ‘The October 2020 ice storm and the frigid temperatures of February this year have left homeowners and city parks reinforced that commitment in 2020 when they upheld TSET’s officials needing to plant replacement trees. Courtesy photo. mandate.” As established by constitutional mandate in 2000, TSET in- vests 75% of state payments received by the Master Settlement By Trisha Gedon of year when people are taking ofthe surrounding soil. This al- Homeowners should contact Agreement and utilizes only earnings from the endowment to road trips to see the changing lows for settling and increases a reputable International So- fund research, prevention and programs that improve health for STILLWATER- The October colors of the leaves, but with soil drainage and available oxy- ciety of Arboriculture profes- all Oklahomans. TSET works to reduce the main causes of pre- 2020 ice storm and frigid tem- those two storms just a few gen to the roots. ventable death in Oklahoma, tobacco use and obesity and ensure peratures in February took a months apart, homeowners Refill the hole using only sional arborist to tackle jobs that funds are protected for long-range programs that will benefit toll on trees in Oklahoma. The and city parks employees need the dirt removed when digging that are too big for them to Oklahomans in perpetuity. Since TSET’s inception, Oklahoma's sound of chainsaws filled the to be making plans to establish and pat it down around the tree handle on their own.” smoking rate has dropped 10x faster than in similar states, Okla- homa has avoided $1 billion in direct medical costs and saved air as homeowners and parks new trees,” Hillock said. “Fall or shrub. Water thoroughly to He also suggested keep- 42,000 lives. employees cleared debris. offers several advantages for settle the soil and eliminate air ing trees well hydrated. While Ina second resolution, the TSET Board called on the Oklaho- Many trees were too dam- getting trees and shrubs in the pockets. Although tempting, Oklahoma has received a de- ma Legislature to include new and emerging tobacco products in aged and had to be removed. ground before winter arrives.” don’t fertilize immediately af- cent amount of rainfall, it’s Oklahoma's statutory definition of tobacco products and to limit Others will take years to fully Roots grow when the soil ter planting as this can burn or advertising of all tobacco products, especially on social media and recover, said Mark Bays, urban temperature is above 40 de- injure the root system, which important to remember trees at retail locations that target youth. forestry coordinator with the grees. The root systems of would result in plant death. require a much different water- New and emerging products such as nicotine pouches, tooth- Oklahoma Forestry Services. fall-planted trees and shrubs Bays said newly planted ing schedule than turf. An easy picks and dissolvables are currently exempt from exempt from While people often take will have an opportunity to trees will require some extra state tobacco excise taxes, making them more affordable and ac- them for granted in the land- develop and become estab- way to check if a tree needs care, including regular deep- cessible to youth. Oklahoma's tobacco taxes are an effective tool in tobacco prevention and source of state revenue for cancer re- scape, trees are an integral lished if planted now. Hillock root watering for the first cou- water is to stick a 10-inch-long search and public health. part of everyday life. They do said when spring arrives with ple of years. screwdriver into the soil, re- “As we've seen with vaping, Big Tobacco is evolving to hook a much more than provide shade warmer temperatures, an ex- “Tree watering is differ- move it and check for moisture. new generation of users on their deadly products,” Stephens said. or a place to build a treehouse. panded root system that was ent than turf watering. The If the soil is moist, skip the wa- “It’s important that tobacco control laws evolve just as quickly to ‘They are a critical part of what amount and frequency depend tering. If the soil appears dry, established in the fall can bet- protect Oklahoma youth froma lifetime of addiction.” makes Oklahoma communities ter support and take advantage on the size of the tree at plant- a slow, deep soaking is recom- Finally, the TSET Board called on the Oklahoma Legislature livable, Bays said. of the growth surge. ing and the type of soil. Home- to repeal a law that prohibits local governments from adopting “Besides cleaning the air “Balled and burlapped owners will need to provide mended around the area of the smoke-free workplace ordinances that are stricter than state law. and water and increasing prop- plants can be planted now enough water to provide mois- tree as far as the branches ex- Second-hand smoke can lead to heart disease, lung cancer and erty values, research has deter- so they have time to recover ture to the entire root system,” tend from the main trunk. stroke, and there is no safe level of exposure. Currently, Oklahoma is one of only three states that lacks a mined that spending time in from transplanting and prolif- he said. “It’s important for home- comprehensive clean indoor air law and also preempts local gov- ‘open spaces such as your back erate roots before the spring What can homeowners owners and public parks care- ernments from enacting their own stricter measures. While re- yard or a park setting where growing season begins,” he do to help prevent the dev- takers to keep trees healthy search shows that smoke-free laws do not have adverse impacts trees are present helps main- said. “However, not all trees astation Oklahoma experi- on local businesses, they are the only way to fully protect patrons tain a healthy immune system, and shrubs should be planted enced with these two weather through ongoing maintenance and staff from secondhand smoke. reduces stress and even con- at this time. Bare root plants events? Bays had a couple of and watering,” Bays said. “The “Clean air is a right of all Oklahomans,” Stephens said. “It’s tributes to lower heart rates,” should be planted in late win- suggestions. healthier a tree is going into a far past time that communities had the power to act in the best Bays said. “More doctors are ter when they're completely “Our trees were severely severe weather event, the bet- interest of residents and protect all workers from the dangers of beginning to prescribe to their dormant.” impacted, and it'll take years secondhand smoke.” ter the opportunity it has for patients to spend time in na- In order to give the tree for some of them to recover. ‘The full resolutions can be found at tset.ok.gov/content/reso- ture to help improve overall or shrub the best chance at Corrective pruning on dam- making it through.” lutions. health.” survival, proper planting is a aged trees is essential in the OSU Extension offers ad- ‘The Oklahoma Tobacco Settlement Endowment Trust (TSET) serves as a partner and bridge builder for organizations shaping a healthier fu- Tree replacement should be must. Dig a hole at least two recovery process. There's still ditional information in its Tree ture for all Oklahomans. TSET provides leadership at the intersections done in the fall, whether in pri- times wider, but not deeper time to remove broken and Planting Guide fact sheet. OSU of health by working with local coalitions and initiatives across the state, vate yards or public parks, said than the root ball. Homeown- dead branches that may still be Extension’s Oklahoma Gar- cultivating innovative and life-changing research, and working across David Hillock, Oklahoma State ers who are dealing with heavy, hanging from trees,” he said. public and private sectors to develop, support, implement and evaluate University Extension consum- poorly drained soils should “Seek guidance from profes- dening television program also creative strategies to take advantage of emerging opportunities to im- er horticulturist. plant the tree so the top of the sionals to help guide you on has information on planting prove the public's health. To learn more, visit TSET.ok.gov. “Fall is typically the time root ball is just above the level how to correctly prune them. trees online.