Overdose Deaths Hit Record Highs in Kentucky
By Erinn Broadus
New data from the CDC provides provisional counts for drug overdose deaths based on mortality data from the National Vital Statistics System. The data covers drug overdose deaths from October 2019 to October 2020. During this time, every state but two saw increases in deaths. Kentucky saw the second largest increase in overdose deaths—from 1,314 in 2019 to 2,012 in 2020—a 53 percent increase. Kentucky trailed behind only the District of Columbia (+57 percent). Nationally, overdose deaths increased by 30 percent during this time. While Kentucky has been hit harder than other states in terms of overdose deaths, most of the nation saw an increase in these deaths during this time.
The increase in overdose deaths aligns neatly with the start of the pandemic. The pandemic likely fueled at least some of the increase in overdose deaths because of the increased social isolation, mental distress and economic instability associated with it. Social isolation and the lack of access to the social networks traditionally used by those with addictions to stay sober, like church programs, outpatient programs, AA, and NA, have likely contributed to the increase in overdose deaths. Kentucky has also experienced staggering unemployment over the past year which is a recipe for relapse when coupled with isolation.
The increase in overdoses in Kentucky has also led to an increase in EMS opioid runs. According to the Kentucky Injury Prevention and Research Center, EMS opioid calls increased from 25 in January 2020 to more than 70 during May of this year. UofL Health recorded over 1,000 overdose cases in 2020—that is one overdose every eight hours.
When the Safer-at-home order was enacted on March 25th, there had been 904 emergency room visits for nonfatal drug overdoses. Two months later, in May, there were 1,348.
Overdose deaths are not inevitable, and there are resources available to those who need them. Casey’s Law was passed in 2004, and it allows parents, relatives, or friends to involuntarily commit someone who is in danger of harming themselves or others because of drug use. You can petition to involuntarily commit someone as many times as necessary.
The process starts by finding two mental health experts to assess the situation and determine if your loved one could benefit from treatment. The specific treatment plan is decided in front of a judge and if the patient refuses to go, or walks out before completion, they can be arrested. Prices differ depending on the type of treatment chosen, but there are several free treatment plans available.
In addition, the Kentucky State Police started the Angel Initiative in 2016 to provide those with substance abuse problems an opportunity to turn themselves in for help without getting arrested. So far, the Angel Initiative has helped 196 Kentuckians get treatment. While involuntary treatment can sometimes be beneficial, like in Casey’s Law instances, taking steps to provide treatment in lieu of arrest is a sign of progress for the bluegrass state. In 2000, Kentucky passed a Good Samaritan Law, which protects users from arrest for possession if they request help for an overdose. Access to Narcan, a life-saving antidote that reverses the effects of opioids, and clean needles has expanded significantly in the past several years, but there is more work that needs to be done to address this crisis.
Currently, medically-assisted treatment such as suboxone and methadone are only offered to pregnant inmates. Medically-assisted treatment is used to curb withdrawal and cravings for opioid users and is considered the leading treatment for users struggling with addiction. Many people use methadone or suboxone for the rest of their lives. Expanding access to medically-assisted treatment options in prisons and jails would be a proactive approach to addressing the drug issues that are the crux of many offenders’ crimes.
Kentucky has a robust prescription monitoring system, called Kentucky All Schedule Prescription Electronic Monitoring (KASPER) which tracks the drugs and dosages that are prescribed to people, any overdoses or criminal acts related to drug use, and other pertinent facts that limit the availability of prescription pills. KASPER has been extremely effective in curbing the availability of prescription pills. A study of Kasper’s effectiveness found that it reduced doctor shopping, or getting the same prescription from several doctors, by 50 percent. It closed 28 pain clinics and decreased the overall number of prescribed opioids from 368,174,000 in 2012 to 267,191,000 in 2020–a reduction of over 100 million dosage units.
While the implementation of Kasper has led to a significant reduction in prescription opioids in Kentucky, opioids remain the leading cause of overdose death. Overdose death data from the last quarter of 2019 indicate that the three substances causing the most overdose deaths are not prescription pills, but fentanyl (229 overdose deaths), a fentanyl derivative called 4-ANPP (172 overdose deaths), and methamphetamine (159 overdose deaths).
This indicates that the problem Kentucky faces is no longer prescription pills, but illicit drugs such as fentanyl and meth being smuggled in from outside of the state. Despite considerable efforts, Kentucky cannot arrest our way out of the overdose crisis. Incarcerating drug users actually increases the likelihood of a fatal overdose upon release due to a reduced tolerance. Efforts like Casey’s Law, the Angels Initiative, and FindHelpNowKY.org are considerable and should be expanded to more Kentuckians. Today, many Kentuckians are finding themselves or their loved ones in crisis and access to treatment and resources that reduce harm have never been more important.