Drug overdose deaths up 296 percent from 2000 to 2010 in Kentucky

bestep@herald-leader.comDecember 20, 2012 

The number of drug-overdose deaths in Kentucky rose a staggering 296 percent from 2000 to 2010, according to a study by a research center at the University of Kentucky.

A tidal wave of prescription-drug abuse drove the steep increase in overdose deaths. Of the 979 deaths in 2010, prescription drugs were involved in 522, or 53 percent, according to the study by the Kentucky Injury Prevention and Research Center.

The rate of overdose deaths rose from 6 per 100,000 Kentucky residents to 22.9 per 100,000 residents over the 11 years covered in the study. That meant Kentucky had the third-highest rate of overdose deaths in the U.S. in 2010, up from fifth the year before, said Terry Bunn, director of the research center and an author of the report.

Preliminary information shows the state's overdose death rate rose even higher in 2011, Bunn said Thursday. "The problem is no better," she said.

The highest rates of overdose deaths during the study period were concentrated in Eastern Kentucky, where Powell County led the state with an annual overdose death rate of 75.4 per 100,000 residents.

Karen Kelly, head of Operation UNITE, said the findings match what her agency has witnessed in the 29 Eastern and southern Kentucky counties where it investigates drug crimes and provides education and drug treatment.

"We've seen an overwhelming devastation with this issue for some time," Kelly said Thursday.

There are people in Kentucky raising their great-grandchildren because two generations in some families have died from drug abuse, Kelly said.

The increase in deaths might have been even greater because information was not available for Kentucky residents treated in neighboring states, and because some death certificates might not have listed an overdose as the cause of a person's death when in fact it was.

The report did not measure the impact of changes Kentucky lawmakers made this year aimed at confronting the prescription-drug problem, though it will provide a way to help measure the impact of the law.

Among other things, the law requires greater use by doctors of the state's prescription-drug tracking system and toughens rules on pain clinics.

The goal was to shut down so-called "pill mills," where unscrupulous doctors improperly prescribe painkillers and other drugs to people. Those clinics have been a key source of many more pills available for abuse.

Kelly said the law has put some "bad actors" out of business, and she said she believes it will help save lives.

But the cost of prescription-drug abuse is not measured only in lives, the report noted.

In 2010, for instance, in-patient hospital charges related to drug overdoses totaled $68.5 million — up from $14.3 million in 2000 — with an additional $9.5 million in emergency-room charges.

A good bit of that fell on taxpayers, with charges to Medicaid alone totaling more than $21 million, the report said.

Over the 11 years covered in the study, Medicare and Medicaid were the providers billed for 48 percent of hospitalizations for drug overdoses, the study found.

The study paints a picture of who is most likely to die in Kentucky from an overdose and the drugs most likely to result in a death.

Death rates tripled among men and women between 2000 and 2010, but men were much more likely to die. In 2010, for instance, 62 percent of overdose deaths were among men, and the highest number of deaths involved painkillers called opioids, such as OxyContin, Lortab and Roxicet, according to the report.

Those drugs also accounted for the most emergency-room visits for overdoses, followed closely by drugs called benzodiazepines — central nervous system depressants such as Valium and Xanax.

The highest rate of deaths in 2010 was among people 35 to 44 years old, with about 47 deaths per 100,000 residents.

Over the whole study period, 96 percent of overdose deaths were among white residents.

Researchers studied data from emergency departments, hospital-billing records and death certificates to understand the state's worsening, fatal abuse of drugs, which includes both suicides and unintentional deaths.

The goal was to inform health-care workers, public-health professionals and lawmakers and help come up with ways to reduce the burden of prescription-drug abuse, the study said. The study included a number of recommendations, including a substantial increase in the number of substance abuse treatment programs in Kentucky.

Kelly said Operation UNITE gets 1,200 calls a month from people seeking information about drug treatment. The program has money to put 65 people a month into treatment.

When someone addicted to drugs faces a long wait to get help, "that's like telling someone to go die," said Dr. Michelle Lofwall, a psychiatrist at UK who treats addicts.

Lofwall said the increase in prescription-drug abuse has been driven by a number of factors, including a huge increase in the supply of such drugs. Kentucky and the nation need to better address not just the demand for drugs, through treatment, but also the supply side, she said.

Federal and state funding for substance-abuse treatment in Kentucky remained flat from 2006 to 2011 at about $28 million a year, even as the drug problem increased, according to figures from the Cabinet for Health and Family Services.

However, lawmakers approved Gov. Steve Beshear's request for an increase in funding in the current two-year budget cycle that will make an additional 5,800 treatment slots available, according to the cabinet.

The report made other recommendations as well, including enhancing suicide-prevention programs; increasing opportunities for people to turn in unused prescription drugs to authorities to be destroyed; and getting more prescribers, such as doctors, formally trained on substance abuse and addiction issues.

"The use of only one prevention strategy will not be enough to substantially reduce prescription-drug abuse among our residents; it's going to require multiple strategies," the report concluded. "It will take a cooperative effort among Kentucky legislators, doctors, public-health advocates, law enforcers, educators and concerned residents — a united Kentucky — to address these alarming facts and create a safer environment for all Kentucky residents."

Bill Estep: (606) 678-4655. Twitter: @billestep1

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