The increased use of heroin in Kentucky is exposing potentially deadly gaps in the state's substance-abuse network.
Kentucky has made significant strides in treating substance abuse since prescription pain medicine abuse became a scourge a decade ago, but the state continues to lack support for those coming out of emergency care, drug court or jail.
"There is a huge gap," Lexington Police Chief Mark Barnard said Thursday, when he and other leaders in health care, treatment and law enforcement shared concerns with Michael Botticelli, the director of the White House Office of National Drug Control Policy.
Botticelli, also known as the nation's drug czar, visited Lexington's Hope Center on Thursday morning.
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Barnard is among dozens of state leaders struggling with Kentucky's growing heroin problem and persistent addiction problems with pain pills, alcohol, meth, cocaine and other drugs.
Botticelli was heartened to hear Barnard and other law enforcement officials speak of the need for treatment and cohesive care for people whose legal troubles might offer the first opportunity to help.
It has been proven, he said, that "arrest and incarceration for people with substance-abuse disorders is not effective." Instead, there needs to be a focus on substance abuse as a public health problem, he said.
And the health impact is sometimes fatal.
Dr. Roger Humphries, chairman of UK's Department of Emergency Medicine, used the word "frustrated" several times as he spoke about what he described as the "Russian roulette" aspect of heroin abuse that can at any point turn into tragedy.
It has become sadly commonplace for someone to be saved from overdose at the emergency room at the University of Kentucky only to return within weeks, having taken a fatal dose of heroin, he said.
"I need to be able to plug them into a system" that supports recovery, Humphries said.
Danielle Sanders, supervisor of Fayette County's drug court, said the Recovery Kentucky program provides long-term treatment — generally a year — but the state needs more options for short-term treatment.
Drug court participants also need more help finding safe housing and jobs, she said, and although heroin is the trending drug of abuse, people continue to struggle with crack, alcohol, marijuana and pain pills.
Educating doctors on how to treat addiction, specifically how to treat pain, is crucial in making a lasting impact on the nation's drug epidemic, Botticelli said. Many veterinarians receive more training in pain management than physicians, he said. Physician groups including the American Medical Association have not been eager to change, he said. "The medical community needs to come to the table in a more meaningful way," he said.
Thursday's meeting, hosted by U.S. Rep. Andy Barr, R-Lexington, came after Botticelli spent two days in Eastern Kentucky learning about community efforts there to combat addiction.
Botticelli praised the efforts of Operation Unite and Kentucky's drug court system, and the state's recent law to support needle-exchange programs.
Barr announced Thursday that he is creating the Sixth Congressional District Drug Abuse Task Force, which will recommend possible federal action, and provide advice and feedback on proposed legislation.