Why it’s so hard to break an opioid addiction
Fatal overdose rates in Kentucky and across the country dropped in 2018 for the first time in years, according to new reports.
Nationwide, 68,557 people are estimated to have died from overdoses between 2017 and 2018 -- a reduction of more than 5 percent, the Centers for Disease Control reported Wednesday. In Kentucky, fatal overdose rates dropped more than 15 percent, according to the CDC and Kentucky data released Thursday, meaning 230 fewer Kentuckians died last year than in 2017.
State figures show that 1,333 people died in Kentucky from overdoses last year, compared with 1,566 people the year prior. That includes deaths of Kentucky residents and people from elsewhere who died in Kentucky.
Counting just Kentucky residents, 1,247 died of overdoses last year, compared with 1,477 the year prior.
Rates have steadily declined since they peaked between late 2016 and 2017, when drug overdoses killed 1,600 people. Kentucky’s rates haven’t been this low since the summer of 2016, the CDC reported.
While the national data is provisional and results could vary once the full report is released later this year, nationwide, the figures represent the most substantial reduction of overdose deaths in nearly three decades. In Kentucky, overdose rates haven’t fallen at all since 2013. Last year’s reductions represent the most dramatic downward shift Kentucky has seen in more than 10 years, according to the state’s Justice and Public Safety Cabinet.
Republican Gov. Matt Bevin said his administration is “extremely grateful to see a significant decline in overdose fatalities, but there is still much work to do,” and vowed to continue the state’s partnership with “legislators, law enforcement officers and health care professionals, as we allocate unprecedented resources to combat this scourge and save lives.”
The collective decline shows that the country’s “united efforts to curb opioid use disorder and addiction are working,” U.S. Health and Human Services Secretary Alex Azar said Wednesday.
Van Ingram, executive director of the Office of Drug Control Policy, said the overall decline in deaths was the likely result of numerous policy initiatives underway in Kentucky along with a growing awareness about the dangers of opioids and the threat of overdose.
“We’ve pushed hard to develop the most comprehensive approach possible, combining education and treatment with a multitude of other harm-reduction strategies,” Ingram said. “We still have a great deal of work to do, but it’s clear that Kentucky’s efforts are making an impact.”
Overdose rates in Kentucky, prior to 2018, had been steadily on the rise, jumping from 1,010 in 2013 to the high of 1,566 in 2017. But the drugs involved in those deaths changed through the years, showing the shifting nature of substance abuse.
In 2015, for instance, fentanyl was present in 34 percent of overdose deaths in which an autopsy was conducted. Fentanyl is a synthetic opioid more powerful than heroin.
That same year, oxycodone, the drug in pain pills such as OxyContin that led to a spike in abuse and deaths in Appalachia and elsewhere, was present in 23 percent of deaths, and medical examiners found hydrocodone in 21 percent of deaths.
In 2017, fentanyl was present in 52 percent of deaths as abuse of the drug increased in Fayette County, which includes Lexington, and other urban areas of Kentucky, but deaths with oxydocone or hydrocodone present had dropped to 14 percent each.
That decline in deaths with pain pills present was in part a reflection of efforts by lawmakers, law enforcement and the medical community to curb improper prescribing.
In 2018, fentanyl use in overdoses increased, playing a part in 61 percent of the overdose deaths and claiming 786 lives. The state also saw an increase in methamphetamine-related deaths — 428 overdoses, up from 357 in 2017 — while overdoses involving heroin declined.
Geographically, the biggest change occurred in Jefferson County, which includes Louisville, where 89 fewer people died from overdoses last year. Kenton, Campbell, Nelson and Jessamine counties collectively saw 63 fewer fatal overdoses, the state reported.
The counties with the highest per-capita fatal overdose rates in 2018 were Boyd, Madison, Kenton, Clark, and Campbell.
Fayette County had 121 fatal overdoses, which was higher than the state rate.
Police and prosecutors around Kentucky have also said they’ve seen a marked increase in abuse of crystal meth. Much of the meth available in Kentucky and the U.S. is produced in large laboratories in Mexico and smuggled into the country. Use of meth rose last year, as did cocaine, but prescription painkiller deaths collectively dropped, from nearly 14,500 in 2017 to roughly 12,750 in 2018.
The newest batches of data were released days after a U.S. district judge in Ohio lifted a protective order on a trove of Drug Enforcement Administration documents showing that 76 billion oxycodone and hydrocodone pills were prescribed to Americans by only a handful of companies between 2006 and 2012, contributing to more than 100,000 deaths. A band of Appalachia, hugging the borders of Kentucky, West Virginia and Virginia, saw the worst prescription rates nationwide, according to the database.
During that six year period, a staggering 1,901,662,933 prescription pain pills were distributed across Kentucky.
The information was unsealed late Monday as part of an ongoing federal lawsuit brought by roughly 2,000 municipalities and counties across the country, alleging nefarious actions and intent on the part of opioid manufacturers and distributors.
Most of the hardest hit counties were in Eastern Kentucky, including Whitley County, which saw a prescription rate of 187 pills per person, per year; Perry County, where 175 pills were prescribed per person a year; Floyd County, which saw 168 pills per person per year; and Bell County, with 156 pills per person annually.