Growing abuse of the powerful painkiller fentanyl drove the number of overdose deaths in Kentucky to a new record high in 2015, according to a report released Tuesday.
A total of 1,248 people died of drug overdoses, up from 1,088 in 2014, according to the report from the Kentucky Office of Drug Control Policy.
The number of overdose deaths in Fayette County increased from 112 in 2014 to 141 in 2015.
Statewide, the number of deaths in 2015 will likely go up as autopsy and toxicology reports become available in additional cases.
Fentanyl was a key factor in the increase in deaths across the state, said Van Ingram, director of the state Office of Drug Control Policy.
The drug — the same one blamed for the accidental drug overdose of pop music legend Prince — was involved in about 121 deaths in 2014 in Kentucky, Ingram said. In 2015, the number of deaths involving fentanyl, either alone or combined with heroin, jumped to 420, according to the report. That was 34 percent of all overdose deaths.
Fentanyl is a legal drug, but also is manufactured in criminal labs in Mexico and is available directly from China, the U.S. Drug Enforcement Administration said in a recent advisory.
It is 40 to 50 times stronger than street level heroin, the DEA said.
Abuse of the drug drives up deaths because it is sold as heroin or mixed with heroin so users don’t know the strength of what they’re getting, Ingram said.
Drug cartels have gotten involved in making and selling the drug because production isn’t affected by the vagaries of weather, as heroin can be, and because it’s so powerful traffickers can sell smaller amounts and make more money, Ingram said.
“We already had a dangerous situation. It’s gotten worse,” Ingram said. “This is a business model change for the cartels.”
The 1,248 people who died were either Kentucky residents or people from other states who where here when they died.
While fentanyl was present in the most deaths, heroin and prescription pills continued as factors in many deaths.
Overdoses attributed to heroin account for 28 percent of deaths in 2015, about the same percent as the prior two years, Ingram said.
Fayette County ranked near the top in heroin-related deaths, with 34, and fentanyl-related deaths, with 51.
However, counties in Eastern Kentucky ranked worst in the rate of overdose deaths, calculated from 2012 through 2015 per 100,000 people, according to the report.
The top rate by that measure was in Leslie County, at 68.6 deaths per 100,000 people, followed by Bell at 61.2. The next three were Gallatin, 52.5; Knott, 48.65; and Wolfe, 48.3.
Abuse of pills exploded in Eastern Kentucky beginning in the late 1990s when the painkiller OxyContin became widely available.
The maker — which pleaded guilty to making misleading claims about the addiction potential of the drug — later created an abuse-deterrent version of the pill, but addicts sought other drugs.
The report released Tuesday said the anti-anxiety drug alprazolam — sold under the name Xanax — was detected in 28 percent of 2015 overdoses, while the painkillers oxycodone and hydrocodone were detected in 23 and 21 percent, respectively.
There is often more than one drug present in someone who has died from an overdose.
Bell County Commonwealth’s Attorney Karen Greene Blondell said authorities are starting to see some cases with heroin in her area, but that prescription pills remain the biggest problem.
“It’s still an overwhelming problem even with everyone’s best efforts,” Blondell said of drug abuse.
One problem is that a shortage of access to substance abuse treatment persists, Blondell said.
Ingram said treatment is more widely available in the state than it was a few years ago, though there is still a gap.
Medicaid, for instance, now covers substance abuse treatment, but there aren’t enough providers in Kentucky, he said.
This year, lawmakers approved Gov. Matt Bevin’s request to boost spending on anti-drug efforts by $30 million in the two year budget, according to a Justice Cabinet news release.
That spending will boost substance-abuse treatment at community mental health centers and elsewhere, Ingram said.
Ingram said another promising development is that federal policymakers are starting to give more attention to the nation’s substance-abuse problem.
The Obama Administration has proposed significantly more funding for treatment.
State lawmakers have approved measures in recent years to crack down on improper prescribing, toughen penalties for selling heroin or fentanyl, and improve access to naloxone, which can reverse overdoses of opioid drugs such as heroin.
But the state and nation are battling an opioid epidemic that will take a long time to overcome, Ingram said.
State Justice Secretary John Tilley said the report released Tuesday shows the need for continued diligence in efforts to curb drug abuse.
“We all know someone who has suffered under this scourge, and today’s report is another troubling reminder that the complex problem of drug abuse demands a multi-faceted approach,” Tilley said. “We must remain focused and proactive and continue to build on these efforts.”