Kentucky has been hit hard by the opioid epidemic. Throughout this crisis, the opioid epidemic has taught us important lessons in four main areas:
Access to prescription drugs
The whack-a-mole problem of substance use prevention
Publicly available tools to prevent overdoses
Harm reduction strategies
Context: The Beginning of the Crisis
The opioid epidemic began after prescription opioids were widely prescribed by physicians after prematurely being marketed as safe by pharmaceutical companies. Prescription opioids were later found to be highly addictive and rising numbers of people across the country were misusing the substances.
Curbing the Trend of Prescription Opioid Misuse
The number of prescriptions for most commonly prescribed opioids, hydrocodone and oxycodone, decreased after 2012. Hydrocodone has continued to steadily decline, but since 2013, oxycodone prescriptions have slowly increased.
Though there are more hydrocodone prescriptions than oxycodone, oxycodone remains the most common prescription opioid contributing to Kentucky opioid overdose deaths. Opioid overdose deaths have mirrored the trend line of oxycodone prescriptions in Kentucky, increasing until 2012, dropping, increasing again [and insert trend in 2017-2018]
Heroin and Fentanyl
After prescription opioids became harder to obtain and use for nonmedical purposes, many people who were using opioids switched to heroin. A few years later, fentanyl, an extremely potent opioid became increasingly available.
Importance of Comprehensive Prevention Efforts
While very few young people use opioids, youth who began using alcohol, tobacco, or marijuana before they were 13 are significantly more likely to use opioids later in adolescence and into adulthood.
An analysis from 2018 KIP Survey showed that after controlling for gender, race/ethnicity, free/reduced lunch, and military connection, 10th graders who began using alcohol, cigarettes, or marijuana before age 13 were 15.9 times as likely to misuse prescription opioids as their peers who had never used these substances. 10th graders who began using alcohol, cigarettes, or marijuana at age 13 or older were 9.6 times as likely to misuse prescription opioids than those who had never used these substances. Similar findings were found using data from the NSDUH survey looking at adults who began using substances before 18.
This underscores the importance of reaching young people early and changing their attitudes towards substance use in order to impact the trend of opioid misuse and substance use more broadly.
Kentucky's Regional Prevention Centers (RPCs) have been working to identify and facilitate collaboration between coalitions and community groups working to reduce and prevent substance use. RPCs also provide training and connect community members to prevention resources like specific evidence-based prevention programs as well as initiatives that support building resilience and overcoming trauma. To learn more about how you can plug in with the RPC in your region, click here.
Life-Saving Impact of Naloxone
Naloxone is a drug that has been used for decades to reverse opioid overdoses. In 2015, an easy-to-use nasal spray of naloxone (NARCAN) was approved by the FDA. This made naloxone much more easily used by people without medical training. In March 2015, Kentucky passed Senate Bill 192, which allowed pharmacies to dispense naloxone to individuals without a prescription. This greatly expanded access to naloxone and has helped to curb the trends of opioid deaths.
Syringe Exchanges
To address the risk of disease outbreaks, Kentucky's Senate Bill 192 allowed counties to start harm reduction syringe exchanges, which provide new, clean syringes to people who use drugs. Syringe exchanges are an evidence-based strategy to prevent the transmission of diseases like HIV and Hepatitis C that can occur if drug users share and reuse syringes. Syringe exchange programs also help to connect people who use drugs to treatment services, overdose prevention resources (e.g. naloxone) and other important behavioral health resources. There are now 74 operating syringe exchange programs in 64 counties in Kentucky.
Resources
Find a pharmacy selling naloxone or a syringe exchange by clicking the map below:
If you or a loved one need help…
FindHelpNowKY.org helps individuals find a treatment center that is accepting new patients for substance use now. Available online or by phone. Call 1-877-318-1871.
The Kentucky Opioid Assistance and Resource Hotline is staffed by nurses and pharmacists nationally certified in toxicology. A service of the Kentucky Poison Control Center, the hotline is available 24 hours a day – 7 days a week. Call 1-800-854-6813.
The National Suicide Prevention Lifeline provides 24/7, free and confidential support for people in distress, prevention and crisis resources for you or your loved ones, and best practices for professionals. Call 1-800-273-8255 or chat at SuicidePreventionLifeline.org.