Opioid dispensing rates have fallen across the board, but Kentucky’s is still well above the national average. Why?
HAZARD, Ky. (WKYT) – Despite progress being made on many fronts in the fight against opioid misuse and abuse, Kentucky’s opioid prescription dispensing rates are still among the highest in the country, numbers show.
[INTERACTIVE MAPS | State- and county-level opioid dispensing rates]
Opioid dispensing rates have declined across the board – and declined steadily from a national rate of 46.8 opioid prescriptions dispensed per 100 persons in 2019 to a rate of 39.5 in 2022 (the most recent year for which data is currently available), according to data from the Centers for Disease Control and Prevention.
- Kentucky’s opioid dispensing rates, 2019-2022:
- 2019: 72.4
- 2020: 67.8
- 2021: 65.7
- 2022: 61.6
- U.S. national opioid dispensing rates, 2019-2022:
- 2019: 46.8
- 2020: 43.2
- 2021: 42.0
- 2022: 39.5
Yet, even as policies put in place in the last decade-plus tightened restrictions on the highly-addictive medication and limited how much of it that patients can get at one time, Kentucky’s rate currently ranks fifth-highest in the country and is well above the national rate, according to data from the Centers for Disease Control and Prevention.
- Highest opioid dispensing rates in 2022:
- Alabama: 74.5
- Arkansas: 72.2
- Louisiana: 65.6
- Mississippi: 64.0
- Kentucky: 61.6
- Lowest opioid dispensing rates in 2022:
- Hawaii: 24.3
- California: 25.6
- Minnesota: 27.7
- New Jersey: 28.0
“This is a real challenge across our nation,” said Van Ingram, executive director of the Kentucky Office of Drug Control Policy. “It’s a real challenge here in Kentucky.”
Ingram praised the state’s steps over the past 12 years that have significantly dropped the number of opioids prescribed. He pointed to changes implemented in a 2012 special session about opioid use for chronic pain that dropped the number of units prescribed by 100 million doses in the next year. Further steps in 2017 set a dosage level of just three days for acute pain.
[FACT SHEET | Kentucky’s Oversight of Opioid Prescribing and Monitoring of Opioid Use]
Still, Ingram said he is “somewhat” concerned that Kentucky’s dispensing rate remains well above the national rate. He attributes the higher dispensing rates in Kentucky and other nearby states to a regional health issue.
“Our people – just like folks in Mississippi and West Virginia and Tennessee – are not the healthiest in the nation,” he said. “We have a lot of chronic diseases, a lot of heart disease, a lot of diabetes, cancer. All of that, I think, contributes to that higher prescribing rate.”
Ingram said his office has worked closely on opioid stewardship with hospital and primary care industry associations. Those efforts are “ongoing” and “fruitful,” he said.
“We’ve got some good things happening,” Ingram said, “but there’s still so much work to be done.”
Several Kentucky counties have among the highest opioid dispensing rates of any locality in the country. In 2022, Perry County had the third-highest nationwide; it was 270.1, according to CDC data, which was eight times the national rate.
Perry County had the fourth-highest opioid dispensing rate in the country in 2021, 2020 and 2019.
Right now, prescription opioids are not considered a primary driver of drug overdoses, but they do contribute to opioid-related deaths, the CDC says.
However, a study from the National Institutes of Health did find that “[c]ounty-level opioid dispensing rates are directly associated with individual-level prescription opioid misuse, frequency of misuse, and dependence.”
The initial flood of pills into the region – before much was publicly known about the pills’ addictive qualities – has been blamed for igniting the opioid crisis.
Now many states are receiving their portion of billions of dollars from settlements with companies accused of fueling the opioid epidemic. The Kentucky Opioid Abatement Advisory Commission is in the process of figuring out how to distribute the commonwealth’s portion of these settlements.
Advocates have made progress in the fight against the opioid crisis, though experts say the number of lives lost still remains too high.
Kentucky overdose deaths dropped in 2022 – the state’s first reduction since 2018.
But overall, overdose deaths have been trending upward for decades.
In 2000, the state recorded 246 drug overdose deaths. That number nearly doubled by 2003 and, by 2010, had approached 1,000. In 2021 overdose deaths surpassed 2,000 for the year. The 2022 total of 2,135 marked a five-percent drop compared to 2021.
Ingram says 160,000 units of naloxone, a life-saving opioid overdose reversal agent, were dispensed last year.
In 2022, Kentucky was tied for the third-highest naloxone dispensing rate, with a rate more than double the national rate of 0.5, according to CDC data.
- Highest naloxone dispensing rates in 2022:
- Arkansas: 1.7
- New Mexico: 1.4
- Rhode Island: 1.1
- District of Columbia: 1.1
- Kentucky: 1.1
- Lowest naloxone dispensing rates in 2022:
- Texas: 0.2
- New Hampshire: 0.2
- South Dakota: 0.2
- Georgia: 0.2
- Access to treatment has also gotten easier as its availability has widened.
- In a news conference last June covering the state’s latest overdose fatality report, Gov. Andy Beshear cited a 50% increase in the number of drug treatment beds in Kentucky since he took office in late 2019.
- Kentucky’s 2022 dispensing rate for buprenorphine, an FDA-approved medication used to treat opioid use disorder, was also among the highest in the country – more than four times the national rate of 4.9.
- Highest buprenorphine dispensing rates in 2022:
- West Virginia: 27.2
- Vermont: 25.5
- Kentucky: 23.6
- Maine: 17.8
- Lowest buprenorphine dispensing rates in 2022:
- Iowa: 1.3
- Texas: 1.4
- California: 1.6
- Hawaii: 1.8
“It’s not like it used to be,” said Chasity Combs, a peer support specialist at The Rebound Center in Hazard, where she works to help people in the same community that she was born in, grew up in and – for 25 years – struggled in.
Combs, once addicted to heroin and meth, was at one point a client herself at The Rebound Center.
“Where it’s a small town, most of them knew me before,” she said. “I feel like my job here is just to give them hope.”
Combs said prescription opioid pills are not nearly as widely available now as they once were, but they are seeing other drugs fill the hole left behind.
“Now it’s more heroin, fentanyl, methamphetamine,” she said. “And now the prescription pills that you can buy, you have to worry about them being pressed and having fentanyl in it, too.”
It is why advocates know their work remains as important as ever, even as the scourge they are fighting continues to evolve.
RESOURCES
If you or someone you know is struggling with addiction, the KY HELP call center can connect you to treatment. Call 1-833-8-KY-HELP (1-833-859-4357).
You can also find treatment programs near you online by going to findhelpnowky.org.