Fentanyl linked to half of Ky. OD deaths; in NKY, Kenton County sees drop in fatalities

The powerful synthetic opiate fentanyl killed about half the people in Kentucky who died from overdoses last year, but officials say the toll could've been far grimmer.

The Kentucky Office of Drug Control Policy on Tuesday released its 2016 Overdose Fatality Report. The state's Office of Vital Statistics counted 1,404 overdose deaths last year, up 7.4 percent from 2015.

Naloxone credited in overdose fight

Executive Director Van Ingram, who's been watching the numbers through the year, credited the overdose reversal drug Narcan, the brand for generic naloxone, with saving countless other lives.

"Had it not been for the hundreds of police officers around the state, if not for families and friends who have carried Narcan, these numbers would be a lot worse," Ingram said.

The state has ramped up naloxone distribution, giving kits to some hospitals, including Northern Kentucky's St. Elizabeth, for families at risk for overdose. The state also has funded community prevention and response groups and the Kentucky Harm Prevention Coalition; the groups train people in how to use the medication and hand out kits. Kentucky also has funded a mobile program that distributes the non-narcotic opiate blocker to areas with less access to it, Ingram said.

Kenton County OD drop doesn't satisfy judge-executive

The report lists Boone, Campbell and Kenton County in Northern Kentucky in three top-five lists compiled: counties with the most heroin-related overdose deaths; those with the most fentanyl-related overdose deaths; counties with the most heroin-fentanyl combined overdose deaths.

The three counties' overdose deaths totaled 208, according to the state count.

Boone County dipped from 56 deaths from 62 in 2015. Campbell County saw more deaths last year, 62, up from 43 the previous year.

Kenton County experienced the biggest drop in such deaths in all of Kentucky, with 22 fewer overdose fatalities in 2016 – from 112 to 90.

"Wow. That's great news," said county Judge-executive Kris Knochelmann. "Any of us knows that saving lives is the No. 1 priority, and if it's Narcan that's doing it, that's great," he said.

But Knochelmann said the death toll is still far too high.

"I'm absolutely not satisfied," he said. "We want to drive those numbers down. We're still underserved with education, prevention, treatment, detox. If anything, we need to double down."

Northern Kentucky counties have been fighting the scourge for five years, alerted to the heroin epidemic in 2012 by Dr. Jeremy Engel. He saw an influx in his family practice with St. Elizabeth Physicians that hasn't stopped.

Engel, who continues to monitor the epidemic's impact on the region, agreed that people are surviving largely because of naloxone. But from anecdotal discussions with those addicted, he noted this: "The individuals using it are becoming a little more sophisticated on how to use it without dying." Engel attributes their survival to their knowledge that the "new form of heroin," fentanyl and the elephant analgesic carfentanil, is highly potent. Knowing this prompts them to use their drugs with more caution.

Engel said he also sees improvement in the medical system's response.

"Medical systems that are treating heroin addiction are starting to do the right thing: Treat with medication, assisted by therapy and other support," Engel said. "We are still way below the capacity to treat all the individuals with addiction."

Fentanyl threat seen nationwide

Statewide, fentanyl, combined with heroin or straight, killed 623 people through overdose, or 47 percent of the total deaths. Heroin changes to morphine in the body, and morphine was present in about 45 percent of all cases, the state said.

Fentanyl has streaked across the United States and north, into Canada, alarming treatment and harm reduction advocates who've been working for years to curb heroin's impact.

The synthetic opiate has become a primary offender in the opioid scourge, often entering the country via the U.S. Postal Service, slipped into heroin and lately, cocaine, and often sold to unwitting people addicted to heroin.

Fentanyl was blamed for 1,155 overdose deaths in Ohio in 2015, the last year the state had a full report issued. That was up from 503 such deaths the previous year. 

When Dr. Lakshmi Sammarco, the Hamilton County coroner, released her 2016 overdose death count, which amounted to 403, she noted a continuing surge in fentanyl-related deaths. The coroner issued the report in May, showing that most overdose deaths in 2016 were from a heroin and fentanyl mixture.

The drug is largely created in overseas "bucket" factories, without precision, and varying in strength. Just a few grains can kill someone, depending on his or her tolerance to opiates. Manufacturers are finding new ways to create analogs of fentanyl, which themselves vary in strength and can be hard to pinpoint for crime-lab analysts. The drug is sometimes sold over the internet, on the dark web, as in the case of two people of accused of smuggling fentanyl to Norwood recently.

Top 5 Kentucky counties for fentanyl-related overdose deaths

Jefferson County 182

Fayette County 59
Kenton County 26
Boone County 25
Campbell County 21

Top 5 Kentucky counties for heroin-related overdose deaths

Jefferson County: 122

Fayette County: 48

Kenton County: 20

Campbell County: 17

Boone County: 12

Top 5 Kentucky counties for heroin-fentanyl combination overdose deaths

Jefferson County: 59

Campbell County: 21

Fayette County: 20

Boone County: 12

Kenton County: 11

Source: Kentucky Office of Drug Control Policy