Study: Kentucky ranks fourth among 38 states studied in per-resident costs of opioid-use disorder and deaths resulting from it

Map from CDC report

By Melissa Patrick
Kentucky Health News

Kentucky ranked fourth in cost of opioid-use disorder and deaths from it, adjusted for population, in a report that shows the economic impact of the opioid epidemic across most of the nation.

The Centers for Disease Control and Prevention report found Kentucky's combined per-resident costs from opioid-use disorder and its resulting deaths in 2017 was $5,491, including $3,007 for OUD deaths.  

The study covered the 38 states that had sufficiently specific data. Only West Virginia, Ohio and New Hampshire spent more per person because of OUD and its deaths than Kentucky. Kentucky ranked second for per-resident cost of OUD, after Nevada, and 10th for per-resident spending on OUD deaths.  

Nationwide, the combined economic cost of opioid-use disorder and OUD deaths in 2017 was about $1 billion, including $471 billion for OUD and $550 billion for its deaths. The combined cost varied substantially, ranging from $985 million in Wyoming to $72 billion in Ohio. 

In Kentucky, that cost was about $24.5 billion, including about $11 billion for opioid-use disorder and $13.4 million for OUD deaths. Kentucky ranked 13th in costs without regard to population.

Costs of opioid-use disorder and fatal overdoses include the costs of health care, substance-use treatment, criminal justice, lost productivity, reduced quality of life, and the value of statistical life lost. 

"Reduced quality of life was the largest component of the cost of opioid-use disorder, and the value of statistical life lost was the largest component of the cost of fatal opioid overdose," says the report. "These two components together accounted for approximately 84% of combined costs, followed by lost productivity." 

The report estimated that Kentucky had 50,000 people with an opioid-use disorder and 1,160 opioid related deaths in 2017.

Opioid epidemic worsens during pandemic

And while the study looked at 2017, likely the most recent year with enough data, it's important to note that the opioid epidemic hasn't gone away and appears to have gotten worse since the beginning of the pandemic, suggesting the cost associated with OUD and its deaths has likely gone up since then.  

A study published in the journal Drug and Alcohol Dependence found that the daily number of Kentucky ambulance runs for opioid overdose in the 52 days before and after a state of emergency was declared March 6, rose 17 percent for runs to an emergency department, 71% for runs "with refused transportation, and a 50% increase in runs for suspected opioid overdoses with deaths at the scene." 

"This Kentucky-specific study provides empirical evidence for concerns that opioid overdoses are rising during the Covid-19 pandemic," says the study. 

Further, "In 2019, Kentucky recorded 1,316 drug overdose deaths. In 2020, from January to September, the state reported 1,454 drug overdose deaths, according to the Kentucky Cabinet for Health and Family Services," Spectrum News reports. 

Also, provisional data from the CDC shows that drug-overdose deaths in the U.S. are at their highest on record, soaring to more than 87,000 deaths in the 12 months period ending in September 2020. 

Strategies for improvement

The report offers a list of effective strategies to improve opioid prescribing, treat OUD and prevent fatal overdose, including pain-clinic laws, state monitoring of drug prescriptions, medication-assisted therapies for OUD, overdose education and distribution of naloxone, which counters overdose.

Kentucky has implemented all of these measures and more. The General Assembly passed several laws during the recently completed legislative session to improve addiction care for Kentuckians. 

One bans the requirement of prior authorization for any prescription drug now approved for  treatment of alcoholism or opioid-use disorder and that contains methadone, buprenorphine or Naltrexone. The bill also has provisions to examine prescribing practices to see if providers also prescribe concurrent counseling.  

Another law creates written recommendations for distribution of information to individuals who suffer from substance-use disorder to help them get treatment. And another allows pharmacies to sell hypodermic syringes and needles without a prescription, with no questions asked. 

The study report does not mention harm-reduction programs, more commonly known as syringe-exchange programs, as an effective strategy to treat OUD and prevent fatal overdose. 

These programs are designed to prevent outbreaks of HIV and hepatitis C, which are commonly spread by needle sharing among IV drug users. They also provide health screenings and vaccines, and connect drug users to treatment. They are allowed by a 2015 state law that requires approval by the county health board, the fiscal court and the city where the exchange is to be located.

Kentucky has the third largest number of counties in the nation and leads the country in the number of syringe exchange programs. As of Feb. 25, it has 74 operational programs in 63 of the state's 120 counties, with one more approved but not yet operational. 

 

The report acknowledges several limitations to the study: 12 states were omitted; the cost of OUD was measured for a single year, rather than a lifetime; the estimated case counts likely underrepresent the true prevalence of OUD; and national cost estimates were used to calculate state costs.

For help in finding treatment for substance-use disorder for yourself, a friend, or loved one, the state has a website: findhelpnowky.org.