Recently, a Kentucky Substance Use Research and Enforcement (K-SURE) study was released, providing an overview of the five most prevalent substances in 2018 Kentucky overdoses.

According to K-SURE officials involved in the study process, the study was done in a partnership between the Kentucky State Police and the Kentucky Injury Prevention and Research Center in an effort to use data to drive public safety and public health efforts against substance use across the Commonwealth.

The report discusses statistics relating to the substances fentanyl, cocaine, methamphetamine, opioids and heroin, and examines and compares rates of possession and trafficking citations, overdose related deaths, ER visits and hospitalizations and KSP lab submissions related to those substances from Jan. 1, 2017 through Dec. 31, 2018.

Capt. Jennifer Sandlin, of KSP Post 13, said this is the first report of this kind regarding overdoses.

“Before, public health had their data and the state police had their data, so we kind of did our report and they did their report. What this does is overlays that data and gives a much bigger picture of what’s going on,” said Sandlin. “The state police is unique as far as their data, because we collect data across the entire state from all agencies, so we have a program called KY-OPS. Basically, the goal of it is to educate the public about overdoses.”

According to the study, many of the key findings relating to heroin have decreased within the past year.

Heroin possession and trafficking citations, the study said, decreased from Jan. 2017 to Dec. 2018 by 12.3 percent and 9.1 percent, respectively. Additionally, KSP officials said, there was a statewide decrease of heroin related tested lab submissions (by 34.7 percent). The study also showed that heroin related deaths decreased by 69.3 percent among Kentucky residents during the time of the study. KSP officials said that while the total heroin related events in regards to heroin possession and trafficking citations, related deaths, emergency department visits, hospitalizations and tested lab submissions have decreased overall through that time-frame (by 40.3 percent), nevertheless, the substance still remains a public safety and public health concern in the state.

Other local officials agree that heroin is still a large concern.

“We’re seeing heroin a lot in our area,” said Lonnie Brewer, the jail administrator at Kentucky River Regional Jail. “I’m not an expert on it, but I have to deal with the aftermath of it.”

The jail population, he said, consists of drug addicts for the most part, with very few being held for crimes unrelated to drugs.

“It’s an epidemic already in other parts of the state and now it is coming into our area,” said Brewer, explaining that the drug movement is coming from the northern part of the state. “If you look at that area of northern Kentucky, it is filtering down, and now in southeastern Kentucky we’re seeing a lot of things.”

Another substance the study highlights that is largely abused in the state is opioids. Many of the findings for opioids, K-SURE documents said, showed a similar pattern of decrease.

Statewide opioid possession citations decreased by 15.9 percent during that time, and related trafficking citations substantially decreased by 42.2 percent. Opioid related emergency department visits decreased by 30.4 percent, hospitalizations decreased by 29.2 percent and opioid related deaths decreased by 33.9 percent among Kentucky residents, documentation said. Opioids, said KSP officials, remain the leading substances identified among fatal drug overdoses. According to the study, despite the 36.8 percent decrease in tested lab submissions positively identifying opioids, no significant changes were observed in the percentage of opioids identified among all tested lab submissions from 2017-2018, with opioids accounting for nearly a tenth of the total tested lab submissions to KSP Laboratories.

“Opioids and their adverse effects continue to plague the Commonwealth, despite the number of opioid related events decreasing by an average of 31.4 percent from 2017 through 2018,” said KSP officials in the study documentation.

Cocaine-related findings, KSP officials said, have mostly decreased within the last few years. Statewide cocaine possession citations increased by only 2.4 percent during the time of the study, while trafficking citations decreased by 19.5 percent during this same time-frame, said KSP officials within the report. Tested lab submissions positively identifying cocaine decreased by 16.6 percent from 2017 through 2018, and cocaine accounted for 10 percent of the total tested lab submissions to KSP Laboratories, a percentage that did not significantly change from 2017 through 2018, said study officials.

In addition to the decreased citations, officials said, there was also a decline in hospital and emergency room visits relating to cocaine use.

“There was a stark decrease in the number of cocaine related deaths and hospitalizations from 2017 through 2018,” KSP officials said, explaining that both decreased by over half (52.9 percent and 53.5 percent, respectively). Additionally, documentation showed that cocaine related emergency department visits declined by 9.7 percent in the state from 2017 through 2018.

Although many of the cocaine-related findings show a decrease, KSP officials said they still believe that cocaine use, misuse and distribution have remained prevalent in Kentucky.

While some substance abuse activity decreased, others, such as methamphetamine and fentanyl, rapidly spread throughout Kentucky, the study showed.

Statewide methamphetamine possession citations increased by 34.9 percent and trafficking citations by 21.2 percent during the time of the K-SURE study, said officials. Methamphetamine related overdose deaths also increased (by 2.8 percent), the study said, when looking at the beginning of 2017 through the end of 2018.

Methamphetamine, KSP officials said, continues to be the most commonly-submitted drug to the KSP laboratories, accounting for 43 percent of tested lab submissions last year, and methamphetamine related events increased by an average of 32.6 percent.

“Methamphetamine is a high-level threat to the commonwealth’s safety and health,” said officials with the KSP.

“We started seeing an increase in meth probably about two years ago, give or take. We saw the switch from opioids to meth,” said Sandlin, explaining that their data shows more and more people trying methamphetamine.

“Meth, to me, is probably what we see most of because people are trying to get it into the jail,” said Brewer. He continued, stating that the KRRJ staff does often see other drugs, but most of the times it is methamphetamine. “I’m afraid we’re going to see more overdoses and ultimately more deaths because of it.”

Fentanyl and fentanyl analog key findings also showed a large increase, the study said, causing alarm for many law enforcement agencies, as the substance is extremely dangerous and exposure is very risky.

Last year, said KSP officials, Kentucky fentanyl and fentanyl analog trafficking citations increased 87 percent. Additionally, the K-SURE report showed that tested lab submissions positively identifying fentanyl and fentanyl analogs increased by 57.9 percent during the past year. Fentanyl and fentanyl analog related deaths, documents said, decreased by 28.9 percent from the beginning of 2017 to the end of 2018.

“KSP laboratories continue to see several different fentanyl derivatives in casework along with poly-drug mixtures, including heroin/fentanyl mixtures, as well as cocaine/fentanyl mixtures and methamphetamine/fentanyl mixtures,” said KSP officials. “Most recently, fentanyl mixed only with other fentanyl analogs was prevalent in tested lab submissions last year.

“Fentanyl and fentanyl analogs have become increasingly pervasive throughout Kentucky, emerging in our streets and communities, increasing risks of overdose and exposures to law enforcement,” said officials with the KSP.

Fentanyl, Sandlin said, is often used with other substances, which causes even more uncertainty and unpredictability with street drugs.

“Fentanyl is usually mixed, or cut, in with something,” said Sandlin, explaining that many street dealers mix it with meth, opioids and marijuana. This, she said, is very dangerous, because buyers never truly know what they are getting, as it is very hard to properly measure those illegal substances, which can often cause overdoses. “Usually if you see a concentrated increase in overdoses, it is usually fentanyl,” said Sandlin.

Sandlin said the study shows that many organizations have the same goal — to help end addiction and to help people in recovery succeed in their journey of being clean. “When it comes to addiction, it’s not just a law enforcement problem,” said Sandlin. Law enforcement, she said, takes care of the legal aspects and getting drugs off the street, but public health helps with recovery, while others help with transportation and jobs after the individuals are released. “The overlap will probably be a lot more productive than everybody trying to do their own thing,” Sandlin said.

Due to the success of the study, Sandlin said, the organizations plan to do more studies like this in the future, stating that they will gather data quarterly and then provide a year-long summary.

“It’s still a work in progress, but I think overtime those reports will probably evolve and have more details. I think this is a big step,” said Sandlin.

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