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Kentucky Counties With Worst Drug Problems

by Landmark Recovery

February 6, 2019
An individual pointing to Kentucky on a map

The drug epidemic in the United States is fueled by the rise of opioids, predominantly fentanyl, a drug involved in 30,000 overdose fatalities in 2017. Many states across the country are suffering from this drug epidemic that is killing tens of thousands of Americans each year.


Kentucky is no exception.


According to data from the National Center of Health Statistics, Kentucky had the third-highest drug overdose fatality rate in the country in 2015. Unfortunately, the drug overdose numbers have continued to rise since 2015. The most recent data from Kentucky shows that the state’s overdose fatalities rose from 1248 deaths in 2015 to 1404 deaths in 2016 to 1565 deaths in 2017. Of the nearly 1600 drug deaths, the toxicology report was available for 1468 of them. Data from the state says that fentanyl was involved in over 50 percent of overdoses in Kentucky.

While Kentucky is one of the most drug-ridden states in the country, there are only a few specific counties that are harshly affected by the drug epidemic. The most notable of which is Jefferson County due to the high volume of overdoses. However, there have been some measures passed by the state government in order to crackdown on the availability drugs, especially prescription medication.


The Problem in Kentucky

An individual pointing to Kentucky on a map

Many counties in Kentucky don’t have much of a problem with drug overdoses, but because other countries have been so severely affected, Kentucky has one of the highest drug overdose death rates in the country.


Jefferson County

Jefferson is the most populous county in the commonwealth, with over double the population of the second most populous county. In 2017, Jefferson had over 350 drug overdose deaths the most of any county and, despite its large population, it still had one of the highest overdose rates in Kentucky. The problem is growing so quickly that a Jefferson County Coroner has been asking for more room to bury drug victims.

Jefferson County, and the Louisville metro area in general, is one of the hubs for heroin and opioids in the state. In 2016, there was 119 heroin overdose deaths. Meanwhile, fentanyl saw a an abrupt rise in deaths from 2015 to 2016, going from 39 to 176 in just one year.

While there were a high number of overdose deaths in 2017, there was a slight decline from the year before. This decline may be due to emergency services carrying more Narcan, a narcotic that is used to treat and reverse narcotic overdoses. Data from Louisville, shows that there were twice as many Narcan administrations from 2015 to 2016. And the fight hasn’t stopped, funding for Narcan reached almost $350,000 for the state of Kentucky in 2017.


Kenton County

Kenton is one of the most northern counties in Kentucky and is the third most populous. Kenton had the second-highest drug overdose rate in the state and had 115 drug overdoses in 2017, fentanyl was involved in 112, or 97 percent, of those deaths.

Since 2012, Kenton county has seen an abrupt spike in drug overdose deaths. This is likely due to the emergence of fentanyl as a deadly drug. The increase parallels the rise of fentanyl throughout the country. According to data from the Center for Disease Control and Prevention, in 2012 fentanyl accounted for 1615 drug overdoses throughout the country, that number eventually ballooned to 18,335 in 2016.

Kenton had the second-highest overdose deaths per capita, behind only Estill County.


Estill County

Estill County is located in the eastern central portion of the commonwealth. Despite its small population of over 14,000, Estill County had the highest drug overdose death rate across all of Kentucky. In 2017, the county had a overdose death rate of 77 per 100,000 residents.

The problem in Estill County is, in part, fueled by their access to prescription medication. According to 2017 data from the CDC, the county has one of the highest prescription rates in the state with 132.2 prescriptions per 100 persons. Comparing this to the national rate of 58.7 helps to illustrate the problem in Estill County, and Kentucky in general.


Fayette County

Fayette County had the second most overdose fatalities in the state with 123 deaths, a number that has risen steadily since 2012 when there was 74 deaths. Fayette County is the second most populous county in the commonwealth and is home to Lexington, the second largest city in Kentucky.

Fayette County had the second most heroin-related and fentanyl-related overdose deaths, behind Jefferson County.

In September of 2018, the city of Lexington won a $2 million federal grant to fight opioid abuse. “This is a public health emergency and we’ve worked hard to put programs in place that our citizens need,” said Mayor Jim Gray. “This grant will help us build on those programs.”


Campbell County

Campbell had the third-highest drug overdose deaths per capita in the commonwealth and had 61 overdose deaths in 2017. Campbell’s drug overdose numbers have seen an abrupt rise in recent years when the county saw a 44 percent increase in overdose fatalities from 2015 to 2016.



Since the state first started gathering specific drug statistics, it has become clear that the commonwealth has a problem with morphine. In 2014, Morphine was present in over 40 percent of drug-related deaths, making it the most problematic drug for Kentucky that year. However, as the drug epidemic has transitioned more to opioids, fentanyl is now the most frequently seen drug in drug overdose deaths. But, morphine abuse is still high and was present in over 500 drug deaths in 2017.



Like all states across the nation, the problem isn’t just with drugs but other substances as well. Alcohol is one of the more deadly substances in the country. According to the National Institutes on Health, an estimated 88,000 people die annually from alcohol-related causes. Kentucky specifically ranks as one of the higher binge-drinking states in the country.

Specifically, Kentucky ranks higher than the national average when it comes to drunk driving. Between 2003 and 2012, there were over 2000 people killed in drunk driving crashes in the state.



It should be mentioned that there are a number of drugs on the rise besides fentanyl in Kentucky. One drug that has seen major increases in drug deaths in recent years is Gabapentin. Gabapentin’s rising prevalence has been overshadowed because of the opioid crisis and the dramatic emergence of fentanyl. However, gabapentin is proving to be a drug that has a number of deadly side effects. The drug, which is not an opioid nor a designated controlled substance by federal authorities, is used to treat nerve pain.

According to data from Kentucky’s Office of Drug Control Policy, gabapentin was the second most prescribed controlled substance in Kentucky in 2017. Similarly, the drug was involved in over 360 drug overdose fatalities in 2017.

The High Intensity Drug Trafficking Areas program listed the drug as an “emerging threat”


What Is Being Done?

A man sitting and thinking about substance abuse in Kentucky

Coming Together for Hope, Healing, and Recovery

In March 2018, Jefferson county and Louisville revealed a 2-year action plan with the goal of reducing the burden of substance use disorder in that they hope will put an end to the rising drug death rate in the county.

Substance use disorder is a complex, but not an insurmountable problem, especially when we come together as a community to align our resources and expertise,” said Mayor Greg Fischer in the report. “Louisville is taking a collaborative approach— and using best practices from other communities—to bring the epidemic under control.”

The multi-pronged approach looks to tackle the drug issue from many angles. For example, one measure is to create a public health social media campaign in Louisville to reduce the stigma associated with substance abuse. However, the action plan isn’t just preventative measures, another initiative is to improve job placement following recovery by establishing a taskforce to help with expanding job networks.


Other features of the plan include:

  • Prevent and reduce youth substance use
  • Improve connection to treatment
  • Measure quality of treatment programs
  • Establish guidelines for sober living homes and more


Changes in Prescription Laws

Kentucky admits that “prescription pills are still the largest driver of addiction in Kentucky.”

“Over 80 percent of heroin users become addicted through these pill,” Attorney General Andy Beshear’s website.

Legislative change is important for establishing a different culture surrounding drugs, the action plan mentioned above tries to do a lot to shift the stigma surrounding treatment. However, other preventative laws need to be enacted in order to address the root of the problem. Changing laws related to prescription drugs is one way to attack the issue, especially since prescription drugs, like oxycodone and fentanyl, are some of the most abused and deadly drugs in the state.

One prescribing law passed in 2017, was signed to prevent extra opioid pain pills from entering the market. Sponsors of the bill explained that the goal is to get drugs like fentanyl off the streets and out of drug traffickers. The law centers on a 3-day pain pill limit which prohibits doctors from issuing a prescription for more than three days for narcotics like oxycodone.

Similarly, in August 2017, Attorney General Beshear launched the Kentucky Opioid Disposal Program. Some estimates say that the program has the potential to dispose of more than 2.2 million unused opioids that would otherwise be misused or abused.


Don’t Let Them Die

Don’t Let Them Die is a public awareness campaign to bring the drug issue to the spotlight in Kentucky. The website consists of information on opioids and overdoses, educational videos and testimonies on the opioid crisis, and treatment information for those looking to get help. The campaign is working with Find Help Now KY to design and create awareness about the dangers of opioid use and provide Kentuckians with the resources for finding treatment facilities with openings.


Northern Kentucky Drug Strike Force

The Northern Kentucky Drug Strike Force (NKDSF) first came into existence in the early 80s. The mission of the force is to work with police agencies and the community to form partnerships that will be used to provide the best possible drug enforcement for counties throughout Northern Kentucky. Many counties in Northern Kentucky like Boone and Kenton face drug-related problems with fentanyl, morphine, and heroin.

The NKDSF uses undercover operations, canine units, and in-depth investigations to monitor drug activities and create more arrests.


Jefferson County Family Drug Court

After an eight-year absence, the family drug recovery court returned to Jefferson county. The program aims to turn around the lives of some parents who are addicted to drugs who end up in courtrooms because of child abuse or neglect.

A study from 1998 about the effectiveness of Jefferson family drug courts and found that they were having a positive effect. Despite evidence suggesting that the family drug courts were successful, budget cuts in 2010 forced the closure of the drug courts statewide, but after outside groups raised money to bring the program back.

“We have so many families that are desperately in need,” Patricia Walker FitzGerald, a previous family court judge in Jefferson County, said. “We can do this. We can see more families succeed.”


What Now?

The drug epidemic that is currently plaguing the nation has had major effects on the Commonwealth of Kentucky. There are many counties that have been severely impacted by the drug and opioid crisis, counties like Jefferson, Kenton, Estill, and more have dealt with high drug overdose rates over the past few years as a result of drugs like heroin, fentanyl, and morphine. While legislative measures have been passed and awareness campaigns have been started to try and curb the drug problem, there is still more work to be done.

At Landmark Recovery, we are dedicated to being a part of the solution. Our inpatient facility in Louisville and our outpatient detox center in Lexington are equipped with the staff and tools that you need to help usher you in to your new sober lifestyle. Please reach out to our admissions staff to learn more about drug and alcohol treatment options.


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About the Author

Landmark Recovery

Landmark Recovery

Landmark Recovery was founded with a determination to make addiction treatment accessible for all. Through our integrated treatment programs, we've helped thousands of people choose recovery over addiction and get back to life on their own terms. We're on a mission to save one million lives over the next century. We encourage all those struggling with substance use to seek professional help.