Monday, over 100 southcentral Kentucky leaders, service providers and residents met at the National Corvette Museum in Bowling Green to discuss how the region would use its portion of a historic opioid settlement.

Kentucky has a major problem. In 2022, 2,135 Kentuckians died from a drug overdose, 90% of which involved opioids. That’s 62% higher than 2019’s drug overdose deaths.

But now, Kentucky also has the money to fund potential solutions, much of it coming down from the a historic $26 billion multi-state settlement with manufacturers, distributors, and pharmacies implicated in the spread of the opioid crisis.

How does the opioid settlement work?

Kentucky has received more than $900 million through opioid settlements so far. Half the money goes to the state, to be managed by the Opioid Abatement Advisory Commission.

The other half goes to Kentucky’s counties, local governments and cities.

It can be spent for 29 different purposes, including treatment and emergency response services, supportive or recovery housing, employment training and education  for those in recovery and public education about opioids.

Monday, the region’s first opioid symposium was hosted by the Barren River Area Development District, Med Center Health Bowling Green, LifeSkills and the Barren River District Health Department.

The state of the opioid crisis in southcentral Kentucky

The 10-county Barren River region is home to about 340,000 people. In 2022, nearly 2,000 of them ended up in the emergency room for non-fatal overdoses.

In Warren County specifically, there were 16 opioid-involved fatal overdoses per 100,000 residents.

“It does put a strain on our families, our communities, but also our healthcare delivery system,” said Matt Hunt, Barren River District Health Department district director.

Hunt said that during his time as director, the department has begun dispensing Narcan, a life-saving medication that can reverse opioid overdoses, in all eight counties it serves. It also works with schools and community centers to distribute Narcan.

They’ve also increased staffing for harm reduction and hired peer support specialists to help those suffering from opioid addictions.

However, Hunt said that the region needs more mental health providers and evidence-based treatment immediately.

LifeSkills President and CEO Joe Dan Beavers also shared regional gaps. He said that it needs a higher availability of medical detox, which reduces opioid withdrawal symptoms.

Beavers said that while medical detox may be costly and risky at times, it is critical to recovery.

He also suggested a focus on not only treating someone at their lowest, crisis level, but also connecting them to long term help.

How does opioid addiction work?

When someone takes an opioid to treat pain, it binds to receptors in the body that then release dopamine, a “feel good hormone,” said Melinda Joyce, executive director of the WKU Heart and Lung Research Foundation.

Over a period of days or weeks, the body gets used to that dopamine release. The central nervous system rewires itself to expect it.

So, while a patient may first take opioids to feel better, they later might take them to feel normal, and eventually, just to avoid a painful withdrawal from the drug, Joyce said.

Warren County Sheriff Brett Hightower said that when he talks to people with opioid addictions, they all say that the drug changes their thought process.

“It’s almost like you’re gonna wake up in the morning with the flu and you can take something where you weren’t sick the rest of the day,” he said.

Several of the symposium’s panel experts emphasized that the most important thing to recognize about opioid addiction is that it does not discriminate.

There may be certain genetic or physiological predispositions and risk factors for some, but nobody is immune, said Dr. Austin Griffiths, WKU associate professor in the Department of Social Work.

“Each individual has certain genetic or physiological conditions, risk factors, certainly preventive factors that might help on a personal individual level, but there’s also this kind of societal impact,” he said.

“There’s a greater impact and kind of a way that these things work together.”

So, how might south-central Kentucky use the settlement money?

The BRADD region has received about $2 million in settlement money to date, and will end up with about $6.7 million over the next 17 years.

While the settlement money goes to individual counties and cities, State Rep. Brandon Reed, R-Hodgenville, suggested that the BRADD region pool part of it for a regional project.

“If you all come together in a cooperative state you can get more bang for your buck, and we can really make an impact, especially in the Barren River area,” Reed said.

“…it’s easier to sell regional projects to the General Assembly because it affects so many parts of this Commonwealth.”

While Reed can’t promise that the state legislators would match funds, he said that regional solutions and local buy-in are what they generally look for in their investments.

BRADD Executive Director Eric Sexton’s goal is to create a regional opioid abatement advisory committee to discuss how to use the funds on a regional level.

As people left the symposium, they signed up for one of four working groups—prevention, treatment, recovery or assurance of care—that Sexton said would naturally form the regional committee’s structure.

A potential model—Life Learning Center

At the meeting, several ideas were presented, including bringing fentanyl test strips into schools and forming a mental health cooperative.

But one was highlighted. Life Learning Center is a 60,000 square-foot facility in Northern Kentucky focused on helping “at-risk” Kentuckians who were on their way to jail.

It houses over 132 residential and community partners in its facility that collaborate to get people back in the workforce.

90% of its residents suffer from substance use disorder, 77% have a mental health diagnosis and a majority are 200% below the poverty level.

The Life Learning Center is not a treatment center, but it partners with St. Elizabeth Healthcare to help those experiencing addiction.

The centers clients participate in a care continuum, run by licensed clinical social workers and peer support specialists. Simultaneously, they are enrolled in a 12-week education continuum teaching them to overcome barriers in five domains of life: physical, emotional, financial, relational and spiritual.

To graduate the program, participants must get a job or graduate from a post-secondary institution.

The center, whose $2 million budget is primarily funded by the community, has cut Kenton County’s recidivism rate to 8%, compared to a 83% national average.

“You can’t incarcerate your way out of this crisis,” said Tara Higgins, director of enrollment. “So we’ve got to become a little more creative in how we are handling folks with substance use disorder and mental health issues.”

Sexton said that the regional workgroup would discuss how a model like Life Learning Center might work in southcentral Kentucky.