327 Overton Street
Newport, KY 41071

June 23, 2015

Steve Beshear
704 Capitol Avenue
Frankfort, KY 40601

Dear Governor Beshear:

Without question, we are well aware of the heroin epidemic that has infected our communities. As time progresses more and more people are being swallowed by the black cloud that is captivating new victims every day. Unfortunately, this cannot be solved by administering a vaccine, and we must face the issue head on by providing long term residential treatment. We’ve seen the data, people are dying while they wait for treatment. Controlling an epidemic requires many resources. Our state has taken the much needed steps to get a grip on heroin abuse; however there are several dimensions of the disease where we are falling short. We have succeeded in part by controlling the flow of drugs through our cities, thus now we must focus on rebuilding healthy communities.

Treatment programs, specifically in the Northern Kentucky region are lacking resources to help facilitate the rehabilitation process. According to the Northern Kentucky’s Collective Response to the Heroin Epidemic (NKCRHE), “Of the Commonwealth’s 14 regions, Northern Kentucky receives the lowest per capita allocation of federal and state funds for treatment of substance use and mental health disorders (2013, p. 12).” It is my concern that without the proper funding for more beds in our current facilities and allocation of monies to build more treatment centers the counties of N.KY will continue to lose loved ones to heroin.

In 2013, the heroin overdose mortality rate from in the state of Kentucky was 1,049 among a population of 4,395,295 according to the Centers of Disease Control and Prevention (CDC), (CDC Wonder, 2013). To put it into perspective, the total population of Boone, Campbell and Kenton County combined is a total of 378,575 with an overdose mortality rate of 141 (CDC Wonder, 2013). Fayette county, home of Lexington, KY has a total population of 308,428 comparable to the combined population of Boone, Campbell and Kenton counties. However, the startling find is that the mortality rate due to heroin is 50% lower at 65 people (CDC Wonder, 2013). Jefferson county, home of Louisville, KY has a population of 756,832 (CDC Wonder, 2013), approximately twice the population size of Boone, Campbell and Kenton counties yet, a mortality rate slightly above N. KY with 191. Thus the question remains, why is a population of approximately 375,000 continue to have high rates of mortality by heroin overdose? It is my opinion that the answer can be found within the statistics. The mortality rate from heroin overdose can be correlated to the number of treatment beds provided in per county.

Data supplied by the University of Kentucky Center for Drug and Alcohol Research, indicates that the region of N. KY has the resources to provide treatment for substance abuse for less than one-fourth of the patients in the region who need treatment (NKCRHE, 2013, p.36). In September of 2013, Judge Arlinghaus of Kenton County stated during the Commissioner’s Report in open court, that he personally sent a letter to Kentucky state legislators asking for help to fund the substance abuse problem (Minutes, 2013). The judge further states, that it is his understanding, that Frankfort penalizes N. KY because the region has a separate tax, the COLT tax (Minutes, 2013). Judge Arlinghaus further stated, to Commissioner Knochelmann and the court:

Jefferson County does have quite a few more beds than we do. They have approximately 1000 beds in Jefferson County… and Fayette County has approximately 500 beds… in Northern Kentucky with our population of 375,000 we should be in the neighborhood of 600 beds and in actuality we have 199. (Minutes, 2013)

According to Glen Hanson’s Research Report, long-term residential treatment facilities that adopt the therapeutic community model, with a planned length of stay for 6 to 12 months, has produced advantageous outcomes for the patients seeking treatment (NIDA, 2002). Currently in N. KY region, two facilities emphasize this long term treatment philosophy, providing a total of 210 beds (NKCRHE, 2013 p. 38).

As the region of N. KY continues to be deprived of funding for beds in treatment facilities, we are filling our beds in our hospitals and jails. Infections that stem from intravenous drug use, such as Hepatitis C and endocarditis are skyrocketing in the region (NKCRHE, 2013, p.15). It is estimated that the lifetime health care costs for such infections like Hepatitis C is $64,490 per person (NKCRHE, 2013, p. 15). In an interview with Terry Carl, jailer at Kenton County Detention Center, he estimated that in 2010, out of the 610 inmates in jail, approximately 80% of the beds are occupied by offenders for drug related offenses (NKCRHE, 2013, p. 13). Furthermore, the total cost per bed per year in the Kenton County Detention Center totals to $23,000 (NRHE, 2013 p. 13). However, during the Commissioner’s Report, Judge Arlinghaus also points out that a bed for 9 months in a treatment facility, which he states is the approximate length of time to rehabilitate a person from substance abuse, is $13,500 (Minutes, 2013). Judge Arlinghaus, also states in the report:

As tax payers we’re going to pay for this one way or another and it’s our choice. Do we want to decide to pay $23,000 per inmate or $13,500 for an individual to have a chance to be back on the payrolls of society?”

Thus, what I am asking of you Governor Beshear is that you take into consideration the current health status of the communities in N. KY. Of the $10 million allocated to curb heroin use, you have announced in your plan that $2.6 million will be appropriated to fund substance abuse treatment. I propose, like so many in my community of N. KY that these funds be dispersed to the areas where treatment centers are needed. The communities here are desperate, and without your help Northern Kentucky will continue to lose the battle against heroin. I leave you with the motto found on our state seal, “United we stand, divided we fall.”

Sincerely,

Blair Smith

Works Cited

Centers for Disease control and prevention. (2015). National center for health statistics: Underlying cause of death 1999-2013. Retrieved June 20, 2015, from CDC WONDER: http://wonder.cdc.gov/ucd-icd10.html
Hanson, G. R. (2002, August). Research report series: Therapeutic community. Retrieved June 21, 2015, from National Institute on Drug Abuse: http://archives.drugabuse.gov/researchreports/Therapeutic/Therapeutic2.html
Kenton County Fiscal Court: Minutes. (2013, September 24). Retrieved June 20, 2015, from Kentucky Public Records: http://publicrecords.onlinesearches.com/view/lid/82944
Kentucky.gov: Gov. Steve Beshear's Announces Funds to Curb Heroin Use. (2015, June 15). Retrieved June 16, 2015, from Kentucky.gov: http://migration.kentucky.gov/Newsroom/governor/20150615heroin.htm
Northern Kentucky's Collective Response to the Heroin Epidemic: Our Plan For Recovery. (2014, March 31). Retrieved June 20, 2015, from Drugfree.nky.org: http://heroin.drugfreenky.org/?p=30