An annual report by the Kentucky Office of Drug Control Policy shows that heroin was replaced by the significantly more potent opioid fentanyl as the main contributor of fatal drug overdoses in 2016, present in 44 percent of the 1,404 fatalities statewide and 50 percent of Jefferson County’s 364 fatal overdoses.

Kentucky’s 1,404 fatal drug overdoses in 2016 was a 7.4 percent increase from the previous year, following the 17 percent increase that occurred in 2015. Louisville’s 364 fatalities last year was a 36 percent increase from 2015, and a 78 percent increase from the 204 fatal overdoses just two years earlier.

Statewide, fentanyl — an opioid up to 50 times more powerful than heroin — was present in 623 fatal overdoses, which amounts to 47 percent of the 1,330 cases where toxicology data was available. This was a significant increase from 2015, in which fentanyl was present in 459 fatal overdoses, amounting to 34 percent of all fatal drug overdoses. Heroin was present in 34 percent of fatal overdoses in 2016, while opioid prescription painkillers oxycodone and hydrocodone — which just five years ago were the main contributor to fatalities  — were present in 19 and 16 percent, respectively. That amounted to a 4 percent decline for oxycodone and a 5 percent decline for hydrocodone, in yet another sign that those addicted to these prescription painkillers have moved on to cheaper, more available and much more potent opioids like heroin and fentanyl.

The totals from Jefferson County align with the figures reported earlier this year from the Jefferson County Coroner’s office, showing that fentanyl was the main driver of its significant spike in fatalities in 2016. Exactly half of Louisville’s 364 fatal drug overdoses involved fentanyl, whereas in 2015 that drug accounted for less than 15 percent of such cases. Nearly half of the fatal overdoses in 2015 involved heroin, but that actually decreased to 33 percent in Jefferson County last year.

Jefferson County’s 182 fatal overdoses involving fentanyl made up 29 percent of such fatalities statewide last year. While its 364 total fatalities was more than double that of the next-closest county — Fayette County had 162 — Jefferson County was not close to the counties with the highest number of oversdoses per capita, with the top four all located in Eastern Kentucky.

In a press release announcing this year’s report from the Kentucky Justice & Public Safety Cabinet, Gov. Matt Bevin said that if this “is not a wake-up call, I don’t know what is.”

“We don’t have the luxury of pretending there isn’t a massive problem,” stated Bevin. “The consequences of the opioid crisis are far-reaching, affecting every corner of our communities. We must stand united against the opioid scourge and work together to find solutions. Failure is not an option.”

Van Ingram, the executive director for the Kentucky Office of Drug Control Policy, noted that fentanyl is frequently mixed with heroin or in the form of counterfeit pills mislabeled as much-less-powerful painkiller, leaving many users unaware that they are ingesting such a powerful drug. Louisville’s health department first put out a warning about fentanyl entering heroin supplies in March of 2016, when fatal overdoses began a rapid spike upward within the city.

“Fentanyl’s impact is really unprecedented,” stated Ingram. “Users have no way of knowing what drugs they are taking, and even the smallest amounts can trigger a lethal reaction. We’ve seen cases where a bad batch of drugs has led to dozens of overdoses in a single community overnight.”

The 2016 Overdose Fatality Report was compiled with data from the Kentucky Medical Examiner’s Office, the Kentucky Injury Prevention & Research Center and the Kentucky Office of Vital Statistics.