Citing a local and national shortage of forensic pathologists amid the dramatic rise of fatal overdoses and the opioid epidemic, the Kentucky Justice and Public Safety Cabinet announced a new partnership this week with the University of Louisville and the University of Kentucky to strengthen the state Medical Examiner’s Office and increase salaries to improve the retainment of such doctors.
The Medical Examiner’s Office within this cabinet performs autopsies from all around the state, employing six doctors at the office in Louisville, two in Frankfort and one in Madisonville. The state office in Louisville conducts autopsies on individuals from other counties in the region, while the separate Jefferson County Coroner’s office performs autopsies on those within the city.
According to the cabinet’s news release, UofL will provide up to six forensic pathologists to the state office and UK will offer up four, with this combining of resources for autopsies and medical education “expected to boost salaries for doctors, helping improve recruitment and retention, and it will help the cabinet avoid charging counties a fee for autopsies.”
“The opioid crisis has placed tremendous strains on our state, and we must take every opportunity to innovate and find efficiencies,” stated Secretary John Tilley of the Justice Cabinet. “By partnering with universities, we can improve the pay and size of our forensics team while also ensuring that families, coroners and police get the answers they need when tragedy strikes.”
Under the partnership, the cabinet will pay the universities for any services performed by these pathologists “on a scale similar to current costs,” with all doctors having “an opportunity to transition into university positions, and those who do are expected to receive a salary increase depending on the individual contracts between doctors and universities.”
This is expected to create an immediate net increase of one pathologist for the state office, with possibilities for adding more thanks to recruitment assistance from universities.
Kentucky is not alone in its struggle to recruit forensic pathologists, as there are only roughly 500 practicing nationwide. This shortage also comes amid the alarming and record-breaking increases in fatal drug overdoses, and the opioid crisis has moved from prescription painkillers, to heroin, and now to fentanyl.
According to the Kentucky Office of Drug Control Policy, there were 1,404 fatal drug overdoses in the state in 2016, a 7.4 percent increase from the previous year.
Fentanyl — an opioid that is at least 50 times more potent than heroin — went from being a rarity in 2015 to being present in the toxicology reports of 44 percent of fatal overdose victims in 2016.
The statewide report for 2017 is expected to be completed this summer, but if the state trends mirror what was found in Louisville last year, Kentucky could set another record high in overdose deaths and show an even larger increase in those involving fentanyl.
According to Jefferson County Coroner’s office records in 2017, 398 people died from an accidental drug overdose within Louisville, a 23 percent increase from 2016. Of those deaths last year, a remarkable 64 percent of overdose victims had fentanyl in their system, compared to 43 percent in 2016 and 12 percent in 2015.
As for the early results from 2018, Mayor Greg Fischer stated in his budget address last week that overdose deaths reported by LMPD in the first four months are down 40 percent from that period last year.
While a review of an internal police record from this week shows this figure to be a 45 percent decrease from January through April this year — 73 fatal overdose investigations, compared to 133 last year — a closer looks suggests that this is overstated.
The 133 figure cited by LMPD was its total for that period calculated at the end of 2017, but these figures continue to grow throughout the year as LMPD gains cases. For example, the internal weekly report of LMPD from this time last year showed only 100 fatal overdose cases in the first four months, meaning that the 2018 decline is likely closer to 27 percent.
Additionally, February of last year was by far the deadliest month that Louisville has ever seen in terms of fatal drug overdoses, as 65 died during that month’s abnormal spike — 20 more than any other month in recent years.
Preliminary 2018 data from the Jefferson County Coroner’s office — which has much larger totals on fatal overdoses than LMPD has overdose cases — shows that at least 79 individuals died from an accidental drug overdose in just the first three months of this year.
Looking at the data from January and February of this year, a remarkable 80 percent of the 59 fatal overdose victims in Louisville had fentanyl in their system.