"Drug manufacturers and distributors have pumped prescription opioid painkillers into rural America, in response to demand—much of it from adults who had become physically addicted," Galewitz writes. "The expansion of Medicaid through the Affordable Care Act increased the percentage of Clay County residents with Medicaid and gave more of them access to free prescription drugs, including pain pills. Though Clay County’s opioid problem long preceded the act, the improved legal access helped bring a long standing problem out from the shadows. Statistics show residents are swallowing the preferred prescription opioid more."
|Clay County's hydrocodone dosage leads the state. (KHN map)|
Clay County's health status is one of the worst in the nation, Galewitz notes: "Four in 10 residents rate their health status as being fair or poor, twice the share for the entire state population. Close to half the county is obese. The rate of diabetes is also higher than average."
The inpatient drug-treatment facility closest to Manchester carries a waiting list of 100 that’s grown more than 50 percent in recent years, said Tim Cesario, director of substance abuse services at the Cumberland River Comprehensive Care Center in Corbin. The facility—with 41 beds for men and 15 for women—has been at capacity for several years, he said."
"About 60 percent of Clay’s residents are on Medicaid, up from 35 percent three years ago. It is among the most highly concentrated Medicaid populations in the country," Galewitz writes. Steve Shannon, executive director of the Kentucky Association of Regional Programs, says Medicaid’s expansion has not created more addicts. He told Galewitz, “People who were uninsured were pretty resourceful when it came to finding drugs."