FRANKFORT, Ky. (AP) — Since 2011, a year when Kentucky was flooded with 371 million doses of opioid painkillers, state officials have cracked down on pain clinics, sued pharmaceutical companies and limited how many pills doctors can prescribe.

The result is nearly 100 million fewer opioid prescriptions in 2017 — and an 11.5 percent increase in drug overdose deaths.

That's the sobering findings of a new report from the Kentucky Office of Drug Control Policy in a state on the front lines of the nation's opioid epidemic. The report says 1,565 people died from drug overdoses in 2017, a 40 percent increase in the past five years.

Deaths attributed to prescription painkillers and heroin are declining. But other drugs have taken their place. Fentanyl, a synthetic opioid, accounted for more than half of all the deaths. And methamphetamine has made a comeback, accounting for 360 deaths. That's a 57 percent increase in just one year.

"We are in a crisis state," Republican Gov. Matt Bevin said. "While we are putting money at it and while we are drawing attention to it, until we start to truly address this and look at underlying causes of these things and what is leading to this it is not going to be addressed."

[Kentucky Gov. Matt Bevin speaks with reporters about a new report detailing an increase in drug overdose deaths on Wednesday, July 25, 2018, in Frankfort, Ky. //photo Adam Beam]

Nationally, opioids accounted for more than 42,000 deaths in 2016. States with the highest rates of drug overdose deaths that year were West Virginia, Ohio, New Hampshire, Pennsylvania and Kentucky, according to the Centers for Disease Control and Prevention.

Every year, Kentucky lawmakers have been passing more laws designed to address the opioid problem. They have increased penalties for heroin dealers. They have diverted more money to drug treatment programs. And they limited patients to a three-day supply of prescription painkillers unless a doctor gives them written permission for a larger amount.

State officials spent $500,000 to create 1-833-8KY-HELP, a hotline to connect people with treatment options. And they have spent thousands of dollars giving first responders naloxone, medicine that can reverse an opioid overdose.

Anti-drug advocates celebrate those changes, but their celebration is tempered once a year when the new numbers come out detailing how many more people have died.

[Syringes of the opioid painkiller fentanyl in an inpatient pharmacy. //photo Rick Bowmer, AP]

"Most of the things we do we realize are not going to take that immediate effect," said Van Ingram, executive director of the Kentucky Office of Drug Control Policy. "It just never gets any easier."

Many anti-drug advocates have credited the Affordable Care Act with helping people get treatment. The law, known as Obamacare, expanded the Medicaid program to give more than 400,000 Kentuckians health coverage. Many used that coverage to get drug treatment.

Bevin wants to require people in Kentucky's expanded Medicaid population to get a job, go to school or do volunteer work to keep their coverage. He also wants to charge them small monthly premiums to model private insurance plans.

Critics have said the result will be fewer people on Medicaid with fewer treatment options. But Bevin's plan would exempt people with substance abuse disorder from complying with the new rules. Those rules were supposed to go into effect July 1, but were blocked by a federal judge.—ADAM BEAM, AP

[cover photo Mark Duffel via Unsplash]