UK Pharmacy researcher wins state grant to map opioid crisis
LEXINGTON, Ky. — When Kentucky officials distribute opioid settlement dollars to the counties that need them most, they rely on the best available data. For years, that data has had a glaring gap: no one could say with precision how many Kentuckians in each of the state's 120 counties are living with opioid use disorder.
Chris Delcher, Ph.D., associate professor in the Department of Pharmacy Practice and Science and director of the Institute for Pharmaceutical Outcomes and Policy (IPOP), aims to change that. Delcher has been awarded a research grant from the Kentucky Opioid Abatement Advisory Commission (KYOAAC), part of more than $30 million the commission distributed this year to over 100 organizations statewide. The funds flow directly from landmark settlements with opioid manufacturers and distributors, which have directed more than $1 billion to Kentucky to date.
Delcher was one of three University of Kentucky recipients of research and innovation grants from the commission and the only pharmacy researcher in the entire recipient group. He is collaborating with Anna Smith, Ph.D., an associate professor of statistics in the Dr. Bing Zhang Department of Statistics at the College of Arts and Sciences.
The award addresses a problem that has long complicated the state’s response to the epidemic: allocating settlement funds fairly requires knowing where the burden of opioid use disorder is greatest, but the data available to make that judgment is incomplete. Overdose death rates and prescription data offer partial pictures; neither tells the whole story.
Delcher's project will close that gap using a statistical method called the Bayesian Integrated Abundance (BIA) model to generate county-level estimates of opioid use disorder prevalence for all 120 Kentucky counties from 2018 through 2027. The approach combines multiple publicly available data sources, including overdose death counts, buprenorphine prescription rates and treatment program enrollment figures, to calculate not only the known population with opioid use disorder, but also the population that existing systems miss.
The potential scale of that undercount is significant. Prior research that Delcher participated in using a different estimation method found that Kentucky's “truer” opioid use disorder population was roughly 2.6 times higher than federal survey estimates suggested — about 148,000 people in 2018, compared to the roughly 55,000 counted by the National Survey on Drug Use and Health. In Jefferson County alone, the gap was nearly 24,000 people.
“The data that currently exist to guide opioid abatement spending and other programs relying on such data are incomplete,” Delcher said. “Counties are making consequential decisions about where to put resources, and our goal is to give the state the most accurate, county-specific picture of who is living with opioid use disorder and where the epidemic is most intense or even improving. Better data means better decisions, and better decisions mean more lives saved.”
That work sits squarely at the intersection of pharmacoepidemiology, data science and public health — a natural extension of Delcher's career studying prescription drug use and drug policy. His research focuses on the epidemiology of prescription drug use derived from medical and pharmacy encounter data, the intended and unintended consequences of drug policy on population health and the enhancement of public health surveillance systems. The opioid crisis was fueled in part by the prescribing and distribution of legal pharmaceuticals, and IPOP, which Delcher directs, has built interactive county-level dashboards tracking opioid outcomes that state partners already use.
For Craig Martin, Pharm.D., MBA, interim dean of the UK College of Pharmacy, the grant reflects an institutional mission that extends well beyond the laboratory or the clinic.
“Dr. Delcher's work is a powerful example of why pharmacy must be part of the broader public health response to the opioid epidemic,” Martin said. “Pharmacists and pharmacy researchers bring unique expertise in how medications intersect with health outcomes at the population level. This grant recognizes that expertise and positions the College of Pharmacy as a critical partner in Kentucky's efforts to turn settlement funds into real, lasting change for families across the commonwealth.”
The project is also built to outlast the grant itself. Because the BIA method draws exclusively on publicly available, aggregated data rather than individually linked records requiring complex interagency agreements, it can be updated annually as new data become available. Delcher's team plans to publish all programming code and a plain-language guide, so state agencies, counties and future researchers can replicate and build on the work. The project also establishes a formal research partnership between IPOP and KYOAAC, creating an ongoing channel for the commission to request data analysis as the epidemic evolves. Interactive dashboards with county-level estimates are planned for public release and could be embedded directly on the commission's website.
Attorney General Russell Coleman, who oversees KYOAAC, said at the April grant announcement that Kentucky is leading the nation in deploying settlement dollars, with more than $100 million awarded since the program began. Delcher's research stands to sharpen the aim of those investments by ensuring the most affected communities receive proportionate support, and the model goes beyond Kentucky's border. Delcher is already collaborating with colleagues at Wake Forest University on analogous work in other states and believes the approach could eventually scale nationally with federal support.
For now, the work begins at home: county by county, year by year, building the evidence base Kentucky needs to ensure the billions in settlement funds make the difference they were meant to make.