Quick answer
Fentanyl-involved deaths in McCracken County rose 28.6% in 2024, from 7 to 9, even as the county's total overdose deaths stayed at 15. Medication for opioid use disorder is the standard of care and Kentucky Medicaid covers it. Four Rivers Behavioral Health and the Purchase District Health Department are the local ways in. Here is how to start.
Fentanyl is the drug most likely to be in whatever is being sold as a pill or a bag in western Kentucky, and McCracken County's numbers show it getting worse even as the overall toll holds steady. That is the case for acting now rather than waiting. Opioid use disorder is treatable with medication, and Paducah has a clinic and a health department ready to help.
What McCracken County's numbers show
The Kentucky Injury Prevention and Research Center found that McCracken County had one of only two reportable increases in fentanyl-involved overdose deaths statewide in 2024: 9 deaths, up 28.6% from 7 in 2023. The county's appendix data show 15 total overdose deaths in 2024, an age-adjusted rate of 22.5 per 100,000, with 9 involving opioids and 8 involving stimulants.
Statewide, fentanyl was involved in 829 Kentucky overdose deaths in 2024 — 57.6% of the total — and 93.6% of those deaths also involved another drug.
Medication is the standard of care
The National Institute on Drug Abuse describes medication for opioid use disorder as the standard of care, and reports that people treated with methadone or buprenorphine are less likely to die or overdose than people who go without.
- Buprenorphine — a daily tablet or film, prescribable in a clinic or doctor's office.
- Methadone — dispensed daily at a certified opioid treatment program.
- Naltrexone — blocks opioid receptors, but only after you are fully through withdrawal.
Medication works best with counseling, and it can continue safely through pregnancy under medical care. Ask a clinician which option fits your situation.
Where to get care in Paducah
Four Rivers Behavioral Health is the community behavioral health provider for the region, with outpatient substance use treatment and a 24-hour crisis line at 800-592-3980. If you are not sure where to start, that line can point you to an assessment.
For anyone whose opioid use is part of a larger picture, the same provider can address co-occurring mental health needs — which matters, because treating one without the other rarely holds.
Naloxone and harm reduction
Fentanyl is lethal in tiny amounts and is often pressed into counterfeit pills, so everyone using opioids should carry naloxone and the people around them should know how to use it.
- The Purchase District Health Department's Harm Reduction Hub at 916 Kentucky Avenue in Paducah offers free naloxone on Mondays, Wednesdays, and Fridays, along with fentanyl and xylazine test strips and referral to treatment.
- Certified Kentucky pharmacies can dispense naloxone without a separate prescription under the state's standing physician protocol.
Naloxone will not harm someone who is not overdosing. If you are unsure, give it and call 911.
Paying for treatment
Kentucky Medicaid covers medically necessary treatment for opioid use disorder for eligible members, including medication and counseling. If you are uninsured, a community behavioral health provider can still serve you — ask about the sliding fee scale.
How to start today
- If someone is unresponsive or breathing slowly, call 911 and give naloxone if you have it. For a crisis, call or text 988.
- Call or text (800) 653-9376 to talk through options with a treatment specialist — free and without obligation:
Calling is free; the referral service is paid for by treatment providers.
- Call Four Rivers Behavioral Health at 800-592-3980 (24 hours) and ask for a substance use assessment.
- Ask about starting buprenorphine this week — same-day or next-day induction is possible at many programs now.
Fentanyl use disorder is treatable, and Paducah has providers ready to start. The first call is the hardest part.
Emergency and crisis lines
Call 911 first if someone is unresponsive, breathing slowly, or turning blue. For a mental health or substance use crisis that is not a medical emergency, call or text 988, the national Suicide and Crisis Lifeline.
This page is general health information, not medical advice. It is not affiliated with or endorsed by any facility named above.
Last updated: Mon Oct 19 2026 00:00:00 GMT+0000 (Coordinated Universal Time)
Frequently asked questions
How bad is fentanyl in McCracken County?
The Kentucky Injury Prevention and Research Center reports 9 fentanyl-involved overdose deaths among McCracken County residents in 2024, a 28.6% increase from 7 in 2023 - one of only two Kentucky counties with a reportable increase. McCracken County recorded 15 total overdose deaths in 2024, an age-adjusted rate of 22.5 per 100,000.
What medications treat opioid use disorder?
The FDA has approved methadone, buprenorphine, and naltrexone for opioid use disorder. Per NIDA, people treated with methadone or buprenorphine are less likely to die or overdose than people who get no medication, and medication works best alongside counseling.
Where can I get naloxone in Paducah?
The Purchase District Health Department's Harm Reduction Hub at 916 Kentucky Avenue in Paducah offers free naloxone on Mondays, Wednesdays, and Fridays, along with fentanyl and xylazine test strips and referral to treatment. Certified Kentucky pharmacies can also dispense naloxone without a separate prescription.
Who do I call in an opioid emergency in Paducah?
If someone is unresponsive, breathing slowly, or turning blue, call 911 and give naloxone if you have it. For a mental health or substance use crisis that is not a medical emergency, call or text 988, or call Four Rivers Behavioral Health's 24-hour crisis line at 800-592-3980.
Does Kentucky Medicaid cover treatment for fentanyl use near Paducah?
For eligible members, yes. Kentucky Medicaid covers medically necessary substance use disorder treatment, including medications for opioid use disorder and counseling. Confirm network and prior authorization with your plan when you call.