Chronic Pain and Addiction Treatment in Kentucky

How is chronic pain treated when someone also has a substance use disorder?

In Kentucky, chronic pain and a substance use disorder are usually treated through one shared plan, with pain clinicians and addiction clinicians working as a team instead of separately. In practice, the addiction team knows every medicine the pain prescriber has written, and the pain prescriber knows about the addiction treatment.

Physical dependence and a use disorder are different things. Many Kentuckians take long-term opioids as prescribed and have withdrawal if a dose drops, an expected effect of the medicine and not, on its own, an addiction. A use disorder involves cravings, loss of control and continued use despite harm, and only a clinician can make that diagnosis.

Options on the table include buprenorphine, a medication for opioid use disorder with pain-relieving effects, and methadone, given through licensed opioid treatment programs. Non-opioid medicines and physical therapy also have a place. Programs that also treat depression, anxiety or trauma appear on the dual diagnosis rehab page for Kentucky.

Cutting a long-term opioid or benzodiazepine prescription abruptly is unsafe, since withdrawal and a spike in pain can follow. Before starting, ask a program whether it treats pain and addiction together, whether it can continue medication for opioid use disorder, and whether staff will coordinate with your pain prescriber before changing any dose.

Choices among these options are made by the clinicians together with the patient. The Department for Behavioral Health, Developmental and Intellectual Disabilities serves as Kentucky’s State Opioid Treatment Authority, which covers programs that dispense methadone. Buprenorphine prescribers are listed on the Suboxone clinics in Kentucky page, and methadone programs on the Kentucky methadone clinics page.

Is it safe to stop or reduce pain medication on my own?

No. Stopping or sharply cutting a long-term opioid or benzodiazepine prescription on your own is not considered safe. A sudden change can bring severe withdrawal and a spike in pain, and stopping benzodiazepines abruptly can cause seizures. Federal clinical guidance advises planning any taper with the prescriber, at a pace the patient can manage.

Benzodiazepines are not a pain treatment. Taking them with opioids raises the risk of dangerously slowed breathing, so a program needs to know about both. Anyone entering addiction treatment in Kentucky can ask the admissions team to contact their current prescriber before any dose changes. Programs that work with sedative use are on the benzo rehab in Kentucky page.

Which Kentucky rules might a patient run into?

In Kentucky, pharmacists certified by the Kentucky Board of Pharmacy can dispense naloxone under a physician-approved protocol, under KRS 217.186. The Office of Drug Control Policy’s Stop Overdoses page lists naloxone and syringe exchange locations, along with the Find Naloxone Now Kentucky locator. Kentucky’s Good Samaritan law, KRS 218A.133, protects a person who seeks medical help for an overdose in good faith from prosecution for drug or paraphernalia possession.

Kentucky Medicaid covers telehealth under 907 KAR 3:170, including audio-only visits, and members can ask for an in-person or video visit instead. Programs offering remote care appear on the telehealth rehab in Kentucky page.

How do I pay for pain and addiction treatment in Kentucky?

Most people in Kentucky pay through Kentucky Medicaid, private insurance or state-funded programs. Kentucky Medicaid is run by the Department for Medicaid Services and delivers care through five managed care plans:

• Aetna Better Health of Kentucky
• Humana Healthy Horizons in Kentucky
• Passport Health Plan by Molina Healthcare
• UnitedHealthcare Community Plan
• WellCare of Kentucky

Behavioral health is built into those plans. Anthem stopped being a Kentucky Medicaid plan on January 1, 2025. The state’s behavioral health fee schedule sets daily rates for residential and intensive outpatient treatment. See programs that accept Medicaid.

Private plans that cover substance use care generally have to treat it on terms comparable to medical care under federal parity rules. For people without coverage, the Division of Substance Use Disorder within DBHDID oversees state and federal funds for community providers. Those programs are gathered on the state-funded rehab in Kentucky page.

What should I ask a Kentucky program before starting?

Before starting, ask three questions:

• Does the program treat pain and substance use together?
• Can it continue or start medication for opioid use disorder?
• Will it coordinate with your pain prescriber?

Then ask which levels of care it offers, such as outpatient rehab or an intensive outpatient program, and which insurers it accepts. Programs focused on opioid use are on the opioid rehab in Kentucky page.

Kentucky’s pain and addiction listings are spread across settings: 40 percent rural, 37 percent urban and 21 percent in towns. Almost all of them, 98 percent, sit within 25 miles of a river, most often the Dix River, at a median distance of 13.3 miles. Blue Grass Airport is the nearest airport for the largest share of listings, and the median distance to an airport is 31.8 miles. That matters for anyone traveling in from out of state or from the eastern counties near Daniel Boone National Forest.

Free places to start

Find Help Now Kentucky, 800-854-6813, shows treatment openings, recovery housing and mental health services. In eastern Kentucky, the Operation UNITE Treatment Referral and Help Line is 866-908-6483. The national treatment referral line gives free referrals, and 988 answers calls and texts during a crisis. For other kinds of care, start at the Kentucky treatment directory, or compare pain and addiction programs nationwide.