A University of Missouri-St. Louis (UMSL) report shows that for the first time in several years, the state's drug overdose deaths declined in 2023. The 11% drop shows that nearly 2,000 people still died in Missouri.
Rachel Winograd, an associate professor at UMSL, said initial data for this year shows a positive trend.
"The Missouri Department of Health and Senior Services tracks overdose deaths data for our state and shows preliminary death by quarter," she told Missourinet. "And indeed, looking at the first half of this current year, it's showing that we're nearly 30% down from last year, which was already a decrease. This is still an unfathomably high number and more lives lost than we should accept to a preventable death, like a drug overdose."
Winograd said after many years of climbing, the rate of overdose deaths among Black men declined last year.
"This is good news and a step in the right direction, but Black men in Missouri continue to die at disproportionate rates from drug overdose - a rate nearly three-times higher than their white counterparts. That continues to be unacceptable," said Winograd.
According to Winograd, Missouri's "epicenter" of drug overdose deaths is still St. Louis.
"For many, many decades, and we continue here in the St Louis area to have the highest rates of deaths and also the highest numbers of deaths, simply because we have the most people. That being said, we also experienced the largest decline, or close to it, in 2023. So, in the St Louis metro area, we experienced a 14% decrease in deaths in 2023, still accounting for nearly 50% of deaths statewide," she said.
The report shows that each region except for northwest Missouri experienced declines in overdose deaths last year.
Winograd said nearly three-quarters of Missouri's drug overdose deaths are a result of opioids, with 93% involving fentanyl. About half of the deaths involve stimulants, such as cocaine and meth. About one in three deaths involve both an opioid and a stimulant.
What has led to the decline in overdose deaths? Winnograd thinks there could be several reasons why.
She said the increased distribution of drug overdose reversal drugs, such as Naloxone, has made a difference. You can spray it into a person's nose or inject the drug into their arm.
"Our state has done a really good job of getting Naloxone into the hands of people who need it the most. Here in Missouri, we distributed over a quarter-million doses of Naloxone in 2023, which was nearly three times as much as we were able to distribute the year prior," she said. "I'm sure there are still people out there in pockets of Missouri who don't have Naloxone and don't know where to get it. And I think our job will not be done until we get Naloxone in their hands and make sure they know where to get it moving forward."
According to Winograd, fewer young adults are using fentanyl. Other reasons for the decline could be a lower drug supply, as well as an increased focus on policy, funding, and treatment.
She said medication-assisted treatments are also highly effective to help people to overcome addiction.
"Specifically for opioid use disorder, so we have two medications -buprenorphine and methadone - that are shown to reduce overdose risks by 50% to 80%," Winograd said. "That is an astronomical figure. And yet these medications still carry with them a lot of stigma, a lot of barriers."
Winograd said access to these drugs is the main barrier and more prescribers are needed across all healthcare settings.
She said that in-patient rehab centers can cost up to $30,000 a month.
"We don't have a lot of residential treatment available at this time in Missouri for people in our safety nets," said Winograd. "That being said, there is zero evidence to suggest that that treatment is more effective than low-barrier, outpatient, publically-funded safety net treatment."