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Public health experts: Missouri needs to better track, treat opioid addiction

Public health experts on a panel in St. Louis Friday admonished Missouri lawmakers for failing to pass a prescription drug monitoring bill during the last legislative session. They also called for more treatment centers.

At least 712 people died after opioid overdoses in the bi-state St. Louis region last year — nearly 200 more than the year before, according to the anti-addiction group NCADA St. Louis. Missouri is the only state without a statewide database.

“It is absolutely cheaper to get high than to use the medications to treat addiction,” said Kendra Holmes, chief operating officer of Affinia Healthcare in St. Louis. “To not have a prescription drug monitoring program in Missouri, and we have an opioid epidemic, does not make sense.”

The panel, convened by the St. Louis chapter of the National Association of Health Services Executives, covered local efforts to prevent the abuse of opioid drugs — heroin, fentanyl and pain pills — as well as racial disparities in treatment. While heroin addiction in the 1970’s was seen as an issue confined to poor, black neighborhoods, the largest cohort of addicts today are young, white men.  Meanwhile, public concern — and funding for prevention efforts — has ballooned.

“This data should not be taken to say there is less heroin use in the inner city. It’s just been dwarfed,” said Dr. Ted Cicero, an addiction expert at Washington University in St. Louis.

It’s a welcome development for many in the addiction world, who felt their pleas had fallen on deaf ears for decades.

“Is it fair that we’re finally treating this as a public health problem when a generation of African American families had their doors broken down? No,” said panelist Howard Weissman, executive director of the anti-addiction group NCADA St. Louis. “But we’re hoping this is the tide that rises all ships.”

But there is a long ways to go, said Holmes, the pharmacist. Every two weeks, Affinia’s medication-assisted treatment program provides 20 patients with a daily suboxone prescription to alleviate symptoms of withdrawal. By the end of the 10-day course, just a handful of patients remain.

“With the population we treat, it’s really difficult because they’re going back to the same environment where people are using,” said Holmes, also a pharmacist. “There are treatment centers, but they’re at capacity. More treatment centers in low income areas are necessary and affordable treatment.”

During remarks before the discussion, Missouri Health Director Randall Williams said he will soon release a statewide plan to push naloxone, the overdose antidote, out to first responders.

“In North Carolina when we did that, we had more reversals than deaths,” Williams said, referring to the state where he most recently served as director of health and senior services.

Others said there is some hope in the statistics. Eighth graders — the youngest cohort measured by the Monitoring the Future study — are less likely to use drugs other than marijuana at record lows. It’s a sign that the cautionary tale of this generation’s opioid epidemic could prevent future deaths.

Follow Durrie on Twitter: @durrieB

Copyright 2017 St. Louis Public Radio

Durrie Bouscaren was a general assignment reporter with Iowa Public Radio from March 2013 through July 2014.
Durrie Bouscaren
Durrie Bouscaren covers healthcare and medical research throughout the St. Louis metro area. She comes most recently from Iowa Public Radio’s newsroom in Des Moines, where she reported on floods, a propane shortage, and small-town defense contractors. Since catching the radio bug in college, Bouscaren has freelanced and interned at NPR member stations WRVO, WAER and KQED. Her work has aired on All Things Considered, KQED’s The California Report, and Harvest Public Media, a regional reporting collaborative.