JEFFERSON CITY, MO – While the opioid epidemic is not over, the Missouri Department of Health and Senior Services reports the first significant year-over-year decrease in the number of deaths due to drug overdose since 2015. Down from Missouri’s all-time high of 2,180 overdose deaths in 2022, 1,948 were reported in 2023. Over 73% of those deaths were attributed to opioids, meaning 1 out of 47 deaths statewide were attributed to an opioid-involved overdose. While prescription opioids and heroin once drove this epidemic, synthetic opioids such as fentanyl have taken over as the primary substance causing death.
Fentanyl is a powerful synthetic opioid that is 50 times stronger than heroin and 100 times stronger than morphine. It is available in prescription form for pain relief, but fentanyl is also made illegally. The Drug Enforcement Administration reports that 5 out of every 10 pills they seize contains a lethal dose of fentanyl.
Efforts to mitigate this problem have been in place in Missouri for many years. One of these efforts is increasing the availability of Naloxone—a lifesaving medication that reverses opioid overdoses. It is now widely available at pharmacies, local public health agencies and some clinics.
In 2017, DHSS issued a statewide standing order that greatly increased availability of the rescue medication by not requiring a prescription at pharmacies and local public health agencies. Since its installment, nearly 30% of all naloxone prescriptions through MO HealthNet stemmed from the DHSS standing order. Medicaid clients have been provided 233,035 naloxone doses since 2017, with 68,424 doses being sought under the DHSS standing order.
Although prescriptions are no longer required for naloxone, the standing order has provided and continues to provide access to Medicaid clients and other insured individuals who may not have affordable access to the lifesaving drug without the order.
Still, the opioid epidemic continues to impact families, communities and health care systems.
“The improvements we are seeing are evidence-based, promising and indicative of successful statewide interdisciplinary comprehensive efforts. But, we can’t take our foot off the pedal toward assertively preventing and addressing substance use disorder and related overdose deaths,” said Dr. Heidi Miller, DHSS chief medical officer.
While naloxone is available over the counter at pharmacies, it may not always be free for patients. If insured, individuals should ask the pharmacy to use their health insurance to cover naloxone via the Missouri State Standing Order for Naloxone. Those with coverage through MO HealthNet can receive the naloxone at no cost. Those who do not have insurance and are unable to pay for naloxone can request it be mailed to them for free at GetMissouriNaloxone.com,
In addition to pharmacies, individuals can obtain naloxone, usually at no cost, from local public health agencies, clinics and other organizations throughout the state. Visit NOMoDeaths.org/where-to-get-naloxone to find your nearest location.
“Opioid use disorder and other substance use disorders are indeed treatable medical conditions,” said Miller. “Increasing awareness of and accessibility to naloxone is a top priority for us at DHSS, as is connecting individuals with substance use disorder to comprehensive clinical treatment.”
Patients can ask their current health care provider or find affordable accessible treatment sites via NOMoDeaths.org/get-treatment.
More information about opioids, treatment options and other resources can be found in the Responding to Opioids in Missouri zine.
Additional information is also available on CDC’s website.