By Randall W. Williams, MD, FACOG
Missouri Director, Health & Senior Services
Randall W. Williams, MD
We believe one out of three families are somehow touched by the opioid epidemic.
As the director of the Department of Health and Senior Services, I have been to every county in Missouri listening to citizens. There are some stories that stay with you forever. I vividly remember a young woman, who was in recovery for substance use, told me that while she was using opioids she just felt “like she was slowly waiting to die.” Another story was of the young women who overdosed with friends and was left by the side of the road to die because the people with her didn’t want to get arrested.
So where do we stand today in Missouri? In 2015, we had 672 people die from opioid misuse, and that drastically increased by 35 percent in 2016. Last year, the rate of increase was less dramatic at 4.7 percent, but still, we anticipate final numbers from 2018 will show nearly 1,100 fatalities. Two thirds of these fatalities occur in the St. Louis area and are driven by the availability of fentanyl and related products which are highly lethal.
The opioid epidemic is widespread.
We have a problem in rural areas from oral prescription narcotics that people may initially use for back pain or dental pain, but because these drugs can be highly addictive, they often get hooked and then progress to injectable drugs like fentanyl. Sadly, 80 percent of people who use heroin or fentanyl started with prescription drugs, and 51 percent who abuse prescription drugs don’t get them from doctors, but obtain them from friends, neighbors or some other diverted source. The average time for people who die from heroin overdose is 3 years from the time of onset of abusing prescription drugs.
In the public health domain, we are big believers in prevention. Since so many people who eventually become addicted start with prescription drugs, either prescribed by a doctor or given to them illegally by a friend, we encourage people to always consider non-narcotic methods of treating pain, such as Motrin, Tylenol or physical therapy. Also, try to avoid taking opioids for chronic conditions that last one year or more, limit your activities of daily living and require ongoing medical attention. We increasingly worry when patients get a narcotic prescription refilled more than one or two times for acute pain. Acute pain is a type of pain that typically lasts less than 3 to 6 months, or pain that is directly related to soft tissue damage such as a sprained ankle.
Remember, almost half of patients with narcotic addictions get pills from the medicine cabinets of relatives or friends. Avoid the temptation to have narcotics unsecured in your house where a babysitter or child’s friend can be tempted to take them.
Missouri’s Good Samaritan Law
For the first time in Missouri’s history, you can now go to the drug store and get a prescription for a nasal spray, called Narcan, which saves lives by reversing the effects of an overdose. The prescription is written by me for all Missourians under the state’s universal Narcan law. Now under Missouri’s Good Samaritan Law, if you witness someone experiencing an overdose and seek help for that person, you will not be charged or prosecuted for possession of a controlled substance. Saving the life is the top priority for all.
And as I mentioned earlier, I have people come up and thank me because a loved one received Narcan from our state prescription. Someone’s life was saved so they could have another chance at living.
I will end as I started. We don’t want anyone in Missouri to face addiction or the opioid crisis alone. Let us help you identify the counseling and treatment services you need for recovery. For more information visit, www.missouriopioidstr.org.