St. Louis County declares opioid addiction a public health emergency | St. Louis Public Radio

St. Louis County declares opioid addiction a public health emergency

Jun 28, 2018

St. Louis County Executive Steve Stenger declared the opioid epidemic in the county a public health emergency and endorsed a plan to have public health officials work with other organizations to combat the addiction crisis.

The declaration Stenger signed Thursday at the Department of Public Health in Berkeley endorsed an action plan that includes county health officials and other organizations, including the county's Justice Services department and the Missouri Hospital Association.

It aims to increase the public’s access to the anti-overdose drug naloxone, boost prevention education and raise access to treatment for high-risk populations such as the uninsured.

“The emergency declaration signifies an issue of direct and immediate relevance to the health of the public that needs more resources [and] needs a regional effort that’s redoubled and refocused from everything that’s going on,” County Health Director Faisal Khan said Thursday.

Stenger plans to ask the St. Louis County Council for $1.5 million during the next budget to help fund the goals.

Opioid deaths in St. Louis County have close to doubled, to 203, in the past five years, according to county officials. Many of those who died had taken the powerful synthetic drug fentanyl.

So far this year, there have been more the 85 overdose deaths related to opioids in St. Louis County.

The emergency declaration was a way to get several agencies on board with a comprehensive plan to address the problem, Khan said.

“A lot of people and agencies are doing work to combat opioid epidemic and substance-use disorder, but it is in piecemeal fashion; it’s very soloed,” he said. “The result is we don’t have a comprehensive regional approach to prevention.”

For example, to increase access to treatment, county public health officials will begin offering medication-assisted treatment in its clinics and start to integrate it into existing services.

Getting the department to offer medication-assisted treatment, which includes maintenance therapies such as methadone and buprenorphine, took a long time, Khan said. Doctors largely consider it the most effective form of treatment for substance-use disorder, but medication-assisted treatment has historically been politically unpopular.

The new plan endorses it as well as several harm-reduction initiatives such as researching a syringe-services program, which would distribute clean needles to drug users in order to stop the spread of diseases such as hepatitis and HIV.

According to Khan, one doctor out of five on the health department’s full-time staff is trained to dispense addiction medication, but he said he hopes that number will increase in the next year.

The county’s plan also involves researching and surveying best treatment practices and seeking funding for services, such as one which directs the county’s health and justice services departments to find money and assistance for expanded opioid use treatment in county jails.

“We’re not the federal government,” Stenger said, referring the limited resources the county has to fund the health budget.

“I will tell you that that is probably not enough, but from a local level, that’s what we have, and that’s actually a very large request for our budget,” he said.

Stenger said the county’s prescription-drug monitoring system is funded with federal dollars.

The report didn’t mention the opioid task force the County Council created earlier this week. That council created the task force to make its own recommendations. It’s unclear if the council will go ahead with its own recommendations after the release of Thursday’s plan.

“I don’t think the County Council was aware of all the work that was going on,” Stenger said. “One of the things that the task force was going to want to produce was probably a plan very similar to this one.”

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