Addiction | St. Louis Public Radio

Addiction

Dr. Katherine Austman, a fellow with the Addiction Recovery Centers of America, conducts a follow-up appointment with a patient living at an encampment for homeless people on May 28, 2020.
Eli Chen | St. Louis Public Radio

Emergency workers in St. Louis responded to an increased number of drug overdoses this spring, according to city health data. 

St. Louis EMS responders used the overdose-reversing medication Narcan 246 times in March and April, nearly twice as often as during the same period last year. 

The increased stress and isolation during the coronavirus pandemic has made some people more likely to use drugs, St. Louis Fire Department Chief Dennis Jenkerson said.

Missouri Network for Opiate Reform and Recovery Executive Director stands beside the nonprofit's mobile outreach van. The decal on the back window represents the molecule naloxone, a chemical that can reverse and overdose.
File photo | Sarah Fentem | St. Louis Public Radio

On most days, workers from the Missouri Network for Opiate Reform and Recovery meet with clients at the addiction treatment center’s South Broadway storefront location or hit the streets to distribute naloxone and clean syringes to people using drugs.

But this week, the organization paused in-person meetings and decreased street outreach as the organization tries to balance protecting its staff from the spread of the coronavirus with its mission to support those currently and formerly addicted to drugs.

With many people isolated during the pandemic, those with addictions are at greater risk for relapse and overdose.

The St. Louis County Health Department is distributing free two packs of Narcan nasal spray, which can save people from opioid overdoses.
Sarah Fentem | St. Louis Public Radio

The St. Louis County Health Department is distributing free bottles of an overdose antidote to save people addicted to opioids.

The department announced Monday it is offering naloxone at its health clinic in north St. Louis County and at the Buzz Westfall Justice Center in Clayton. When given to a person who has overdosed on opioids, the medicine can immediately reverse the effects of the overdose.

Washington University's Clinic for Acceptance, Recovery and Empowerment (CARE) is one of two clinics in St. Louis that provides care for pregnant women facing the challenges of an opioid use disorder.
DAVID KOVALUK | ST. LOUIS PUBLIC RADIO

Washington University’s Clinic for Acceptance, Recovery and Empowerment treats women who become pregnant while dealing with an opioid use disorder. It provides prenatal care, substance abuse treatment and extended postpartum support. 

On Tuesday’s St. Louis on the Air, the clinic’s medical director said there is a high demand for these services in the St. Louis region.

“We started as a half-a-day-a-week clinic, and volume has expanded so much that we are opening a second half-day in addition to our original,” said Dr. Jeannie Kelly. “We have seen a pretty high number [of clients] in our clinic.”

Saint Louis University School of Medicine recently was taken off probation by the nation's accrediting body.
Wikimedia Commons

St. Louis University is starting a program to train doctors to treat patients with addictions.

The university’s school of medicine will operate the state’s first addiction medicine fellowship. 

Fellowship doctors will compete rotations at the city’s hospitals, clinics and community health centers. They'll also learn how to treat addiction in pregnant patients and newborns and receive training in telemedicine.

“It’s exciting, because addiction psychiatry has been around since 1991, but addiction medicine now is open to any specialty in medical education,” said Dr. Fred Rottnek, a SLU family medicine professor and director of the fellowship.

The opioid prescribing rate in Missouri went up close to 10 percent between 2017 and 2018 within counties participating in the state's drug monitoring program
Sarah Fentem | St. Louis Public Radio

Nearly three people a day died of opioid overdoses in St. Louis last year, according to data released by the National Council on Alcoholism and Drug Abuse.

There were 1,080 people who died of opioids in St. Louis and eight surrounding counties, up 30% from the year before. 

The 2018 count, released this week, marks the 12th consecutive year of rising drug-related fatalities in the region.

David Patterson Silver Wolf (at left) and Rachel Winograd joined Monday's talk show.
Evie Hemphill | St. Louis Public Radio

A few weeks ago, the Centers for Disease Control and Prevention released some positive statistics related to the ongoing opioid crisis. While drug overdose deaths in the U.S. had reached record levels in 2017, the nation saw an overall 4.2% decline in 2018.

In Missouri, though, the 2018 outcomes were far less hopeful – despite an influx of $65 million in federal funds aimed at addressing the crisis over the past few years. Provisional data for the state indicates a 16% increase in drug overdose deaths over the course of last year.

On Monday’s St. Louis on the Air, host Sarah Fenske talked with two local experts about where Missouri should go from here in light of the discouraging statistics.

A sign outside the Missouri Network for Opiate Reform and Recovery advertises Narcan, a medication that can reverse an opioid overdose.
File photo |Carolina Hidalgo | St. Louis Public Radio

Since 2016, Missouri has received more than $65 million in federal grants to provide treatment and recovery services to people addicted to opioids.

The money has provided thousands of people with addiction medication, counseling and residential services. But the latest grant cycle expires in September 2020, and addiction treatment providers are uncertain if Congress will approve funding after that. With Missouri’s opioid-related death toll rising each year, advocates say funding for medical treatment is more important than ever.

A kit containing the opioid overdose antidote naloxone.
File Photo | Camille Phillips | St. Louis Public Radio

The number of drug-related deaths increased by 16% last year, as fatal overdoses declined by an estimated 5.1% nationwide, according to the Centers for Disease Control and Prevention.

Missouri is one of 17 states that saw a rise in drug-related deaths last year. In 34 states, the number of deaths declined. Only Delaware had a higher increase over the previous year, at 16.7%.

David Kovaluk | St. Louis Public Radio

She started using drugs at 16. After moving around the country and trying to quit several times, she came back to St. Louis four years later, hoping for a fresh start. 

After a few months, B. started using again. She has borderline personality disorder, a mental illness that makes it difficult to regulate emotions. She used drugs, mostly illegal opioids, to deal with the mental pain. 

Last winter, she had a chest cold and went to an urgent care center to get a steroid shot. After an exam, a nurse called her over and explained she couldn’t get the medicine, because it might harm her baby. Soon, she would need help with prenatal care and overcoming her addiction, the kind of treatment a Washington University clinic provides.

Three veterans filed suit in Illinois' Third Judicial Circuit against Purdue Pharma and more than a dozen pharmaceutical companies, alleging they marketed dangerous painkilling drugs to vets.
David Kovaluk, Brian Heffernan | St. Louis Public Radio

For years after he got out of the Navy, Joel Bishop took morphine twice a day.

He used four or five Percocet in between those doses.

“I lived around that pill bottle. It’s the only reason I had a watch,” Bishop said. “I couldn’t wait until it was time to open that bottle.”

On Friday, Bishop and two other veterans filed suit in Illinois’ Third Judicial Circuit, which includes Madison and Bond counties, against Purdue Pharma and more than a dozen other pharmaceutical companies, alleging they marketed dangerous painkilling drugs to vets.

Missouri Network for Opiate Reform and Recovery Executive Director stands beside the nonprofit's mobile outreach van. The decal on the back window represents the molecule naloxone, a chemical that can reverse and overdose.
File photo | Sarah Fentem | St. Louis Public Radio

A St. Louis nonprofit is sending outreach workers to city streets to dispense life-saving treatment from a newly refurbished ambulance.

The Missouri Network For Opiate Reform and Recovery will use the vehicle to dispense the overdose-reversal drug naloxone to active drug users and those in recovery. It also provides testing for sexually transmitted diseases such as hepatitis C and HIV and information about treatment programs.

The mobile unit extends the nonprofit’s reach beyond its headquarters at 4022 S. Broadway.

David Patterson Silver Wolf is an associate professor at the Brown School at Washington University. He's also chief research officer at the institution's newly launched Community Academic Partnership on Addiction.
Evie Hemphill | St. Louis Public Radio

When David Patterson Silver Wolf refers to the U.S. opioid epidemic as part of a “disease of despair” and “a tough disease to treat,” he’s speaking from experience both professional and personal. He experienced substance-use disorder firsthand after growing up in a troubled home that quickly led him toward drugs and alcohol.

“I was young and I was also suicidal – which, a lot of folks, when we talk about [overdosing], it’s hard to separate out what is an OD and what is just taking of your life,” the Washington University faculty member recalled on Monday’s St. Louis on the Air. “And I was also full of despair. I had no hope, I was a high school dropout … and I couldn’t see a vision forward.”

A radiologic technologist clears a trauma bay at St. Louis University Hospital's emergency room.
Carolina Hidalgo | St. Louis Public Radio

A coalition of six medical organizations has recommended that hospital doctors take more caution when prescribing opioids for patients with pain.

To cut down on unnecessary prescriptions of addictive painkillers, the Missouri College of Emergency Physicians, the Missouri Hospital Association and other groups want hospital doctors to limit prescriptions, in some cases to a week's supply.

The guidelines, which update a 2015 list that applied only to emergency departments, now include all hospital personnel who prescribe medicine.

Johnny, played by Michael McClelland, wipes his head and tries to gather his thoughts as he wife Celia, played by Patience Davis, sits nearby, in the Slaying Dragons production of "A Hatful of Rain."
Carolina Hidalgo | St. Louis Public Radio

A St. Louis theater troupe is using a play that highlights drug addiction in the mid-1950s to combat the opioid crisis of today.

This weekend, the Slaying Dragons company will present “A Hatful of Rain” at The Chapel theater. The play, about a Korean War veteran addicted to morphine, examines secrecy, shame and family dynamics.

The production draws on moments from everyday life to show that no family is safe from addiction, director Brad Slavik said in an interview.

A sign outside the Missouri Network for Opiate Reform and Recovery advertises Narcan, a medication that can reverse an opioid overdose.
File photo |Carolina Hidalgo | St. Louis Public Radio

Updated at 3:45 p.m., Sept. 20, with comments from Surgeon General Jerome Adams — A nationwide campaign is needed to combat the opioid abuse epidemic that has damaged many families and communities, U.S. Surgeon General Jerome Adams said Thursday.

Adams and officials from the U.S. Health and Human Services department visited the St. Louis region to discuss the challenges communities face in dealing with opioid addiction. To address the crisis, Health and Human Services officials announced this week that the federal government will give states $1 billion to fight opioid addiction, including $44 million to Illinois and $29 million to Missouri.

From left, Nigel Darvell and Charles Whitehead discussed video-gaming addiction on Friday’s "St. Louis on the Air."
Caitlin Lally | St. Louis Public Radio

The World Health Organization recently announced that digital gaming can be addictive. The type of addiction falls under gaming disorder, which is “characterized by impaired control over gaming … to the extent that gaming takes precedence over other interests and daily activities … despite the occurrence of negative consequences.”

Rici Hoffarth | St. Louis Public Radio

St. Louis health officials want to add addiction treatment to the region’s health program for low-income people without insurance.

The Missouri Department of Health and Senior Services has asked the federal Centers for Medicare and Medicaid Services to add anti-addiction drugs and services to the Gateway to Better Health program.

St. Louis County Health Director Faisal Khan, left, and County Executive Steve Stenger declare a public health emergency due to the opioid crisis at a press conference Thursday in Berkley.
Sarah Fentem | St. Louis Public Radio

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.

A capsule of pills.
FDA | file photo

Last year, frustrated with a lack of commitment from state legislators, St. Louis County created its own prescription-drug monitoring program with the specific expectation other areas of the state could join in – and they have.

airpix | Flickr

The words “Alcoholics Anonymous” are synonymous with addiction treatment, but the people behind an alternative therapy hope that those dealing with addiction know there are other forms of treatment out there.

Arthur Shenker, a St. Louis-based facilitator who was at one time addicted to cocaine, and Dr. Joseph Gerstein, the founder and president of SMART Recovery, joined St. Louis on the Air on Thursday to discuss their program’s approach to treating addiction with cognitive behavioral therapy.

Rici Hoffarth | St. Louis Public Radio

The state of Missouri filed suit Wednesday against three major drug companies, alleging they fueled the nation’s opioid epidemic with a campaign of false advertising and fake claims.

On the steps of St. Louis Circuit Court, Missouri Attorney General Josh Hawley said he would seek “hundreds of millions of dollars” in damages against Purdue Pharma L.P., Endo Pharmaceuticals Inc., and Janssen Pharmaceuticals Inc., a subsidiary of Johnson & Johnson.

Lethal doeses of heroin, left, and fentanyl, right. Fentanyl, a synthetic opioid painkiller, is up to 50 times more potent than heroin.
provided by the New Hampshire State Police Forensic Lab

Fentanyl, a synthetic opioid painkiller, made up almost half of drug overdose deaths in parts of the St. Louis region last year, according to county coroners in Missouri and Illinois.

The drug is up to 50 times more powerful than heroin, and inhaling just a few grains can be lethal.

“If I can be blunt, it’s scary as hell,” said Brandon Costerison, a spokesperson for the anti-addiction group NCADA's St. Louis chapter. “And we don’t really have anything to indicate it’s subsiding yet.”

St. Louis County Officer David Meyer tests pushing the Narcan nasal syringe hard enough to create mist instead of dribbling out.
File Photo | Camille Phillips | St. Louis Public Radio

The St. Louis-based agencies coordinating Missouri’s federal grant to prevent opioid overdose deaths are training their first batch of first responders Monday afternoon.

Officers and EMTs from the Warrenton and Wright City fire protection districts and the Eureka, St. Charles City, Marthasville and Columbia police departments will be taught how to administer the overdose antidote, naloxone, before collecting a supply of the life-saving drug to bring back to their jurisdictions.

St. Louis County Police Officer Kathy Poncin practices administering Narcan Thursday, Feb. 18, 2016 while emergency physician David Tan looks on.
Camille Phillips | St. Louis Public Radio file photo

Federal dollars for the prevention of overdose deaths caused by opioids such as heroin and prescription painkillers are being sent to St. Louis area counties in both Missouri and Illinois.

Each state also received one additional federal grant aimed at fighting the national opioid crisis. One will help the Missouri Department of Health better track opioid overdoses. The other will increase access to medication-assisted addiction treatment in Illinois, but the Metro East won’t benefit from that grant.

Kelly Moffitt | St. Louis Public Radio

In U.S. medical schools, a total of nine hours is required in pain management training for doctors. That’s 0.3% of total time in medical school and, to compare, veterinarian schools spend more than 500x more time spent learning to treat pain in animals.

That’s according to a study conducted by Johns Hopkins in 2011 and cited by Dr. Michael Bottros, the director of acute pain service at Barnes-Jewish Hospital.

U.S. Sen. Roy Blunt meets with people Feb. 20 at Washington University's Alzheimer's Research Center in St. Louis.
Jason Rosenbaum | St. Louis Public Radio | file photo

The U.S. senators representing Missouri and Illinois are playing an active role in congressional efforts to combat the opioid epidemic.

Roy Blunt, R-Mo., Claire McCaskill, D-Mo., Dick Durbin, D-Ill. and Mark Kirk, R-Ill., all voted for the popular Comprehensive Addiction Recovery Act known as CARA.

e-MagineArt.com | Flickr

Updated May 31 with bill signing — St. Louis Mayor Francis Slay went to St. Louis County today to sign the bill setting up the city's Prescription Drug Monitoring Program. The bill allows the city and county to work together to form a cohesive system. The mayor and county Executive Steve Stenger are pledging to bring down drug overdoses.

Probuphine works by implanting four bars like this under the skin of the upper arm. The bars release a dose of the opioid addiction medicine buprenorphine for six months.
Braeburn Pharmaceuticals | provided

Updated May 27 with FDA decision and new pricing details — The Food and Drug Administration approved Thursday the buprenorphine implant Probuphine for use treating addictions to prescription painkillers and heroin.

The implant received a lot of attention in the addiction medicine field in anticipation of its approval as a potential game changer in the fight against opioid addiction. It could also have a $5,000 plus price tag every six months.

Michael Velardo | Flickr

Lawmakers, prosecutors, and first responders are hoping that two bills introduced Friday at the St. Louis Board of Aldermen will help control the region's opioid addiction crisis.

The first bill, sponsored by aldermen Lyda Krewson, D-28th Ward, Cara Spencer, D-20th Ward, Dionne Flowers, D-2nd Ward, and Megan-Ellyia Green, D-15 Ward, would set up a prescription drug monitoring program similar to one in place in St. Louis County. The second, which is sponsored by Spencer and Krewson, is a "good Samaritan" bill intended to convince more people to call 911 when people overdose.

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