Health Care

Missouri and Kansas record more drug overdose deaths even as they decline nationwide

New federal data shows drug overdose deaths declining nationally for the first time in decades — but continuing to rise in Kansas and Missouri.

Health officials have hailed the Centers for Disease Control’s preliminary data for 2018 as a rare bit of positive news, with drug-related deaths declining about 5% after reaching a historic high of 72,000 in 2017. It would be the first year-over-year decrease since 1990, before the opioid epidemic ramped up.

But even as most states are projected to show decreases when death reports are finalized, Kansas and Missouri are among those that are not.

Kansas’ overdose deaths are projected to rise about 4.6% from 326 in 2017 to 341 in 2018. Missouri’s projected hike of 16.3 percent (from 1,406 to 1,635) is second only to Delaware’s 16.7%.

Randall Williams, the director of the Missouri Department of Health and Senior Services, said more than 1,100 of the state’s overdose deaths in 2018 involved opioids and about half of them occurred in the St. Louis area.

“What we are dealing with in Missouri is an increased presence of (highly concentrated opioids like) fentanyl and carfentanil which presents an even greater risk for opioid overdose,” Williams said. “We will continue to concentrate on upstream approaches toward prevention of opioid misuse while simultaneously instituting new measures that will prevent fentanyl overdoses.”

Williams said he signed orders this month to further expand Missourians’ access to naloxone, a rescue drug that can stop opioid overdoses in their tracks. Missourians can already buy it at pharmacies without a prescription under a standing order Williams signed in 2017, but the medication will now be provided free to high schools, colleges, YMCAs and libraries through a grant program.

Williams said the department has also developed a mobile “Community Resource Response Team” in St. Louis to follow up with overdose survivors after they’ve been stabilized and try to connect them with treatment programs.

The unit responded to 210 calls in June alone.

In Kansas, Sedgwick and Johnson counties led the state in total drug overdose deaths from 2015 through 2017, according to the Robert Wood Johnson Foundation’s county health rankings. But the counties with the highest overdose death rates per capita were Saline (central Kansas), Labette (southeast Kansas) and Cowley (south-central Kansas).

In Missouri, Jackson County was third behind St. Louis and St. Louis County in total overdose deaths, but not even in the top 30 in per capita deaths.

Kansas officials have also taken steps to address the problem, including a drug abuse task force convened by former Gov. Jeff Colyer that issued an 80-page report last year. That group found that more than 80% of overdoses in Kansas from 2012 to 2016 involved a prescription medication and one-third of overdose deaths involved methamphetamines.

Kansas officials also enacted a standing order allowing people to access naloxone without a prescription in 2017.

But 33 other states already had such orders by that point. Kansas and Missouri’s late adoption may explain why both are now lagging behind other states in reducing overdose deaths, as widespread use of naloxone is widely credited with helping drive the 5% decrease nationally.

Missouri is also the only state without a prescription drug monitoring program that allows doctors and pharmacists to see if their patients are shopping around for drugs from multiple places.

Margaux Guignon, director of prevention services for First Call KC, said that could have a spillover effect in Kansas as well.

“We’re so close to Kansas, people can just cross state lines and if they’re getting prescription drugs over here there’s no way to track it,” said Guignon, whose group provides addiction prevention, education and treatment services.

Guignon said data also shows that Missouri doctors are writing fewer opioid prescriptions, but she fears that’s driving more people who are already addicted to try more dangerous drugs that they get on the street.

“They’re using fentanyl and I think that’s because we’re trying to cut back on drug prescriptions, and then what are they going to do?” Guignon said. “We have (addiction treatment) resources in our area but not enough. I believe that we need more treatment.”

According to the CDC data, 36 states had reductions in overdose deaths in 2018, led by Alaska at 26%.

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Kansas City Star health reporter Andy Marso was part of a Pulitzer Prize-finalist team at The Star and previously won state and regional awards at the Topeka Capital-Journal and Kansas Health Institute News Service. He has written two books, including one about his near-fatal bout with meningitis.