Revised March 2019
Opioid-Related Overdose Deaths
In 2017, there were 952 overdose deaths involving opioids in Missouri—a rate of 4.1 deaths per 100,000 persons and one-third the national rate of 14.6 deaths per 100,000 persons. The greatest increase in opioid deaths occurred among cases involving synthetic opioids (mainly fentanyl), with an elevenfold increase from 56 deaths in 2012 to 618 in 2017 (Figure 1). Heroin involved deaths and those related to prescription opioids have remained steady in recent years.
Opioid Pain Reliever Prescriptions
In 2017, Missouri providers wrote 71.8 opioid prescriptions for every 100 persons (Figure 2) compared to the average U.S. rate of 58.7 prescriptions for every 100 persons. Overall, this represents a less than 10 percent decline in Missouri opioid prescriptions since 2006 (CDC).
The rate of overdose deaths involving opioid prescriptions has followed this trend with overall rates unchanged in the last decade: 4.3 to 4.1 from 2007 to 2017(Figure 2).
Neonatal Abstinence Syndrome (NAS)
NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. A recent national study revealed a fivefold increase in the incidence of NAS/NOWS between 2004 and 2014, from 1.5 cases per 1,000 hospital births to 8.0 cases per 1,000 hospital births. This is the equivalent of one baby born with symptoms of NAS/NOWS every 15 minutes in the United States. During the same period, hospital costs for NAS/NOW births increased from $91 million to $563 million, after adjusting for inflation (Figure 3).
In 2016, there were 2,112 reported cases of NAS/NOWS in Missouri (Missouri Department of Health and Senior Services).
HIV Prevalence and HIV Diagnoses Attributed to Injection Drug Use (IDU)
- U.S. Incidence: In 2016, 9 percent (3,480) of the 39,589 new diagnoses of HIV in the United States were attributed to IDU. Among new cases, 6.3 percent (2,530) were transmitted via IDU or male-to-male contact and IDU among men, and 2.3 percent (950) were transmitted via IDU among women (CDC).
- U.S. Prevalence: In 2016, 991,447 Americans were living with a diagnosed HIV infection—a rate of 306.6 cases per 100,000 persons. Among males, 19.9 percent (150,4661) contracted HIV from IDU or male-to-male contact and IDU while 21 percent (50,154) of females were living with HIV attributed to IDU (CDC).
- State Incidence: Of the new HIV cases in 2016, 511 occurred in Missouri. Among males, 6.6 percent of new HIV cases were attributed to IDU or male-to-male contact and IDU. Among females, 12.2 percent of new HIV cases were attributed to IDU (Figure 4) (AIDSVu).
- State Prevalence: In 2015, an estimated 11,887 persons were living with a diagnosed HIV infection in Missouri—a rate of 234 cases per 100,000 persons. Of those, 13.4 percent of male cases were attributed to IDU or male-to-male contact and IDU. Among females, 16.3 percent were living with HIV attributed to IDU (AIDSVu).
Hepatitis C (HCV) Prevalence and HCV Diagnoses Attributed to Injection Drug Use1
- U.S. Incidence: In 2016, there were an estimated 41,200 new cases of acute HCV2 (CDC). Among case reports that contain information about IDU, 68.6 percent indicated use of injection drugs (CDC).
- U.S. Prevalence: An estimated 2.4 million Americans are living with HCV based on 2013-2016 annual averages (CDC).
- State Incidence: There were approximately 24 new cases of acute HCV (0.4 per 100,000 persons) reported in Missouri in 2016 (CDC).
- State Prevalence: In Missouri, there are an estimated 41,000 persons living with Hepatitis C (2013-2016 annual average), a rate of 880 cases per 100,000 persons (HepVu).
- Not all states collect or report data on the incidence or prevalence of Hepatitis C or on how Hepatitis C is transmitted. When available, the data will be included.
- Actual acute cases are estimated to be 13.9 times the number of reported cases in any year.
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New Opioid Overdose Materials for Patients
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