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Opioids in Missouri

April 11, 2021
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WRITTEN BY Dr. Joshua Mueller

Opioids (e.g., heroin, fentanyl, oxycodone, etc.) are drugs that activate opioid receptors in the brain and body. Activation of these receptors suppresses pain, so opioids are often prescribed in a medical context (e.g., following surgery, or to manage chronic pain). Abuse of prescription opioids and recreational opioids such as heroin and fentanyl has dramatically increased nationwide since 1999, leading to high rates of opioid-related overdoses and deaths. In Missouri, 1.8% of deaths were the result of an opioid overdose in 2018. State-level policies such as naloxone access laws and mandatory prescription drug monitoring programs have been shown to decrease opioid-related overdose deaths overall, but may lead some opioid users to seek deadlier illicit opioids such as fentanyl. HCR 6 would designate September of each year as "Opioid and Heroin Awareness Month" in recognition of the dangers and costs of the abuse epidemic in the state of Missouri.


  • The amount of opioids prescribed has increased threefold nationally, and opioid-related overdose deaths have increased sixfold nationwide and in Missouri since 1999.
  • Illicit recreational opioids such as heroin and fentanyl account for the largest increase in opioid-related deaths over the past decade.
  • Policies such as naloxone access laws and prescription drug monitoring programs decrease opioid-related deaths.
  • Some policies that decrease prescription opioid access may cause some opioid users to seek alternatives such as heroin and fentanyl. Policies that make opioid use safer may also lead some opioid users to increase their substance use.


  • There are few high-quality studies assessing the effectiveness and safety of long-term (>1 year) opioid use for pain management.
  • Several opioid policies, including pill mill laws, have been enacted fairly recently, so studies of their effects on opioid overdose deaths may not yet have enough data to be conclusive.
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