A Dangerous Intersection: Drug Overdose Deaths Surpass Motor Vehicle Fatalities in Missouri
In 2010, drug overdoses surpassed motor vehicle accidents as a cause of death in Missouri. The highway and vehicle safety lessons learned throughout the last half century can provide a structure for addressing the drug- and opioid-induced spike in deaths contributing to the recent decrease in average life expectancy nationwide, according to a new fact sheet from the Missouri Hospital Association.
“Improvements in roadway design and maintenance, driver education, licensing and vehicle inspection, and additional safety equipment, like seat belts in cars, have significantly increased the safety of driving since they were adopted in the 1960s,” said Herb B. Kuhn, MHA President and CEO. “Similarly, strategic and system wide investments in public health and safety, with strong partnerships between government, providers and community partners, could help reduce the skyrocketing rate of drug-related deaths in Missouri and nationwide.”
The average life expectancy in the U.S. decreased for the second consecutive year in 2016, an unprecedented occurrence in a developed nation. At 77.6 years, life expectancy in Missouri is the 12th lowest in the nation. This decrease has been attributed to drug overdoses.
In 2016, 63,600 Americans suffered a drug-induced death, a 21 percent increase over the previous year and a 300 percent increase since 1999. With more than 1,400 drug overdose deaths in 2016, Missouri was among the states with a statistically higher overdose death rate than the rest of the nation.
“Missouri remains the only state in the nation without a traditional, statewide prescription drug monitoring program,” Kuhn said. “A PDMP can act like a traffic signal for physicians on the front line of care, providing a real-time indication of patient behavior or abuse risk. Without a PDMP, patients and health care providers meet at a dangerous intersection without a stop sign or signals.”
The intersection of drug and vehicle related deaths also is visible at the county level in Missouri. Between 2014 and 2016, there were 29 counties in Missouri with more drug overdose deaths than those caused by motor vehicles. These counties accounting for 70 percent of Missouri’s population, include nine out of the 10 most populous counties, and include Pulaski County, home to many veterans and active service members.
“More than two-thirds of drug-induced deaths are from opioids,” Kuhn said. “Progress toward a PDMP should focus on real-time data available at the point of care. However, a much more robust strategy will be necessary to address the opioid epidemic, including public safety messaging, community engagement, changes in product design and delivery, and improved systems to treat those affected in every setting.”
There has been progress in Missouri. The St. Louis County PDMP is active and covers approximately 80 percent of Missourians. Clinicians, including emergency department physicians, are implementing new opioid prescribing practices. Community-based drug take back programs are increasingly available. In addition, under new state laws enacted in 2017, naloxone, a drug that can reverse an overdose quickly, is now widely available, and fear of criminal consequence for assisting a victim of an overdose has decreased. Further, Gov. Eric Greitens and his leadership team have traversed the state, holding stakeholder meetings to improve community engagement. However, limited treatment options for drug-dependent individuals are available.
“A broad policy would include activities currently underway, in concert with expanded medication-assisted treatment and care for newborns, youths, adults and the elderly,” Kuhn said. “Seatbelts and signals alone didn’t create safer highways. Reducing the death toll required investments throughout the system focusing on the driver, vehicle and highway. That’s the type of public health and safety effort that will be necessary to reduce the high cost of drug-induced death in Missouri and nationally.”