Prescription opioid abuse is a national epidemic, but St. Louisans have reason to be especially concerned. “We, in St. Louis, are one of the worst cities for opiates,” says psychiatrist and addiction specialist Dr. Arturo Taca. “[And] when prescription painkillers become harder to get a hold of, people switch to heroin for a faster, cheaper high.”
With a high demand, a high supply will follow, and a number of factors make St. Louis an attractive hub for drug dealers. “Strategically, St. Louis is a great place to distribute,” notes Taca. “We are right in the middle of the country. We’re small enough to not have as many resources as other cities to stop the issue. If I were a drug dealer, I would think, ‘I could get away with this.’”
What was once viewed as a strictly inner city problem has hit the suburbs—affecting all kinds of people throughout the bistate area. “I see lawyers, doctors, [all kinds of] professionals for addiction treatment, and young teens who start using their parents’ pills,” says Taca. “The problem is all over. You can throw a rock in any direction in St. Louis and find an opioid dealer.”
Unlike Washington University School of Medicine professor and researcher Dr. Theodore Cicero, who considers marijuana a viable solution, Taca believes introducing medical cannabis would have the opposite effect.
“So far, we are far from encouraging prescription writing marijuana for these conditions. In the same states that have legal cannabis, we are seeing a ton of psychosis, intoxication. Medical cannabis would cause more problems than help at this point.”
Even though opioid abuse, accompanied by an increase in heroin use, is a challenging public health crisis, there are preventive measures that could lower the rates of opiate addiction and overdose.
And prevention begins with regulation. “Fixing this epidemic has to start with the physicians and the medical system. There are parts of it that are broken,” says Taca, “We need physicians who are trained in addiction and more toxicology tests to see if people are taking their medicine on a regular basis.”
Taca further states that the market for competing opiate antagonists, drugs that block opioid receptors in addicts, is unevenly distributed, making it harder for smaller companies to excel. “Companies like Vivitrol have the ability to help a lot of people, but they make maybe $100 million annually, while larger companies like Pfizer are making $2 billion quarterly.”
One essential preventive measure that both Cicero and Taco stress is to establish a prescription drug monitoring system in Missouri. “We are the only state to not have an electronic monitoring database,” says Taca. “That would exceedingly cut back on doctor shopping and prescription overdoses.”
Cicero adds, “It’s embarrassing we don’t already have one.”