Blog Behavioral/Mental Health

Missouri’s opioid crisis: A complex puzzle

Written by Celia Zhou, undergraduate student at Wake Forest University and participant in the Institute for Public Health Summer Research Program

Dr. Rachel Winograd—assistant research professor at the Missouri Institute of Mental Health at the University of Missouri – St. Louis who gave a presentation in the Summer Research Program Seminar Series—believes that addressing addition and preventing opioid-related deaths is a complex puzzle. There are no easy answers as to why some individuals become addicted and others do not. Genetics, childhood trauma, sexual abuse, poverty, cycles of incarcerations, and numerous other factors are all interconnected with opioid use.

The state of Missouri was recently ranked in the top 20 of all states for the number of opioid-related deaths, and the eastern region of the state, which includes the City of St. Louis and five surrounding counties, is accountable for 70% of these deaths. However, most of these deaths are from heroin and/or fentanyl overdose rather than prescription drug misuse, Dr. Winograd emphasized.

Missouri’s MO-HOPE Project is currently tackling the opioid crisis through four main strategies: prevention, treatment, harm reduction, and recovery. Nonetheless, Dr. Winograd believes there are additional steps the community can take to support individuals with addictions. According to Dr. Winograd, our systems of care must first change from an acute care model to a chronic care model. Individuals should be allowed to have access to treatment for as long as they need; society should not define an individual’s process of recovery. Furthermore, Dr. Winograd believes that the community must continue laying a foundation that will keep people alive. This includes saturation of naloxone, a drug commonly administered in cases of narcotic overdoses, in specific neighborhoods as well as expanded access to medical care for all. Vilifying individuals who sell drugs and placing direct blame on current users is not effective. Instead, community members should be mindful of unintended consequences that may occur, yet optimistic of progress being made, as interventions to reduce the number of opioid-related deaths are established.

To learn more about the MO-HOPE Project, visit