St. Louis County is the largest county in Missouri. It’s located on the Eastern edge of the state, bordering the Mississippi River and Illinois. Its population demographics are as follows: 62% White, 24% Black/African American, 5% Asian, 4% Latinx.

According to the St. Louis County Medical Examiner’s Office, there were 1,797 substance-related deaths from 2019-2022. About 70% of those were opioid-related fatalities and Fentanyl was involved in 93% of those deaths. For each fatal opioid overdose, there are three emergency room encounters of non-fatal opioid overdoses. The opioid epidemic in St. Louis County is also increasingly affecting Black men at a disproportionate rate. In 2022, the age-adjusted opioid overdose mortality rate was 99.0 per 100,000 for Black men, compared to 35.8 per 100,000 for White men.

Medication assisted treatment (MAT) is currently offered at the St. Louis County jail through induction and maintenance. However, they only induct individuals on MAT prior to release, not at intake. St. Louis County also uses all three FDA approved medications for opioid use disorder (MOUD). In addition to medication, the jail also offers therapeutic treatment including Narcotics Anonymous and the Choices Program, a 90-day in-patient treatment program housed within the jail.

Despite the services the county jail currently offers, there has still been an increase in substance-involved deaths in recent years. St. Louis County seeks to expand their MAT program, specifically to address the disproportionate share of tragedy that the epidemic has had on minority communities. This expansion is needed both in the jail setting and post-release to address the barriers individuals have in their continuity of care.