In 2016, there were approximately 63,000 deaths nationally due to drug overdose. This trend continues to increase with the provisional number of US deaths for 2017 being approximately 72,000 (1). This increase in overdose deaths is fueled largely by the opioid class of drugs. The opioid epidemic began in the 1990s with a steady rise in prescription opioid overdoses. However, after 2010 a rise in heroin overdose deaths also began to occur. In addition to the heroin deaths increasing, there was a sharp rise in overdose deaths due to synthetic opioids including illicitly manufactured fentanyl beginning in 2013 (2). In Missouri, ER visits follow similar trends with heroin overdose visits greatly increasing after 2011. While PDMPs help function as data sources that provide information on the licit drug supply, they cannot give much knowledge on the illicit supply. Because of this, drug seizure data from law enforcement can provide a much-needed tool in understanding the supply of illicit substances and their impact on a county's morbidity.
Objective: To evaluate the relationship between heroin and non-heroin opioid seizures reported by law enforcement and the number of ER visits due to heroin and non-heroin opioid poisoning in selected counties in Missouri.