Since 2016, Missouri has received more than $65 million in federal grants to provide treatment and recovery services to people addicted to opioids.
The money has provided thousands of people with addiction medication, counseling and residential services. But the latest grant cycle expires in September 2020, and addiction treatment providers are uncertain if Congress will approve funding after that. With Missouri’s opioid-related death toll rising each year, advocates say funding for medical treatment is more important than ever.
“We’ve realized we’re really short of funds for that,” said Percy Menzies, founder and president of Assisted Recovery Centers of America in St. Louis. “I don’t know what the future looks like, but we are very concerned. Just as the need is growing, there are rumors we hear that the funding may be cut.”
In 2016, then-President Barack Obama approved the first round of grant funding. Unlike other federal grants for opioid use, the State Targeted Response funds went directly to providers specializing in addiction treatment rather than to primary care clinics and community health centers.
Another round of funding under President Donald Trump put $45 million into Missouri's coffers. In addition to providing money to the state’s treatment centers, the State Opioid Response grants help fund educational programs and distribution of naloxone, which reverses opioid overdoses.
The grants are set to run out just as Missouri’s overdose crisis reaches new heights. More than 1,600 people died of drug poisoning in 2018. That's a 16% increase from the year before. But that trend runs counter to what is happening in the rest of the country. Last month, the Centers for Disease Control and Prevention reported overdose deaths nationally had fallen for the first time in decades that year. Only Delaware outpaced Missouri for an annual increase in overdose fatalities.
“I wish I had a crystal ball, but I think a lot of people are holding their breath,” said Rachel Winograd, an associate professor at the University of Missouri-St. Louis who helps the state Department of Mental Health distribute the grants to treatment centers. “I think it would be a travesty and a huge oversight if funding were to stop. That said, we don’t have a guarantee.”
Lawmakers allocated $20 million in State Targeted Response grants to Missouri in 2016. Menzies said at the time that seemed like an enormous amount of money.
“We thought, 'Oh my goodness, what are we going to do with this money?' We have always scraped the bottom,” he said. “Once we started offering services, we realized that money was woefully inadequate.”
His center is the largest medication-assisted treatment provider in the state, he said. ARCA has 18 medical providers and sees more than 2,100 patients a month.
Addiction treatment is more than medication, Menzies said. To treat it, providers need to offer transportation, counseling services and, sometimes, residential inpatient therapy. The approximately $3 million ARCA receives from the federal grants makes up about half its operating budget, he said.
“We may have to come to a point where we say, ‘Sorry, we have only limited funds, we can’t afford to treat you.' And that would be a tragedy,” Menzies said.
Even if the money is renewed, the year-to-year uncertainty of using annual grants to fund addiction treatment isn’t ideal, Winograd said.
“It has this chilling effect; it just breeds insecurity," she said. “It prevents them from investing in sustainable system changes that we know are needed and we know will work.”
Some members of Congress proposed more funding to treat addiction before the House and Senate left for summer recess.
Sen. Roy Blunt, R-Mo., has supported the State Opioid Response grants as chairman of an Appropriations subcommittee.
Congress returns from recess in mid-September.
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