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St. Louis County plans to use opioid settlement to update medical examiner’s office

Dr. Sam Page, St. Louis County Executive, gives a public update on rental assistance during the COVID-1 pandemic on Wednesday, Sept. 29, 2021, at the St. Louis County Government building in Clayton, Mo.
File Photo/Brian Munoz
St. Louis Public Radio
St. Louis County Executive Sam Page, shown in 2021, said he wants to use the county's cut of a huge statewide settlement with opioid companies for treatment, job training and an updated medical examiner's office.

St. Louis County officials want to use their share of a statewide opioid settlement to upgrade an outdated medical examiner’s office and provide job training to people in recovery.

Missouri Attorney General Eric Schmitt announced the finalized $458 million settlement in February. St. Louis County is to receive $45 million from the settlement with drugmakers and manufacturers, which will be paid out over more than a decade.

All Missouri counties signed onto the settlement with opioid manufacturers and distributors. In return, the counties agreed to drop lawsuits that claimed the companies played down the addictive nature of opioid painkillers.

Many people became addicted to opioids through use of prescription drugs, the lawsuits said. Once addicted, they turn to street drugs like heroin and its dangerous and potent analog, fentanyl.

As a result, the number of fatal drug overdoses has increased in St. Louis County for years. Last year, 343 people died of opioid overdoses in the county, matching the total of the year before, Page said.

There are so many overdose victims, there’s often not enough room for bodies at the medical examiner’s office, he said.

“Chronic shortages of space means the bodies of individuals are being stacked on top of each other,” Page said. “This is not a dignified way to handle the bodies of loved ones.”

The money could buy more space and pay for more employees at the medical examiner’s office, Page said. Not only is the building too small, it is outdated, he said. Often people who arrive to identify bodies need to share a lobby space with other families or delivery drivers.

Page also wants to use the settlement funds for job training and medication-assisted treatment for addicted people.

“Our community and our country has not prioritized mental health services and substance abuse treatment programs like it should have,” Page said. “We have to make a decision as community whether to put resources into that programming in making this more readily available.”

Expanding the medical examiner’s office is a pressing need, said Liz Chiarello, an associate professor at St. Louis University who studies opioids.

The description of the office is “horrifying and heart-wrenching,” she said. But often governments treat the symptoms of the opioid crisis — like overdoses — instead of preventing them to begin with, she said.

“I’m not opposed to using some funds that way,” she said. “But let’s stop having bodies in the medical examiner’s office, let’s keep them alive.”

Officials need to emphasize prevention and medication-assisted treatment, Chiarello said.

“One of the biggest challenges with the opioid overdose crisis is that we have these immediate pressing needs, but we also have to be able to think long-term and comprehensively about how we get ourselves out of this crisis,” she said.

Governments should use money to fund initiatives that help drug users use safely as well as funding recovery programs that use medications to treat addiction, Chiarello said.

Officials can distribute clean syringes, fentanyl test strips and overdose-reversal drugs to keep people from dying, she said.

Follow Sarah on Twitter:@petit_smudge

Sarah Fentem is the health reporter at St. Louis Public Radio.