Missouri Drug and Alcohol Statistics - World Forum for Mental Health

Statistical Data on Drugs in Missouri

Missouri faces a significant substance abuse crisis that impacts individuals across all demographics, age groups, and geographic regions. This comprehensive statistical overview consolidates available data on drug overdose deaths, treatment accessibility, substance use patterns, and demographic trends. The state’s overdose death rate consistently exceeds the national average, with opioids—particularly fentanyl—driving the majority of fatal overdoses. While treatment facilities serve nearly 20,000 clients annually, a substantial gap exists between those needing treatment and those receiving it. The following statistics provide a detailed picture of Missouri’s drug landscape, highlighting both the severity of the crisis and opportunities for intervention.

Overdose Deaths: Trends And Patterns

General Drug Overdose Data

1,583 overdose deaths per year (baseline data)
2.51% of all deaths are from drug overdose
26.9 deaths per 100,000 residents – this rate is 29.95% higher than the national average
2.25% of nationwide overdose deaths occur in Missouri
Overdose deaths increased at an annual rate of 4.84% over a 3-year period

Missouri Drug Overdose Data

Missouri’s overdose death rate significantly exceeds the national average, indicating a more severe drug crisis than much of the country.

Annual Death Toll Progression

Year	Total Deaths	Change from Previous Year	Death Rate (per 100,000)
2011	—	—	16.4
2019	1,581	—	—
2020	1,878	—	—
2021	2,128	+13%	36.5
2022	2,178	+2.3%	—
Nov 2022-Nov 2023	2,000+	—	—

Missouri experienced dramatic increases in overdose deaths, with the rate more than doubling from 2011 to 2021.

2021 Regional Changes

Region	2020 Deaths	2021 Deaths	% Change	2021 Death Rate (per 100,000)
Central Region	183	211	+15%	29.1
Kansas City Metro	268	362	+35%	28.8
Northeastern Region	31	46	+48%	18.5
Northwestern Region	38	51	+34%	21.5
Southeastern Region	134	149	+11%	26.2
Southwestern Region	203	277	+37%	29.3
St. Louis Metro	1,021	1,030	+1%	48.0
MISSOURI TOTAL	1,878	2,128	+13%	—

The Northeastern Region experienced the most dramatic proportional increase, while St. Louis Metro maintained the highest absolute death rate.

Opioid-Specific Overdose Data

Opioid Death Statistics

1,132 people die from opioid overdose annually (baseline data)
1,582 opioid overdose deaths in 2021
73% of all overdose deaths involve opioids
19.6 deaths per 100,000 residents – this is 34.2% above the national death rate
Opioid overdose death rate increased from 10.2 per 100,000 (2011) to 27.1 per 100,000 (2021) in Missouri

Opioid Contributors

76.7% of opioid deaths involve synthetic opioids (primarily fentanyl)
67% of all overdose deaths in 2022 involved fentanyl (second consecutive year)
31% of opioid deaths involve heroin
23.4% of opioid deaths involve prescription opioids

Fentanyl has become the dominant driver of opioid deaths, involved in two-thirds of all overdoses.

Health Impacts

0.52% of hospital births involve neonatal opioid withdrawal syndrome
40,300 cases of hepatitis C attributed to intravenous drug use
12,308 cases of HIV/AIDS attributed to intravenous drug use
Doctors write enough opioid prescriptions for 63.4% of residents to have one (national average: 51.4%)

Missouri’s prescription rate significantly exceeds the national average, though these rates have been declining.

Stimulant-Involved Deaths

Stimulant Death Trends

Region	Stimulant 2020	Stimulant 2021	Change
Central	83	88	+6%
Kansas City Metro	120	173	+44%
Northeastern	15	25	+67%
Northwestern	16	25	+56%
Southeastern	47	52	+11%
Southwestern	95	137	+44%
St. Louis Metro	362	414	+14%
MISSOURI TOTAL	738	914	+24%

Stimulant-involved deaths increased 24% statewide in 2021, with the proportion of overdose deaths involving stimulants (alone or with opioids) continuing to rise.

Combined Opioid and Stimulant Deaths

Region	Combined 2020	Combined 2021	Change
Central	59	55	-7%
Kansas City Metro	45	72	+60%
Northeastern	5	17	+240%
Northwestern	9	14	+56%
Southeastern	23	24	+4%
Southwestern	46	78	+70%
St. Louis Metro	284	334	+18%
MISSOURI TOTAL	471	594	+26%

Deaths involving both opioids and stimulants increased 26% in 2021, with the Northeastern Region experiencing a 240% surge.

Youth Substance Use (Ages 12-17)

Past-Month Illicit Drug Use

35,000 or 7.46% of 12-17-year-olds report using drugs in the last month
7.5% used illicit drugs in past month (2017-2019 average)
Missouri teenagers are 10.39% less likely to have used drugs than the average American teen
7.12% past-month illicit drug use in 2021

Missouri Youth Past Month Illicit Drug Use Statistics

Missouri youth demonstrate slightly lower drug use rates than the national average, though more than 1 in 14 adolescents reported recent drug use.

Youth Marijuana Use

Past-Month Use

5.9% of 12-17-year-olds (28,000 youth) used marijuana in past month (2017-2019)
7.14% in 2021 (35,000 youth)
77.14% of youth drug users report marijuana as their substance

Past-Year Use

10.19% (50,000 youth) in 2021
11.30% of all 12-17-year-olds used marijuana in the past year
11.4% past-year use rate (2018-2019) – lowest on record

First-Time Use

4.1% (19,000 youth) used marijuana for first time in past year (2017-2019)
5.10% among those at risk in 2021
Doubled between 2000 and 2021
Average start age: 14.4 years (for those entering treatment)

Despite historically low past-year rates in 2018-2019, marijuana use among Missouri youth has been increasing, reversing a decade-long downward trend.

Youth Use of Other Substances

0.43% used cocaine in the past year
0.21% used methamphetamines
2.77% misuse pain relievers
1.84% used illicit drugs other than marijuana in past month (2021)

While rates are low, any youth use of hard drugs like cocaine, methamphetamine, and heroin represents serious concern given their high addiction potential and health risks.

Youth Substance Use Disorders

3.20% of 12-17-year-olds met criteria for illicit drug use disorder in past year
1.71% met criteria for alcohol use disorder in past year
15,000 adolescents had illicit drug use disorders (2018-2019)
17,500 young people ages 12-17 struggle with substance use disorder

Approximately 1 in 31 Missouri adolescents meets criteria for illicit drug use disorder, and 1 in 59 for alcohol use disorder

Young Adult Substance Use (Ages 18-25)

General Usage Patterns

204,000 adults aged 18-25 used drugs in the last month
8.16% less likely to use drugs than average American in same age group
25.18% used illicit drugs in past month (2021)
16.28% had drug use disorder (2021)
28.34% had substance use disorder of any type (2021)

Young adults face the highest substance use disorder prevalence of any age group at 28.34%—meaning more than 1 in 4 young adults struggles with addiction.

Marijuana Use (18-25)

32.6% (206,000) used marijuana in past year (2017-2019)
35.96% used marijuana in past year (2021)
25.97% used marijuana in past month (2021)
4.8% (31,000) had marijuana use disorder in past year (2017-2019)

Marijuana is extremely prevalent among young adults, with more than one-third using in the past year.

Opioid Use Disorder (18-25)

0.5% (3,000) had opioid use disorder in past year (2017-2019)
1.11% (7,000) in 2021
3,000 young adults were past-year heroin users (2018-2019)
7,000 young adults were past-year methamphetamine users (2018-2019)

The doubling of opioid use disorder between 2017-2019 and 2021 reflects the escalating opioid crisis among young adults.

Adult Substance Use (Ages 26+)

General Patterns (2021)

568,000 adults used illicit drugs in past month
13.94% past-month illicit drug use rate
2.90% used illicit drugs other than marijuana in past month

Marijuana Use (26+)

690,000 used marijuana in past year (2021)
16.94% past-year marijuana use rate (2021)
546,000 used in past month (2021)
13.40% past-month rate (2021)
302,000 adults over 25 were past-month marijuana users (2018-2019)

Other Substance Use (26+)

66,000 used cocaine in past year (1.62%)
23,000 used heroin in past year
11,000 adults over 25 were past-year heroin users (2018-2019)
37,000 adults over 25 were past-year methamphetamine users (2018-2019)
56,000 used methamphetamine in past year (2021)

Prescription Drug Misuse (26+)

149,000 misused prescription pain relievers in past year (2021)
3.66% prescription pain reliever misuse rate
177,000 adults misused prescription pain medications in past year (2018-2019)

Substance Use Disorders (26+, 2021)

365,000 had drug use disorder (8.96%)
85,000 had illicit drug use disorders (2018-2019)
682,000 had substance use disorder of any type (16.74%)
91,000 had opioid use disorder (2.24%)
81,000 had pain reliever use disorder (1.99%)

Opioid misuse among adults 26+ tripled from 2010 to 2021, reaching 2.24%. This age group comprises the majority of those with substance use disorders in absolute numbers and faces the highest opioid use disorder rates.

Substance Use Disorders: Prevalence Data

Overall Population (2018-2019 NSDUH)

7.4% of Missouri’s adolescent and adult population (358,000 people) had substance use disorders
2.9% (131,000 people) had illicit drug use disorder
0.5% (23,000 people) had pain reliever use disorder
Total count of 412,000 reflects overlap (some had multiple disorders)
Rates nearly identical to national averages

Nearly 1 in 14 Missourians struggles with a substance use disorder, representing a substantial public health burden.

2021 Detailed Prevalence by Age (Per 100,000 Population)

Drug Use Disorder

Ages 12+: 9.70% (503,000 people)
Ages 12-17: 7.52% (37,000)
Ages 18-25: 16.28% (101,000)
Ages 26+: 8.96% (365,000)

Opioid Use Disorder

Ages 12+: 1.98% (103,000 people)
Ages 12-17: 0.98% (5,000)
Ages 18-25: 1.11% (7,000)
Ages 26+: 2.24% (91,000)

Pain Reliever Use Disorder

Ages 12+: 1.78% (92,000 people)
Ages 12-17: 1.00% (5,000)
Ages 18-25: 1.04% (6,000)
Ages 26+: 1.99% (81,000)

Substance Use Disorder (All Types)

Ages 12+: 17.45% (904,000 people)
Ages 12-17: 9.46% (46,000)
Ages 18-25: 28.34% (176,000)
Ages 26+: 16.74% (682,000)

Young adults (18-25) face the highest substance use disorder rates, indicating this demographic requires targeted intervention.

Treatment Access and Statistics

Treatment Facilities and Capacity

293 active treatment facilities statewide
257 addiction treatment facilities in 2006 (number consistent since 2002)
67 facilities offered residential care (2006)
10 facilities offered opioid treatment (2006)
8 facilities offer free drug rehab treatment for all clients

Missouri Treatment Facilities and Capacity Statistics

The number of treatment facilities has remained relatively stagnant despite increasing overdose deaths.

Annual Treatment Statistics

19,996 clients serviced annually for drug rehab statewide
48,628 people entered drug and alcohol rehabs in 2009
20,000+ Missouri residents with illicit drug use disorders accessed DBH-supported treatment (FY 2020)
68.5% of treatment admissions were male, 31.5% female (2009)

A significant gender disparity exists in treatment access.

Treatment Gap

For every 10 people who fatally overdose, only 2 sought substance abuse treatment
130,000 residents needed treatment for drug use disorders but did not receive it at specialty facilities

A staggering treatment gap exists, with 80% of those who fatally overdose never accessing treatment.

Treatment by Setting

Outpatient Services

17,698 clients enroll annually in outpatient services
$30.26 million (1.31% of U.S. public total) spent on outpatient services
Average individual cost: $1,710

Residential (Non-Hospital) Services

1,956 clients enroll annually
$111 million (2.14% of U.S. public total) spent on residential treatment
Average individual cost: $56,782
Missouri ranks 29th for cheapest to most expensive state in residential treatment

Hospital Services

342 clients in Missouri hospitals for drug rehab

Emergency Room and Hospital Admissions

18,000+ Missouri residents entered emergency rooms primarily for drug use disorders (2018)
3,000 remained hospitalized after E.R. services
4,000 additional direct hospital admissions for drug-induced disorders

Missouri Emergency Room Statistics

The vast majority of treatment occurs in outpatient settings.

Medication-Assisted Therapy (MAT) for Opioids

Methadone (March 2019 single-day count)

3,552 people receiving methadone in opioid treatment programs
Increased from 3,083 people in 2015 (+15%)

Buprenorphine (March 2019 single-day count)

2,658 people receiving buprenorphine
Increased from 1,155 people in 2015 (+130%)

The dramatic 130% increase in buprenorphine access represents significant progress in evidence-based opioid treatment, though these numbers still represent a small fraction of those with opioid use disorders.

Treatment Need vs. Access (2021)

Illicit Drug Use

7.58% of population aged 12+ needed but did not receive treatment at specialty facilities (392,000 people)
Youth (12-17): 6.45% (31,000)
Young adults (18-25): 14.87% (92,000)
Adults (26+): 6.60% (269,000)

Any Substance Use

15.49% of population aged 12+ needed but did not receive treatment (803,000 people)
Youth (12-17): 8.61% (42,000)
Young adults (18-25): 25.92% (161,000)
Adults (26+): 14.72% (600,000)

The treatment gap is massive, with approximately 803,000 Missourians needing but not receiving substance use treatment.

Vulnerable Populations

Veterans

Approximately 543,000 veterans in Missouri
~28,444 veterans (almost 6%) struggle with substance use disorder
Primarily involving alcohol and opioids

Veterans face elevated substance use disorder rates compared to the general population.

Pregnant Women

~7,800 pregnant women struggle with alcohol or drug problems
Increases risk for babies born with neonatal abstinence syndrome
0.52% of hospital births involve neonatal opioid withdrawal syndrome

The substantial number of pregnant women with substance use issues creates intergenerational impacts, with infants born dependent on substances requiring intensive medical care and facing long-term developmental risks.

Justice-Involved Individuals

Over 50,000 on probation or parole
Frequently require SUD treatment
Lower recidivism among those completing treatment programs
630 drug-related arrests (2005)
36,665 arrests for possession of illicit drugs (2019)
3,033 arrests for manufacture/sales of drugs (2019)

Missouri Drug Justice Involved Individuals Statistics

The criminal justice system intersects heavily with substance use, with tens of thousands arrested annually for drug offenses.

Traffic Safety

1,251 traffic crashes involving drug-impaired drivers (2019)
75 deaths and 543 injuries from these crashes

Drug-impaired driving represents a significant public safety threat.

Comparative Statistics: Missouri Vs. National

Overdose Death Rates

Missouri 2021: 36.5 per 100,000
U.S. 2021: 32.4 per 100,000
Missouri rate is 29.95% higher than national average

Opioid Overdose Death Rates

Missouri 2021: 27.1 per 100,000
U.S. 2021: 24.7 per 100,000
Missouri rate is 34.2% higher than national average

Illicit Drug Use

Missouri: 7.7% past-month use
U.S.: 8.82% past-month use
Missouri: 2.99% used drugs other than marijuana
U.S.: 3.6% used drugs other than marijuana

Missouri Illicit Drug Use Statistics

Youth Drug Use (12-17)

Missouri teenagers 10.39% less likely to have used drugs than average American teen
Missouri: 7.5% past-month illicit drug use (2017-2019)
U.S.: 8.2% past-month illicit drug use (2017-2019)

Substance Use Disorders (18-25)

Missouri 2017-2019: 11.8%
Regional average: 14.6%
National average: 14.7%
Missouri rate is lower than both regional and national averages

Opioid Prescribing

Missouri: 63.4 prescriptions per 100 persons
U.S.: 51.4 prescriptions per 100 persons
Missouri is 23% higher than national average

Missouri presents a paradox: slightly lower drug use rates but significantly higher overdose death rates compared to national averages. This suggests Missouri drug users face more lethal substances (likely fentanyl-contaminated supplies) or have less access to harm reduction services like naloxone.

Final Words

Missouri’s drug crisis presents a severe public health emergency with overdose death rates nearly 30% above the national average, driven primarily by fentanyl-contaminated opioids and rising methamphetamine use. Despite slightly lower overall drug use rates than the nation, the lethality of Missouri’s drug supply combined with a massive treatment gap—803,000 residents needing but unable to access care—results in devastating mortality outcomes, particularly among young adults, Black men, and specific St. Louis Metro communities. The stagnant number of treatment facilities, coupled with alarming increases in polysubstance deaths involving both opioids and stimulants, demands urgent expansion of evidence-based treatment, harm reduction services, and targeted interventions in the highest-risk populations and geographic areas to reverse this deadly trend.

Statistical Data on Alcohol in Missouri

Alcohol abuse represents a significant and growing public health challenge in Missouri, contributing to nearly 3,000 deaths annually and billions of dollars in economic costs. While Missouri ranks in the middle nationally for excessive drinking rates (30th among states), the state has experienced alarming increases in alcohol-related harm. The crisis disproportionately affects young adults aged 18-25, who demonstrate the highest rates of alcohol use, binge drinking, and alcohol use disorders across all age groups. A staggering 95% of Missouri residents needing specialized alcohol treatment do not receive it, with approximately 505,000 individuals going without necessary care in 2021. This treatment gap, combined with rising disorder rates and the stable consumption patterns among adults over 25, highlights critical deficiencies in the state’s prevention, intervention, and treatment infrastructure for alcohol-related problems.

Alcohol-Attributable Deaths

Total deaths attributable to excessive alcohol use: 2,877
Deaths per capita (ages 18+): 1 per 2,139 people, or 6.02 per 10,000 adults
Under age 21: 107 deaths (3.72% of total)
Males: 70.5%
Adults aged 35+: 80.2%

Missouri Alcohol Attributable Deaths Statistics

Cause of Death

Chronic causes (e.g., Alcohol Use Disorder): 52.5%
Acute causes: 47.5%

Alcohol-Induced Deaths (2019)

Resident deaths: 606

Years of Potential Life Lost

CDC estimate (annual): 77,921 years
Under age 21: 6,111 years

Alcohol-related deaths have increased substantially in recent years, with a 50.4% increase in per-capita death rates between 2015 and 2019.

Overall Population Alcohol Use (Ages 12+, 2021)

Measure	Number	Percentage
Past-Month Alcohol Use	2,403,000	46.37%
Binge Alcohol Use (Past Month)	1,089,000	21.01%
Alcohol Use Disorder (Past Year)	527,000	10.16%
Needed but Did Not Receive Treatment	505,000	9.74%

Nearly half of Missouri residents aged 12 and older consumed alcohol in the past month in 2021, with approximately one in five engaging in binge drinking.

Youth Alcohol Use(Ages 12-17)

Past-Month Use (2021)

Alcohol Use: 35,000 (7.24%)
Binge Alcohol Use: 16,000 (3.25%)
Alcohol Use Disorder: 17,000 (3.56%)
Needed but Did Not Receive Treatment: 19,000 (3.90%)

Trends Over Time

2003: Past-month alcohol use was 19.7%
2019: Past-month alcohol use declined to 9.2%
2003: Past-month binge use was 12.6%
2019: Past-month binge use dropped to 5.0%

Missouri Student Survey (Grades 6-12)

2006: Alcohol use rate was 27.1%
2020: Alcohol use rate decreased to 17.0%
2006: Binge drinking (past 2 weeks) was 12.4%
2016: Binge drinking dropped to 5.6%
2020: Binge drinking increased slightly to 6.8%

Youth alcohol use in Missouri has shown consistent decline over the past two decades, with past-month use dropping by more than half between 2003 and 2019.

Young Adults Alcohol Use (Ages 18-25)

2021 Statistics

Past-Month Alcohol Use: 315,000 (50.75%)
Binge Alcohol Use (Past Month): 197,000 (31.66%)
Alcohol Use Disorder (Past Yea r): 95,000 (15.33%)
Needed but Did Not Receive Treatment: 93,000 (14.95%)

Historical Trends (NSDUH)

2003: Past-month alcohol use was 64.5%
2019: Past-month alcohol use declined to 53.3%
Binge use remained relatively flat at approximately 24% with minimal fluctuation

Young adults aged 18-25 have the highest alcohol use rates among all age groups.

Adults Alcohol Use (Ages 26+)

2021 Statistics

Past-Month Alcohol Use: 2,052,000 (50.38%)
Binge Alcohol Use (Past Month): 876,000 (21.51%)
Alcohol Use Disorder (Past Year): 414,000 (10.16%)
Needed but Did Not Receive Treatment: 393,000 (9.65%)

Adults Over Age 25 (NSDUH Estimates)

Current (past month) drinkers: 53% (rate has fluctuated only slightly since 2003)
Binge alcohol use: 24.7% in 2019 (changed little over time)

Alcohol use patterns among adults over 25 have remained relatively stable since 2003.

Adult Drinking Patterns

Binge drinking: 18.9% binge drink at least once per month
Median drinks per binge: 5.5
Top 25% most active drinkers: 7.7 drinks per binge (median)
Binge frequency: 1.8 times monthly (median)
Top 25% most active drinkers: 4.8 times per month

Missouri Adult Drinking Patterns Statistics

Excessive Drinking Rates

Missouri Value: 17.3% (reported binge or heavy drinking)
Missouri Rank: 30th among states
County-level excessive drinking: 20% of Missouri adults (slightly above U.S. average of 19%)

Highest County Rates

St. Charles County: 23%
Camden County: 22%
Jefferson County: 22%
Cape Girardeau County: 21%

Missouri ranks in the middle nationally for excessive drinking. Geographic variation exists within the state, with certain counties showing notably higher rates than the state average.

Alcohol Use Disorder

Prevalence of Alcohol Use Disorder (2021 Data)

Total with Alcohol Use Disorder: 527,000 (10.16% of population 12+)
Adults 18+: 509,000 (10.85%)

NSDUH Estimates (Past Year)

Total: 267,000 Missouri residents

Adolescents: 8,000
Young Adults (18-25): 59,000
Older Adults: 199,000

Needed but did not receive specialized treatment: 256,000

Trends (Ages 12+, 2017-2019 vs 2002-2004)

Annual average prevalence decreased over this period
2017-2019: 5.1% (259,000) had past-year alcohol use disorder. Similar to regional average (5.5%) and national average (5.3%)

Recent Increase in Prevalence

Year	Alcohol Use Disorder (%)
2018-2019	5.2%
2020	8.1%
2021	10.2%

Alcohol use disorder prevalence more than doubled from 5.2% in 2018-2019 to 10.2% in 2021, representing a dramatic increase that may be related to pandemic-era stressors.

Public Perception of Risk

Perception of Great Risk from 5+ Drinks Once or Twice Weekly (2021)

Age Group	Number	Percentage
Ages 12+	2,090,000	40.33%
Ages 12-17	187,000	38.43%
Ages 18-25	204,000	32.87%
Ages 26+	1,699,000	41.70%

Less than half of Missouri residents perceive great risk from frequent binge drinking, with young adults showing the lowest perception of risk.

Treatment Services

DBH-Supported Treatment Programs (Fiscal Year 2020)

Admissions with alcohol as primary substance: 7,680
Percentage of total admissions: 28%
Average age of first alcohol use: 16.6 years
Gender breakdown: 61% male, 39% female

Missouri Alcohol Treatment Programs Statistics

Racial/ethnic composition:

Non-Hispanic White: 77%
Black or African-American: 17%
Hispanic or multi-racial: 6% (remainder)

2010 Treatment Admissions

Alcohol as primary substance: 10,600
Alcohol combined with secondary drug: 8,605

Males comprise the majority of treatment admissions, and racial disparities exist in treatment access.

Emergency Room and Hospital Care (2018)

Total admissions with primary alcohol use disorder diagnosis: 28,000

56% of all substance use disorder treatments
Emergency room treatment only: 18,000
Emergency room + hospitalization: 6,000
Direct hospital admission: 4,000

Diagnosis Categories

Alcohol-induced morbidity: 11%
Alcohol-induced mental disorders: 9%

Acute alcohol effects:

Intoxication: 59%
Chronic use: 12%
Alcohol withdrawal: 24%
Alcohol dependence: 5%

Alcohol accounts for more than half of all substance use disorder emergency treatments, with the majority presenting for acute intoxication rather than chronic conditions.

Traffic-Related Consequences

Traffic Crashes and Violations (2019)

Alcohol-induced traffic crash deaths: 134
Traffic crash injuries involving alcohol-impaired drivers: 2,616
Total alcohol-related traffic crashes: Nearly 5,000
DWI arrests: 20,000

Youth Traffic Fatalities (Ages 15-20)

Fatal crashes with driver BAC > 0.01%: 27 fatalities
Percentage of all fatal crashes involving this age group: 21%

Despite prevention efforts, alcohol remains a significant factor in traffic fatalities, accounting for more than one in four crash deaths.

Criminal Justice System (State Fiscal Year 2020)

Adult System

New prison admissions for drunk driving: 344
Individuals beginning probation: 887
Parole or conditional release: 529

Juvenile System

Court referrals for alcohol offenses: 346
Out-of-home placements noting parental alcohol use: 382 (cases also identifying parental drug use: 174)
Students suspended for alcohol violations: 340

The criminal justice system processes significant numbers of alcohol-related cases annually, with notable involvement in juvenile cases where parental substance use is a factor in child welfare decisions.

Economic Impact: Taxpayer Costs (2010, adjusted for inflation)

Total cost of excessive alcohol use: $4.604 billion (2010)
Inflation-adjusted equivalent (2022 USD): $6.215 billion
Cost per drink: $2.47 (2022 USD)

The economic burden of excessive alcohol use on Missouri taxpayers is substantial, exceeding $6 billion when adjusted for inflation, demonstrating the far-reaching societal costs beyond direct health impacts.

Final Words

Missouri faces a critical and escalating alcohol crisis that demands immediate attention and comprehensive intervention. The dramatic doubling of alcohol use disorder rates between 2018-2019 and 2021, coupled with a 50.4% surge in alcohol-attributable deaths from 2015 to 2019, reveals a public health emergency that has intensified in recent years. Most alarming is the massive treatment gap, with 95% of the half-million Missouri residents needing specialized alcohol care going without it. Without substantial investments in prevention programs, expanded treatment access, and targeted interventions for high-risk groups Missouri will continue to experience preventable deaths, shattered families, and mounting economic losses that affect every taxpayer and community across the state.

Conclusion

In general, Missouri confronts a severe dual substance abuse crisis with drug overdose rates 30% above the national average and alcohol-related deaths surging 50% in recent years, both driven by fentanyl contamination and a doubling of alcohol use disorders since 2018. The state’s response has been catastrophically inadequate—over 800,000 Missourians need substance use treatment but cannot access it, representing a 95% gap in alcohol care alone, while treatment facilities have remained stagnant despite skyrocketing demand. Young adults aged 18-25 face the highest risk, with more than one in four struggling with substance use disorders, yet they perceive the least danger and receive insufficient intervention. Without immediate expansion of evidence-based treatment, widespread harm reduction services, and targeted prevention programs, Missouri will continue losing thousands of lives annually while bearing over $6 billion in economic costs that devastate families and communities statewide.