Patterns and Trends in Drug Abuse in St. Louis, Missouri: June 2013

Heidi Israel, Ph.D., A.P.N., F.N.P., L.C.S.W.

Summary of Key Findings for the 2012 Reporting Period:

  • Changes were included in the heroin/cocaine picture (along with a media focus and grass-roots efforts with heroin).
  • Methamphetamine problems, including a high number of clandestine laboratories.


Heroin availability and its widespread presence in the St. Louis rural and suburban areas continued to be a concern in 2011. Two types of heroin were available in the St. Louis Met­ropolitan Statistical Area—Mexican black tar and Mexican off-white powder. The proportion of St. Louis area primary treatment admissions for heroin exceeded those for alcohol. The number of deaths involving heroin remained high and were identified in rural medical examiner (ME) data as well as in metropolitan area data. All sources (from school surveys and emergency department visits to law enforcement data) reported access to heroin to be consistent, with the drug at high purity.


Methamphetamine indicators remained low but stable in St. Louis City; access in rural areas was reported and noted in death data and statewide treatment data. The number of methamphetamine clan­destine laboratories remained high. Social networks using “cooks” continued to produce small amounts of the drug locally. Methamphetamine from Mexico and the Southwest supplied most of the methamphetamine in the city and county of St. Louis and the surrounding five Missouri counties.

Crack Cocaine

Crack cocaine, formerly the major stimulant problem in the area, continued to decrease in all indicators for 2012 but remained available, particularly in the city.


Marijuana indicators remained stable in 2012.

Club drugs

Reports of club drug abuse continued to be sparse, primarily through anecdotal reports of MDMA (3,4-methylenedioxymethamphetamine) use and a few GHB (gamma hydroxybutyrate), PCP (phencyclidine), and ketamine ME cases.

Synthetic Drugs

“Bath salts” (substituted cathinones) have been noted in poison control center reports; their use and deaths involving them decreased with new control legislation.


In the St. Louis area, less than 5 percent of human immunodeficiency virus (HIV) cases had a primary risk factor of injection drug use, with most new cases identified among men who have sex with men (79.1 percent) and women of color who contracted it through heterosexual contact (17.2 percent).

For inquiries regarding this report, contact Heidi Israel, Ph.D., F.N.P.-C, Associated Professor, St. Louis University School of Medicine, 3625 Vista, 7N, St. Louis, MO 63110, Phone: 314–577–8851, Fax: 314–268–5121, E-mail: