Substance abuse can be a destructive force for families.  It is capable of eroding relationships and affecting a families’ ability to function and provide for its members.  From a community perspective, substance abuse places a significant burden on the criminal justice, healthcare, and social services systems, and ultimately impacts everyone through societal economic costs that total an estimated $7.7 billion annually in Missouri.1

Substances and Issues

Agencies that address substance abuse frequently define substances as “ATOD,” or alcohol, tobacco (including cigarettes and other tobacco products), and other drugs (including marijuana, narcotics, and unauthorized use of prescription medications).  Agencies are generally either treatment focused or prevention focused, and those that target youth are concerned with risk behaviors – a term that includes frequency of substance use, age of first use, binge drinking, and risky sexual practices, among others.


While drug and alcohol abuse can have a greater immediate impact with consequences such as job loss and incarceration, tobacco-related illnesses pose a significant health risk in the long term.  As in Missouri, smoking-related deaths account for 17 percent of all Illinois deaths; each year about 18,000 people die from tobacco-related conditions.2 Recently the St. Louis metro area made progress toward improving its air quality through several county and municipal ordinances to ban indoor smoking.  St. Louis City, St. Louis County, and Lake St. Louis in St. Charles County have passed clean indoor air ordinances in public venues.  The State of Illinois went smoke-free on Jan. 1, 2008, with much more stringent laws than those on the Missouri side of the metro area.

Data and Statistics

Several national and local systems track data regarding substance use and risk behaviors.

In Missouri

A 2009 ADA report found that past-month adolescent drug and alcohol use has been gradually declining since 2004 from 20.2 percent to 16.3 percent in 2007 (most recent available).  Likewise, there have been declines among the 12-17 year old age group in binge drinking, cigarette use and illicit drug use.  Alcohol use rates were stable in the middle school grades but declined among high school students.  Young adults, aged 18-25 continue to have Missouri’s highest rates of alcohol and drug use including the use of tobacco.  Alcohol and drug use among Missouri adults over age 25 is gradually rising.

While smoking related deaths are beginning to decrease, smoking still causes over 17 percent of Missouri deaths, leading to over 9,300 deaths in 2007.  There were 311 alcohol induced deaths in 2007 a trend that has been steady since 2000.  Drug induced deaths have increased: there were 774 in 2007, and only 324 in 2000.

Both alcohol and drug-related emergency room visits have increased in Missouri.  While motor vehicle accidents have decreased overall, alcohol-related accidents have increased.  Between 35,000 and 40,000 people yearly are arrested for driving while intoxicated in the state, and between 40,000 to 45,000 are arrested for drug manufacturing, sales or possession.  Ten percent of juvenile arrests are for alcohol and drug offenses.1

For more data, see the document “Status Report on Missouri’s Alcohol and Drug Abuse Problems 2009,” available online from the Missouri Department of Mental Health, Division of Alcohol and Drug Abuse website.

Budget Cuts

The MO Department of Mental Health, which oversees programs dealing with psychiatric health, drug and alcohol abuse and Medicaid patients, has been one of the hardest-hit by Missouri budget cuts for FY 2011.  Cuts to state aid for alcohol and drug abuse treatment are expected, and youth tobacco prevention programs were cut out entirely.Locally, the Metropolitan St. Louis Psychiatric Center will close its emergency room and short-term inpatient unit, which served about 2,800 patients yearly.  Severe cuts occurred in operating the Division of Alcohol and Tobacco Control, leaving just five agents to monitor 12,000 liquor licenses.  Local law enforcement will likely have to bridge the regulatory gap – checking licenses and monitoring the sale of alcohol to minors.4

1Missouri Department of Mental Health, Division of Alcohol and Drug Abuse.  (2009).  Status Report on Missouri’s Alcohol and Drug Abuse Problems.

2Illinois Department of Human Services.  Facts About Addiction.

3ACT Missouri, MRN, and MYAA.  (April 29, 2010). Capitol Report #4.

4Join Together. (June 16, 2010). Budget Cuts Gut Missouri Alcohol Enforcement.