Missouri’s naloxone standing order continues to save lives as access expands and overdose deaths decline

According to the Missouri Department of Social Services, annual Medicaid claims for naloxone dispensed through the state standing order exceed 11,000 claims per year, with numbers increasing steadily each year. In 2025 alone, 11,436 Medicaid claims were processed under the standing order—a clear indicator that Missourians are increasingly accessing the lifesaving medication. 

“Overdose deaths are decreasing at the same time naloxone utilization is growing. This is one tactic that is truly saving lives,” said Dr. Heidi Miller, chief medical officer with DHSS. “We have to meet people where they are at. If we can save the life, we then have the opportunity to help them find a path toward a long-term recovery.” 

The updated 2026 standing order simplifies eligibility criteria, explicitly includes individuals under age 18, and allows pharmacists the option to dispense a larger quantity when clinically appropriate. It also incorporates updated instructions for rescue breathing and reinforces the importance of continued monitoring after naloxone administration, particularly critical given potent emerging opioids such as nitazenes, which may require additional doses. 

“Naloxone is effective for all opioids, including newer kratomderived compounds like 7OH and MGM15,” Miller noted, underscoring the importance of broad public access to the medication. 

Missourians of all ages are accessing the standing order, with more than 18,000 claims among adults ages 35–54 and over 13,000 claims among adults 55 and older since 2023. Children under 18 accounted for nearly 600 naloxone claims during the same timeframe.  

The strong utilization of naloxone complements Missouri’s broader prevention strategy. Overdose deaths across the state have fallen for three consecutive years since 2023, with 2025 seeing a 23% decline in opioid deaths and a 17.4% decline in accidental drug poisonings. These reductions exceed the national rate of decline by roughly 1.5%. 

Missourians can access naloxone at pharmacies statewide through the standing order, request free mailorder or pickup naloxone by finding a location at GetMissouriNaloxone.com, and receive training and overdoseresponse information through DHSS and partner organizations. 

DHSS encourages all Missourians—families, educators, healthcare providers and community organizations—to keep naloxone on hand and stay informed about overdose prevention.