Latest quarterly opioid data shows continued impact of fentanyl in overdose deaths

The rate of opioid-related overdose deaths in Massachusetts fell an estimated 5 percent from its peak in 2016, despite the growing presence of the synthetic opioid fentanyl as a driver of opioid-related overdose deaths, according to preliminary data in the latest quarterly opioid surveillance report released by the Massachusetts Department of Public Health.

In 2019, the opioid-related overdose death rate was 29 per 100,000 people, compared to 30.5 per 100,000 people in 2016. Preliminary data shows that in 2019, there were 2,023 confirmed and estimated opioid-related overdose deaths, while for the same period in 2016 there were 2,097 confirmed opioid-related overdose deaths.

“This report demonstrates that focused investments in substance misuse are having an impact, but there is still a lot of work to do to curb the opioid epidemic in our communities,” said Governor Charlie Baker. “We are encouraged by the expanded use of the prescription monitoring program and continued reduction of new prescriptions, and remain committed to making new investments in prevention, education, treatment, and recovery for individuals and families across the Commonwealth.”

“Behind every statistic in each of these quarterly reports is a person, a family, and a community that has been impacted by this crisis,” said Lieutenant Governor Karyn Polito. “Our administration remains committed to working with all stakeholders to continue to provide the resources and supports needed to address the opioid epidemic across the Commonwealth.”

While the presence of fentanyl in the toxicology of opioid-related overdose deaths remains high at 93 percent from January to September 2019, the rate of heroin or likely heroin present in opioid-related overdose deaths has continued to decline since 2014, and was reported as 25 percent during the first nine months of 2019.

The percentage of opioid-related overdose deaths where prescription drugs were present trended downward from 2014 through 2016, and has remained stable since with approximately 13 percent of opioid-related overdose deaths in 2019 having prescription opioids present in toxicology.

The report found a decrease in the confirmed opioid-related overdose death rate for White non-Hispanic and Black non-Hispanic men between 2017 and 2018. During this same time, however, the death rate increased for Asian/Pacific Islander non-Hispanic men. The opioid-related overdose death rate for Hispanic men decreased slightly in 2018 compared with 2017, but has remained the highest across all racial and ethnic groups since 2016.

“This report shows progress on multiple fronts, including a reduction in Schedule II opioid prescriptions,” said Health and Human Services Secretary Marylou Sudders. “We must continue to invest in and focus on providing the best and most effective services and supports across the spectrum of prevention, intervention, treatment, and recovery.”

Continued integration of the Prescription Monitoring Program’s Massachusetts Prescription Awareness Tool, or MassPAT, into larger Electronic Health Record systems has allowed providers to more easily conduct the required MassPAT checks for a patient’s prescription history prior to issuing a prescription for Schedule II or III narcotic medications or a first-time benzodiazepine. In the fourth quarter of 2019:

· Just over 225,000 individuals in Massachusetts received prescriptions for Schedule II opioids in the fourth quarter of 2019, which is nearly a 42 percent decrease from the first quarter of 2015 (n=390,532).

· Registered MassPAT providers searched more than 2.8 million times, which represented an increase of approximately 500,000 searches since the previous quarter.

· There were just under 500,000 Schedule II opioid prescriptions reported to the Massachusetts Prescription Monitoring Program, which is more than a 40 percent decrease from the first quarter of 2015 (n = 841,990 Schedule II opioid prescriptions).

“While we are steadily making progress, it is still unacceptable that 2,000 individuals in Massachusetts die from this preventable disease each year,” said Department of Public Health Commissioner Monica Bharel, MD, MPH. “We will continue to use our data-driven approach to focus on high-risk, high need priority populations and disparities to achieve our goal of reducing opioid overdoses and deaths.”

This week, DPH’s Bureau of Substance Addiction Services reissued a clinical advisory to substance use treatment providers emphasizing the role of polysubstance use in the opioid epidemic. Among other things, the advisory recommends clinicians administer naloxone in any drug overdose if the victim is unresponsive and has reduced or absent breathing and educate individuals and families about the dangers of illicit drugs potentially mixed with fentanyl.

The Baker-Polito Administration, in collaboration with the Legislature, has doubled spending to address the opioid crisis and increased capacity by more than 1,200 treatment beds, including more than 800 adult substance use treatment beds at different treatment levels. In addition, the Administration is investing nearly $220 million over five years from the federally approved 1115 Medicaid waiver, which began in fiscal year 2018, to meet the needs of individuals with addictions and/or co-occurring disorders.

Learn more about the statewide response to the opioid crisis. To get help for a substance use disorder, visit www.helplinema.org or call the Massachusetts Substance Use Helpline at (800) 327-5050.

-Massachusetts Department of Public Health