Opioid-related deaths, unintentional/undetermined January 2000 – December 2016.

By Charles Lane

The Massachusetts Department of Public Health released preliminary 2016 fourth quarter data for opioid-related deaths among Massachusetts residents last week.

The report shows death rates involving heroin continue to decline, however, those deaths have decreased at approximately the same rate that fentanyl-related deaths have increased. The report also shows a 15 percent decrease in 2016 in the number of prescriptions for schedule II and III opioids compared with 2015.

Unintentional opioid overdose deaths that occurred to residents of Somerville between 2012 and 2015 amounted to 5 in 2012; 8 in 2013; 14 in 2014; and 19 in 2015.

“The opioid epidemic continues to threaten individuals and families all across Massachusetts and the country,” said Governor Baker. “Our administration will continue our intense focus on fighting this epidemic by further increasing treatment options and expanding support for law enforcement and their efforts to arrest and convict drug traffickers who prey on vulnerable people, selling them more and more deadly and addictive substances.”

Since coming into office in 2015, the Baker-Polito Administration has made responding to the opioid crisis its top public health priority. Spending on addiction services has been increased by 50 percent, from $120 million to $180 million. Hundreds of additional treatment beds and voluntary programs have come online. Family and peer support groups have doubled and been funded across the state and thousands of naloxone overdose rescue kits have been distributed to first responders and family members.

The Governor’s FY18 budget also includes increased funds for law enforcement efforts around drug trafficking and repurposes MCI-Plymouth into the Massachusetts Alcohol and Substance Abuse Center (MASAC) at Plymouth, allowing men who have been civilly committed to the soon to be decommissioned MASAC center at Bridgewater to be transferred to the new facility, and provides an increase of $1.75 million in funding for an additional 45 treatment beds.

“We are committed to ending the opioid epidemic and will continue our efforts no matter how long it takes. Governor Baker’s FY18 budget sustains $145 million in funding for DPH programming for preventing and treating substance use disorders, with millions more for the women’s addictions treatment program at Taunton State Hospital,” said Secretary of Health and Human Services Marylou Sudders. “In addition, the recently approved MassHealth waiver will support expansion of residential treatment throughout Massachusetts.”

Selected findings & observations from the Q4 report:

The number of confirmed cases of unintentional opioid overdose deaths for 2016 is 1,465, with an estimated 469-562 suspected opioid-related deaths that may be added to the total when the review of cases is complete.

The 2015 confirmed cases of unintentional opioid overdose deaths have been updated to 1,579 and the 2014 confirmed cases of unintentional opioid overdose deaths have been updated to 1,321.

Deaths are still increasing year to year, but an overall decline in the rate of increase in deaths has been observed since 2014:

2012 to 2013 saw a 31 percent increase in deaths

2013 to 2014 saw a 44 percent increase in deaths

2014 to 2015 saw a 21 percent increase in deaths

2015 to 2016 an estimated 13 to 24 percent increase in deaths

Death rates involving heroin continue to decline, however, those deaths have decreased at approximately the same rate that fentanyl-related deaths have increased. The number of fentanyl-related deaths continues to increase with 75 percent of 2016 deaths that had a toxicology screen showing a positive result for fentanyl.

There was a 47 percent increase in the total number of EMS incidents involving the overdose rescue drug naloxone in the first three quarters of 2016 compared with the same time period in 2015.

In 2015, the last full year available, naloxone was administered more than 12,000 times during EMS opioid-related incidents.

EMS opioid-related transports were reported in 280 of 351 cities and towns, or 80 percent of communities in Massachusetts.

“Today’s data release underscores the need to continue our daily fight to bring this epidemic to an end,” said DPH Commissioner Monica Bharel, MD, MPH. “Our sustained efforts are building a strong foundation to fight substance misuse, rooted in the public health framework of prevention, intervention, treatment, and recovery.”

Baker-Polito Administration’s Actions to Respond to the Opioid Epidemic

Prevention:

Implementing a first-in-the-nation 7-day limit of opioid prescriptions to limit first time exposure to opioids in March 2016.

Launching first-in-the-nation core competencies for safe prescribing of opioids to medical schools, community health centers, nursing, physician assistant and dental schools.

Millions in funding and support provided to 64 high-need communities in partnership with over 257 cities and towns across the Commonwealth to prevent opioid misuse and overdose, and other substance use disorders.

Release of the unprecedented Chapter 55 report  and website using advanced data to further explain the underlying causes of opioid-related deaths.

Creating public awareness campaigns to prevent addiction, reduce stigma of substance use disorders, recognize the signs of overdose and raise awareness of Good Samaritan Law protections for assisting someone who is overdosing, supported by free public information materials.

Intervention:

Successfully launching MassPAT, the new online prescription awareness and monitoring tool. As of January, prescribers have made more than 2 million searches on the system.

Expanded access to naloxone, a lifesaving drug to reverse opioid overdoses. Nearly 7,000 people trained and provided naloxone in the first 6 months of 2016, pushing the number of people trained statewide to over 50,000.

More than 1,500 bystander overdose reversals using naloxone were reported for the first six months of 2016.

First responder naloxone grants provided to 32 high-need communities.

The launch of the Municipal Naloxone Bulk Purchasing Program that is open to all communities. The program is serving about 120 cities and towns and had purchased more than 12,000 doses of naloxone at a significant discount.

Treatment:

More than 500 substance use treatment beds added to the system since January 2015.

Ending the practice of sending women who are civilly committed as a result of substance use disorder to MCI-Framingham.

Funding to expand the number of state-supported Office Based Opioid Treatment sites to 30 throughout Massachusetts.

Recovery:

More than 1,900 sober home beds certified in Massachusetts.

Continued funding for the training of Recovery Coaches (more than 800 to date) to strengthen peer support networks throughout the Commonwealth.

Pilot program deploying Recovery Coaches to help make referrals and connections to treatment and recovery support services in the community in 11 Emergency Departments.