Experts: Dip in opioid deaths not cause for celebration
by Nino Mtchedlishvili
Boston University Statehouse Program
Link: The Daily Hampshire Gazette, 12/20/2022
BOSTON — Though opioid overdose deaths in the region and state are down slightly this year compared to significant spikes during the pandemic, health officials, politicians and others who work in the field agree that this is not a cause for complacency as overdoses remain high compared to the last two decades.
“Though we are finally seeing a decline in deaths from the staggering figures of the last two years, we cannot forget that each number still represents a life lost too soon and devastation for families and communities across the commonwealth,” Julie Burns, president and CEO of RIZE Massachusetts Foundation, a Boston nonprofit whose mission is to fund solutions to end the overdose crisis, said in a statement. “Though this is not a moment for celebration, it is one for hope.”
At its December meeting, health officials with the Massachusetts Public Health Council discussed the results from a biannual opioid report.
That report showed that the number of opioid-related overdose fatalities in the state increased by 11% between 2020 and 2021. The latest figures for the first nine months of 2022 showed a slight decrease of 1.5% compared to the same time period last year, with 1,340 opioid-related overdose deaths confirmed or estimated. Department of Health estimates that there will be an additional 41 to 70 deaths by the end of the year, yielding approximately 1,696 total confirmed and estimated opioid-related overdose deaths.
Western Massachusetts is no exception to the statewide opioid crisis. The report shows in the period of 2010-2021 the number of opioid overdose deaths has steadily increased, totaling 1,462 people in Hampden, 374 in Berkshire, 324 in Hampshire, and 177 in Franklin counties.
Deaths during the pandemic also rose in the region. In Hampshire County, 44 people died in 2021, up from 34 in 2020. In Franklin County, 36 people died in 2021, up from 20 in 2020. Hampden County’s deaths hovered at around 215 in both years.
Since Gov. Charlie Baker took office in 2015, he has signed two laws — An Act Relative to Substance Use, Treatment, Education, and Prevention and An Act for Prevention and Access to Appropriate Care and Treatment of Addiction — addressing opioid addiction. As a result, spending on opioid recovery programs and harm reduction has increased across state agencies from $119 million to $597 million in the fiscal 2023 budget that Baker signed in July.
Although the funding grows, the opioid crisis in western Massachusetts is not diminishing, politicians note.
“I think our treatment systems for substance use disorders are woefully under-resourced across the commonwealth and in the region,” said Rep. Mindy Domb, D-Amherst. “In addition, western Massachusetts suffers from shortages in medical providers, including those who work in drug treatment and urgent care, compounding the lack of access for people who need care.”
Rep. Lindsay Sabadosa, D-Northampton, said it is important to establish trusting relationships while treating substance abuse. She said the drop-in centers at Manna and Tapestry work hard to create relationships where people use substances and know they are in a stigma-free environment are crucial.
“We have learned over decades that the war on drugs has failed to stop drug usage, and as a community, we have to lean into harm-reduction to keep people alive,” Sabadosa said. “Establishing safe consumption sites and decriminalizing possession of small quantities would help encourage more people not to use alone, test any substance they use, and have relationships in place to get support when they are ready to stop using. Without those trusting relationships, however, many will continue to use alone and in silence, and we will fail to address the overdose crisis we are currently facing.”
Animal tranquilizer
Public Health Commissioner Margret Cooke warned the field’s professionals of a new drug, xylazine, that has started appearing in toxicology screens. The Federal Drug Administration released an alert in November, noting increasing reports around the country of individuals exposed to fentanyl, heroin, and other illicit drugs contaminated with the animal tranquilizer.
“While the prevalence of xylazine is relatively low among opioid-related overdose deaths, it is important to be aware of it,” Cooke said. “Especially for first responders who need to continue to give oxygen in addition to naloxone for suspected opioid overdoses as naloxone will not reverse the effects of xylazine.”
Cooke said naloxone, commonly known by the brand name Narcan, which rapidly blocks opiate receptors in the nervous system, was administrated in 97% of the acute opioid overdose events during the first nine months of 2022.
The report showed out of 1,340 people who died from the beginning of this year through September in Massachusetts, 961 were men and 379 women. In addition, 70% of those who died in fatal opioid overdose were white, 15% Hispanic, and 11% Black.
Burns, of RIZE, said in a statement that she hopes the incoming Healey-Driscoll administration will continue to build on a data-driven and equity-based public health approach that makes prevention, intervention, treatment, and recovery services readily available to anyone.
At a same roundtable event in November, Gov.-elect Maura Healey discussed work she’s done as the state’s attorney general suing big pharma for its role in the opioid crisis.
“We’re going to continue to make progress on getting the resources in place to address substance use disorder, to address mental health issues, which we know for far too long in this country just haven’t been given the attention and the resources and the investment that has been needed,” Healey said. “But I think we’ve made great strides as a state to do that.”