Year over year opioid-related overdose deaths decline in Massachusetts; opioid prescriptions fall 30 percent
The presence of fentanyl continues to rise, now a factor in nearly 90 percent of deaths
BOSTON (August 24, 2018) – Opioid-related overdose deaths in Massachusetts have fallen steadily over the past three quarters even as the presence of fentanyl in overdose deaths reached an all-time high. The presence of fentanyl in the toxicology of those who died from opioid-related overdose deaths rose to nearly 90 percent in 2018, underscoring its impact as the driving force behind the opioid epidemic in Massachusetts, according to the latest quarterly opioid-related deaths report released today by the Massachusetts Department of Public Health (DPH).
The report illustrates the changing nature of the epidemic, with cocaine now surpassing heroin in the toxicology for opioid-related deaths, beginning with the fourth quarter of 2017 (October through December). Today, DPH officials reissued a June clinical advisory to all medical providers to warn them about the increase of fentanyl in cocaine.
Overall in 2017 there was a 4 percent decrease in opioid-related overdose deaths from 2016. The data also shows that the Commonwealth has experienced a 30 percent decline in opioid prescriptions since the launch of the Massachusetts Prescription Monitoring Program (MassPAT) in August 2016. Between April and June 2018, searches by registered prescribers to MassPAT increased by 100,000 searches over the previous quarter, making it the largest increase in searches conducted in a single quarter.
“The opioid epidemic is a tragic public health crisis that has taken scores of lives in our Commonwealth, and while we have much work to do, there continue to be trends related to a decline in overdose deaths and a decline in the number of opioid prescriptions written by physicians,” said Governor Baker. “This quarterly report provides a new level of data revealing an unsettling correlation between high levels of synthetic fentanyl present in toxicology reports and overdose death rates. It is critically important that the Commonwealth understand and study this information so we can better respond to this disease and help more people. The legislation I signed earlier this month adds another set of tools to our toolkit, including requiring all emergency departments to offer medication-assisted treatment in emergency departments and extending medication-assisted treatment in correctional facilities.”
“Our administration is devoted to addressing the opioid epidemic using every tool available, and detailed reports like this are critically important to ongoing and future efforts ranging from treatment to criminal justice,” said Lt. Governor Polito.
Earlier this month, Governor Baker signed An Act for prevention and access to appropriate care and treatment of addiction which is the second major legislative action by the Baker-Polito Administration to address the opioid crisis since taking office in 2015-- efforts widely regarded as a blueprint for the nation.
This latest quarterly report found that the rate of synthetic fentanyl present in the toxicology of opioid-related overdose deaths continues to rise -- detected in about 40 percent of deaths in 2014 to nearly 90 percent of cases in the first quarter of 2018. As of last October through December, cocaine has surpassed heroin in the toxicology for opioid-related overdose deaths.
Earlier this year, Governor Baker also signed legislation to empower law enforcement by holding fentanyl and carfentanil traffickers more accountable.
“When you look at the trend lines over time, while the results of our efforts are having an impact, we must double down on our efforts to implement treatment strategies that meet the needs of the highest risk individuals and communities,” said Health and Human Services Secretary Marylou Sudders.
This report updated the total number of estimated and confirmed opioid-related overdose deaths in 2017 to 2,071, which is 83 fewer deaths than the 2,154 estimated and confirmed deaths in 2016, representing a decrease of 4 percent. There was an increase in opioid-related overdose deaths in 2017 for non-Hispanic black males, whose death rates increased from 21.5 per 100,000 in 2016 to 31.2 per 100,000 in 2017.
“The increase in the opioid-related death rate among blacks, but especially black males, is concerning,’’ said Public Health Commission Monica Bharel, MD, MPH. ``We will be targeting our community outreach and public awareness campaigns to these individuals as we remain steadfast in our efforts to reduce the impact of this preventable disease on all Massachusetts families and communities.”
Other findings of the 2018 Q2 report include:
- In the first six months of 2018, there were a total of 1,017 confirmed and estimated opioid-related overdose deaths, compared to 975 confirmed and estimated opioid-related overdose deaths in the first six months of 2017.
- Opioid-related overdose deaths have fallen for the last three consecutive quarters – from 527 deaths in the fourth quarter last year (October to December) to 519 deaths in the first quarter of this year (January to March) to 497 deaths in the second quarter of this year (April to June).
- Approximately 258,000 individuals in Massachusetts received prescriptions for Schedule II opioids in the second quarter of 2018 -- more than a 30 percent decrease from the first quarter of 2015, when 390,532 individuals received prescriptions.
- In the second quarter of 2018, registered users of the Massachusetts Prescription Monitoring Program (MassPAT) conducted an additional 100,000 searches from the previous quarter, which is the largest increase in a single quarter. DPH officials attribute the increase to the integration of Electronic Health Records into the MassPAT system.
- The percentage of opioid-related overdose deaths where prescription drugs were present trended downward from 2014 through 2016 and has remained stable since then. In the first quarter of 2018, 19 percent of opioid-related overdose deaths had prescription opioids present in toxicology.
- In the first quarter of 2018, the greatest number of suspected opioid Emergency Medical Services overdose incidents continued to be among males aged 25-34, accounting for 25 percent of opioid-related incidents with a known age and gender.
- The number of confirmed opioid-related overdose deaths for 2017 is updated to 1,909.
- The number of confirmed opioid-related overdose deaths for 2016 is updated to 2,089.
- The number of confirmed opioid-related overdose deaths for 2015 is updated to 1,685.
Massachusetts is recognized as a national leader in addressing the opioid epidemic and was the first state in the nation to implement a 7-day limit of first-time opioid prescriptions and to launch core competencies for safe prescribing of opioids in the state’s medical schools, community health centers, nursing, physician assistant, dental schools and schools of social work.
Since 2015, the Baker-Polito Administration has doubled spending to address the opioid crisis and increased capacity by more than 1,200 treatment beds, including 818 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.
For more information on the Commonwealth’s response to the opioid epidemic as well as links to the latest data, visit www.mass.gov/opioidresponse. To get help for a substance use disorder, visit www.helplinema.org or call the Massachusetts Substance Use Helpline at (800) 327-5050.