Metro

Could the opioid epidemic be easing?

Suzanne Kreiter/Globe staff

Fewer people may be dying from opioid overdoses in Massachusetts, according to new data that offer the first hint of progress against the addiction epidemic gripping the state.

The numbers in the latest quarterly report from the state Department of Public Health, released Wednesday, are preliminary and involve just three months, making it difficult to establish a trend. But they do show a decrease: The state tallied about 450 confirmed and suspected deaths between January and March, compared with about 500 in the previous quarter.

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“That we’re having 50 fewer deaths in a quarter is kind of amazing. Something is working,” said Ronnie Springer, vice president of addiction services at Bay Cove Human Services, which provides detoxification, methadone, recovery, and other services in Eastern Massachusetts. “It will be interesting to see if the trend continues. I’m a little encouraged, not over-the-top encouraged. I’m excited about the possibility of being encouraged.”

Dr. Marc R. Larochelle, a Boston Medical Center addiction researcher, said data from three or four quarters would be needed before concluding there has been a genuine shift. The state’s continuing efforts to address the epidemic of opioid abuse leave him optimistic, Larochelle said, but “we have not been able to get out in front of it yet.”

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And Nancy E. Paull, CEO of the SSTAR treatment program in Fall River, said that even as the state expands services, the need for treatment outruns the capacity. Paull isn’t seeing a decline in addiction or overdoses; Fall River data show that overdoses and overdose deaths continue to increase, she said. SSTAR’s walk-in center saw more than 1,600 people in the past three months and could not find treatment openings for many of them.

The state report also offered more details about the scope of the epidemic in 2016. Opioid deaths continued to increase last year, but the rate of increase slowed.

In 2014, the opioid-related overdose death rate increased 40 percent over 2013. In 2015, the rate went up 31 percent over the previous year. But in 2016, the increase was 16 percent over 2015.

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Still, a disturbing number of people continued to succumb in 2016, with an all-time high of 1,933 confirmed deaths from opioid overdoses, compared with just 656 in 2012. The addiction epidemic is striking disproportionately among people in the prime of life: 56 percent of 2016 deaths occurred among people age 25 to 44.

The state is still investigating the 2017 deaths. Only 172 have been confirmed for the first three months of this year, but health officials estimate an additional 242 to 307 deaths will ultimately be added to the list.

The state’s data show the proportion of overdose deaths attributed to fentanyl continues to rise, while deaths from heroin and prescription painkillers are declining. Fentanyl, many times more potent than heroin, is often mixed with heroin or sold as heroin to people who don’t realize how dangerous it is.

Among the findings:

 Heroin was present or likely to be present in 33 percent of opioid-related deaths in the fourth quarter of 2016, compared with a high of 74 percent in the second quarter of 2014.

 Fentanyl was present in 69 percent of opioid-related deaths in 2016.

 In the fourth quarter of 2016, prescription opioids were present in 9 percent of opioid-related overdose deaths, down from 26 percent in the first quarter of 2014.

The availability of fentanyl exacerbated the overdose crisis and also confounded the state’s ability to understand it, said Larochelle, the Boston Medical Center researcher. It’s not clear whether the increase in overdose deaths in the past two years reflects trends in addiction. Were more people dying merely because the drugs are more deadly, or does the death rate reflect a deepening problem with drug abuse?

“Amazingly, we don’t know the answer to that yet,” Larochelle said. The state has no good data on how many people suffer from opioid use disorders, he said.

The successful efforts to reduce prescription drug use also raise thorny questions, Larochelle said. In the first quarter of 2017, the number of opioid prescriptions dispensed in Massachusetts declined 23 percent compared with the same period in 2015, and by 13 percent compared with the first three months of 2016.

In the short term, hindering access to painkillers could contribute to the overdose problem, if people addicted to prescription opioids are driven to street drugs. But eventually, with fewer prescription opioids in circulation, the number of people who become addicted in the first place may go down.

“We don’t know how long it will take to see that effect,” Larochelle said. “It’s not something that happens overnight.”

Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer.
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