Opioid overdose deaths decline slightly in first quarter of 2020

However, the effects of the pandemic remain unclear

Keith Srakocic/Associated Press

The number of people in Massachusetts who died of opioid-related overdoses in the first quarter of this year declined nearly 6 percent when compared with the same period in 2019, according to the data released Wednesday by the state Department of Public Health.

But the annual number of deaths in recent years continues to hover around 2,000, declining only 1 percent from 2018 to 2019.

And it’s unclear whether the pandemic has worsened the crisis — Wednesday’s report includes tallies only until the end of March. People who work with some of the most vulnerable populations see worrisome signs that the pandemic could be leading to a rise in fatal overdoses.

“As the COVID-19 pandemic evolves, we have taken action to ensure that crucial substance use disorder treatment and recovery systems remain available in the ongoing fight against opioid addiction,” Governor Charlie Baker said in a statement.

Health and Human Services Secretary Marylou Sudders said the state has “worked quickly to implement innovative solutions that keep people struggling with substance use connected to the treatment and recovery services they need.”

These include providing 13,000 kits containing the overdose-reversing drug naloxone, reaching out to high-risk populations such as newly released inmates, and expanding telemedicine.

“We are still seeing a lot of overdoses,” said Dr. Jessie M. Gaeta, chief medical officer for the Boston Health Care for the Homeless Program. “We’re also worried that the percentage of them that are fatal are higher, just from our anecdotal experience. . . . Right now, we’re hearing about more of our patients dying than we’re used to seeing.”

The calls for social distancing encourage people to use drugs alone, making rescue less likely if they overdose, she said. In addition, people in recovery are at risk of relapse, as stress rises and work opportunities disappear. “I’ve seen a lot of people relapse over the past few months because of the additional stress,” she said.

At the same time, treatment options have also diminished. Programs have switched to telehealth, but not everyone has the technology needed to participate.

Gaeta is especially worried about people leaving prisons and jails, a group at extremely high risk of overdose. Family members may be reluctant to take them in, and shelters have less room as they try to limit crowding to prevent disease spread. “Now it’s even more the case that people end up being lost to care in that risky period,” she said.

Richard Baker, program director for Victory Program’s mobile prevention team, leads a team of eight outreach workers with a van and backpacks who provide supplies such as hand sanitizer and clean needles to people, mostly homeless, in several Boston neighborhoods. Although he has heard of overdoses, Baker couldn’t say whether they’ve increased.

But there are worrisome signs. The closure of drop-in centers poses “a really big challenge for a lot of folks we serve,” he said. Additionally, clients have reported disruptions in the drug supply, signs that the drugs they’re using are cut with unknown substances — always a risky situation, he said.

In the first three months of 2020, there were 112 confirmed opioid-related overdose deaths and health officials estimate there will be an additional 319 to 393 deaths tallied when all the data are in. That would be a 5.7 percent drop from the same period last year.

Deadly synthetic fentanyl continues to increase as the major factor in overdoses, while heroin is less common.

Among the cases where a toxicology screen was available, 94 percent of the victims had fentanyl in their systems.

Most people were taking multiple substances, and cocaine was present in 42 percent of deaths and benzodiazepines in 33 percent. Heroin was found only 24 percent of the time.

Broken down by community, the data show notable decreases in opioid-related overdose deaths from 2018 to 2019 in Lowell, Worcester, Taunton, Gardner, and Melrose.

But Somerville, Beverly, Pittsfield, Attleboro, Brockton, Revere, and New Bedford experienced significant increases.