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Fatal opioid overdoses up slightly during pandemic

The overdose-reversal drug Narcan is widely available, but pandemic-related isolation means there is not always another person present to administer it.Craig F. Walker/Globe Staff

The number of people dying of opioid overdoses in Massachusetts rose slightly in the first nine months of 2020, raising concerns from public health officials about caring for people dealing with substance use disorders during the pandemic.

An estimated 1,517 people died of overdoses in the first nine months of this year, compared with 1,485 for the same period in 2019 — about a 2 percent increase, Public Health Commissioner Monica Bharel said Wednesday.

More than 2,000 people have died of opioid overdoses in Massachusetts every year since 2016, when the state saw a grim record of 2,102 deaths.

Public health officials pointed to a few concerning data points: More Black and Latino people are dying in overdoses, and the isolation and stress of the pandemic make reaching vulnerable people more difficult.

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“The pandemic is extremely taxing and difficult and isolating and challenging for all of us,” Bharel said. “And then, what we see is where we have vulnerabilities, and those of us who are vulnerable for either chronic disease exacerbation, or substance use disorder exacerbation, mental health issues exacerbation, that’s happening related to the pandemic. I think that’s what we’re seeing in this report.”

Dr. Edward Bernstein, a member of the state’s Public Health Council, said he was particularly concerned about people who need substance use treatment during a surge in COVID cases. The state has one program for people who need treatment and are COVID-positive, but as COVID cases climb, especially in vulnerable populations, it may need more, he said.

“I am concerned about how we’re preparing for this new surge,” said Bernstein, a professor and vice chair for academic affairs, emergency medicine, at Boston University School of Medicine. “Because right now, they are facing overcrowding. And that’s a critical danger for the spread of the virus.”

The state has been releasing data about overdose deaths twice a year, but Bernstein also questioned whether officials should release it more proactively during the pandemic.

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“I was sort of concerned that we waited until now to know what was going on in March, April, June, July,” he said.

Slightly more Black and Latino people died of opioid overdoses in 2019, compared to previous years, according to the state’s data. The Department of Public Health is responding by offering training to counselors and by starting a pilot program offering more care to men being released from prisons and jails, said Deirdre Calvert, director of the Bureau of Substance Addiction Services at the state Department of Public Health.

The overdose rescue drug naloxone, commonly known by the brand name Narcan, is widely used and remains effective. But pandemic-related isolation means there is not always another person present to administer it, Calvert said.

“No matter how much naloxone we flood our system with, if people are using in isolation and nobody’s there to give them naloxone, it’s an issue,” Calvert said.

Though some drug-treatment programs had to reduce capacities because of the pandemic, the state has not lost any programs since the pandemic began, Calvert said, despite concerns that the economic collapse and concerns about the virus would drive programs out of business.

Another concern, Calvert said, is reaching mothers who need treatment but may be reluctant to seek it. Now, along with long-present concerns that their children may be taken away if they seek help, they also have to worry about the daily care of children whose school buildings are closed.

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“We know that addiction festers and grows in isolation, and we know that recovery is available through community, and right now we’re asking people to isolate,” Calvert said. “So we’re very, very, very worried.”


Gal Tziperman Lotan is a former Globe staff member.