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Health commissioner: Fentanyl, cocaine fuel ‘concerning trends’ in epidemic

In a photo from the US Attorney's Office for the District of Utah, fentanyl-laced fake oxycodone pills collected during an investigation.U.S. ATTORNEY'S OFFICE FOR THE DISTRICT OF UTAH/NYT

State public health officials observed “concerning trends” in the opioid epidemic last year, particularly driven by the rising prevalence of fentanyl and cocaine in overdose deaths.

While the Department of Public Health does not expect to publish the latest estimate of fatal opioid overdoses until its next regular report in May, Commissioner Margret Cooke told lawmakers Monday that worrying signs remain amid significant efforts to blunt the damage.

“We’ve seen concerning trends in 2021. We’ve seen an increase in fentanyl, an increase in cocaine in opioid overdose deaths, an 8 percent increase there,” Cooke said at a Ways and Means Committee hearing, later adding, “This crisis is not going away.”


The department’s report due out in May will for the first time include data on opioid-related overdose deaths where alcohol was also detected, Cooke said, forecasting that 32 percent of fatalities feature alcohol in a person’s system as well.

Nationally, deaths from opioid-related overdoses surged during the COVID-19 pandemic. The US Centers for Disease Control and Prevention reported that total fatalities in the 12-month period ending in April 2021 surpassed 100,000, a 28.5 percent increase from the same stretch one year earlier.

Total opioid overdose deaths in Massachusetts climbed to a record high of 2,104 in 2020. In the first nine months of 2021, DPH reported a roughly 1 percent increase in fatalities from the first nine months of 2020.

Cooke said Monday that she believes there are several factors behind Massachusetts avoiding as potent a spike in deaths as the rest of the country, including a state push starting in March 2020 to distribute 134,000 additional kits of the overdose-reversal drug known as Narcan.

DPH has been using federal funds to distribute test strips for fentanyl, a synthetic opioid far more potent than heroin and present in many overdose deaths. Additionally, Cooke said, the state has worked with the city of Boston to address the epicenter of homelessness and addiction near Massachusetts Avenue and Melnea Cass Boulevard by offering additional methadone take-home doses, boosting outreach staff in the region, and designating more available slots in low-threshold housing.