Several people who believed they were using cocaine have suffered opioid-related overdoses in Nubian Square, according to public health officials who attribute the disturbing trend to increasing levels of fentanyl in cocaine supplies.
The Boston Public Health Commission issued an advisory Thursday alerting local health providers to “concerning levels” of presumed opioid overdoses this month. The city’s Emergency Medical Services responded to 11 cases of narcotic-related illness in patients who believed they were using cocaine within a 24-hour period earlier this week, according to a spokesperson for the BPHC.
Given this trend, people who use cocaine should carry naloxone, a medicine that can reverse opioid overdose, which is available at pharmacies statewide and is covered by MassHealth and many other insurers, according to the commission.
“Fentanyl is a highly dangerous substance that even in small amounts can lead to a fatal overdose, so we urge all residents, health care providers, recovery workers, and outreach workers to remain vigilant for signs of opioid overdose, including among individuals who use cocaine,” said Dr. Bisola Ojikutu, Commissioner of Public Health and Executive Director of the Boston Public Health Commission. “If you believe that someone has overdosed, call 911 immediately and administer naloxone (Narcan).”
Fentanyl is a potent opioid, 30 to 50 times stronger than heroin, that suppresses breathing and can lead to fatal losses of oxygen. Those who primarily use stimulants, such as cocaine, may not have built a tolerance to opioids, making them more susceptible to fentanyl overdoses.
Between 2010 and 2018, overdoses from stimulants increasingly involved opioids, especially among people who used cocaine, according to the Massachusetts Department of Public Health. In 2021, the state detection program found 12 percent of cocaine samples tested in Boston flagged positive for fentanyl.
“We’re seeing increasing fentanyl contamination of any substance not coming out of a pharmacy, including stimulants like cocaine,” said Dr. Jessica Taylor, the medical director of Faster Paths to Treatment, Boston Medical Center’s substance use disorder bridge clinic.
Taylor recommends that anyone using drugs, even if they are not seeking out fentanyl or other opioids, be prepared for an opioid overdose, given the growing levels of fentanyl contamination in other substances.
Boston police on Thursday also confirmed the arrest of a 56-year-old man for allegedly dealing crack cocaine and fentanyl in Nubian Square. Arresting officers allegedly recovered six grams of crack cocaine and eight grams of fentanyl on the man, identified in the statement as Anthony Davis of Dorchester.
Taylor points out that, in addition to this being a public health crisis, it’s also one of equity. A 2019 study found that Massachusetts residents dying from cocaine-opioid overdoses were more likely to be Hispanic or Black, aged 25 to 34 years old, and likely to be experiencing homelessness compared to those experiencing non-cocaine involved opioid overdoses.
AHOPE, the city’s needle exchange program, will distribute both fentanyl test strips and naloxone in Nubian Square Friday, according to the BPHC. Fentanyl test strips are a portable method of testing substances for fentanyl contamination.