Mass. hospital visits for opioid abuse soar

The emergency room at Boston Medical Center.Globe Staff/File

The epidemic of opioid abuse in Massachusetts is often measured in deaths, such as the 1,099 people who succumbed to overdoses last year. But most people who are addicted don’t die. Instead, by the thousands, they wind up in hospitals.

A newly released analysis by a health commission shows that opioid-related hospital visits in the state nearly doubled from 2007 to 2014.

Those visits — including emergency room treatment, observation stays, and admissions — soared to nearly 57,000 in 2014, up from 31,000 in 2007.

Three-quarters of the opioid-related hospital admissions are paid for by the state and federal governments, according to the data, presented to the commission last week.

Opioid patients are distributed unevenly around the state, with certain “hot spots” showing high concentrations of people who needed hospital care related to opioid use, according to the study from the Health Policy Commission, a state agency concerned with health care costs.

“Having more data really begins to bring this conversation down to the community level,” said Martin D. Cohen, a member of the Health Policy Commission. “This is where this data is very powerful.”

The new numbers help identify target populations and guide efforts at intervening earlier to avoid hospital visits, he said.

The Health Policy Commission was formed in 2012 to develop policies for controlling health care costs and improving quality.

Back then, Cohen said, few were thinking about the role of opioid addiction in health spending.

“But it’s certainly a major driver now,” said Cohen, who is president of the MetroWest Health Foundation in Framingham, a philanthropy devoted to improving health in 25 communities.

The report found the Berkshires, Southeastern Massachusetts, and the Lawrence-Lowell area have the highest concentrations of residents who visited the hospital with opioid-related problems. It identified seven hot spots, communities with the greatest rate of inpatient admissions for opioid use: Boston, Holyoke, Leeds (a village in Northampton), Lynn, Pittsfield, Springfield, and Worcester.

In one of those hot spots — Springfield — Dr. Niels K. Rathlev described the situation as “awful.”

“I have personal friends who have lost sons and daughters to this type of thing,” said Rathlev, who is chairman of emergency medicine at Baystate Medical Center.

In one especially dire four-day period last November, he said, Baystate’s five hospitals treated 40 to 45 overdoses.

“We continue to see a steady influx. The majority — at least two-thirds — are young men between 16 and 35,” Rathlev said.

When a patient is medically stable and ready to leave, he said, the hospital can rarely make a next-day appointment with a treatment provider. “We don’t have that kind of access,” he said. “We give them a list of phone numbers to call.”

The commission’s data show that those hospitalized for opioid abuse came from every income bracket, but people earning less than $50,000 a year were most severely affected.

Dr. Alex Sabo, chairman of the Department of Psychiatry and Behavioral Science at Berkshire Medical Center in Pittsfield — another hot spot — blamed the stress of poverty for the high rate of drug abuse in the Berkshires.

“There is a high degree of psychosocial stress,” Sabo said. “We’re experiencing economic hardship here. We’ve had to shift over to a service economy, a tourist economy. . . . It’s beautiful, but it’s poor. We’ve lost our base of high-paying jobs that support a really good lifestyle for working people.”

The situation is similar in Worcester, said Nicole Gagne, interim president of Community Healthlink, which provides services for people recovering from substance abuse, mental illnesses, and homelessness in Central Massachusetts.

“Worcester is an incredibly diverse community with a really high rate of poverty and unemployment compared to other parts of the state. Those social issues can contribute to issues with substance abuse,” Gagne said. “Heroin is inexpensive, easy to get, and for people who are really having challenges with finances, sadly, not unaffordable.”

Among other key findings from the Health Policy Commission study:

■  Hospital visits related to heroin (as opposed to prescription opioids such as OxyContin) tripled from 2007 to 2014, accounting for an increasing share of opioid-related hospital visits in recent years. This finding backs up anecdotal reports that many addicts are turning to heroin because it is cheaper and more readily available than pills.

■ The rate of babies born dependent on opioids increased more than fivefold from 2004 to 2013, and in 2009 was three times the national average. Hospitals with the largest volume of such patients included Boston Medical Center, Baystate Medical Center in Springfield, and Charlton Memorial Hospital in Fall River.

■ Most drug-exposed babies were kept in expensive settings, such as the special care nursery.