In Boston, some areas bear brunt of opioid overdoses
Use of the antioverdose drug Narcan has increased dramatically in Boston, with Roxbury among the hardest hit, according to new data that show which neighborhoods are bearing the brunt of the opioid scourge.
Outside of downtown, a constricted area that attracts transients, Roxbury experienced the highest per-capita use of Narcan for the 12 months ending June 28, according to figures compiled by Boston Emergency Medical Services.
The drug was used 268 times in Roxbury during that period, a 77 percent jump over the previous 12 months, in emergency calls in which Narcan was administered by EMS crews, civilians, and first responders such as police officers and firefighters.
City emergency workers also recorded 608 suspected narcotic incidents in Roxbury in that time, a rise of 49 percent.
“I’ve never seen as many people dying like this year,” said Cyril Ubiem, who coordinates the outpatient addiction program at Whittier Street Health Center in Roxbury. “I can’t even count the number who have OD’d.”
The South End, South Boston, Charlestown, and Jamaica Plain followed Roxbury in per-capita use of Narcan, according to a Globe analysis of the EMS data. Dorchester led the city with 279 total Narcan calls, a 24 percent increase for Boston’s largest neighborhood.
The data provide a snapshot of an apparently growing problem in Boston despite an expanding government response to the crisis, and at a time when much publicity about opioid addiction has focused on the suburbs.
Since 2010, the city’s use of Narcan has grown more than five times, according to EMS. All narcotic-related incidents have more than doubled.
The increases might be attributable to several factors. Narcan has become more widely available in the last several years, including over the counter, so greater use by first responders and civilians could be expected.
However, an increase in EMS transports for overdosed or narcotic-impaired patients, as well as a rise in hospital visits, indicate more people are overdosing and need intervention, said Che Knight, spokeswoman for the Boston Public Health Commission.
City officials cautioned that the statistics show only where the calls occurred, and that they are not limited to the residents in each neighborhood. The data, for example, include emergency calls to shelters, residential treatment facilities, and other addiction services that attract people from elsewhere.
In 2014, 56 percent of patients treated for narcotic-related incidents either were homeless, lived outside of Boston, or had an unknown home.
Monica Valdes Lupi, the Health Commission director, said Narcan is only one tool in a fight that has engaged residents, treatment providers, and agencies across city and state government. She cited Narcan training in neighborhoods across Boston, reaching out to street people who are vulnerable to opioid addiction, and coordination with police, fire, and EMS to get them to treatment.
Ubiem, the addiction program coordinator at Whittier Street, said overdoses occur even within the gleaming health center, which is across Tremont Street from Boston police headquarters. Five people have overdosed at the center in the last two months, Ubiem said, one of whom he found with a needle in his arm.
Lamar Booth, a 50-year-old who was addicted to heroin for three decades, concurred that the drug is claiming an ever-growing number of victims in Roxbury.
“I’m seeing it every day now, everywhere you go. Before, it would be a passing thing,” said Booth, a homeless man who credited Whittier Street staff with helping him stay clean. Booth said his best friend died of an overdose a month ago.
Boston recorded 126 opioid-related deaths in 2015, a 22 percent increase from the previous year and 56 percent higher than 2013, according to the state medical examiner’s office. The city’s opioid fatalities last year were more than twice the 57 counted in Worcester, which had the second-highest total in the state.
“We cannot meet the demand” for treatment, said Colleen LaBelle, director of the Office-Based Addiction Treatment program at Boston Medical Center.
At the Dimock Center, another health-services provider in Roxbury, program manager Barry Butler said the inner city’s drug struggles had been long overlooked.
Much of the public and news media failed to recognize the scope of the opioid epidemic, Butler said, until largely white suburbs began noticing frightening increases in overdoses.
“Why have they waited until now to address it?” asked Butler, who had been addicted to heroin.
That sense of frustration was echoed by Jack Kelly, a busy activist on substance-abuse issues in Charlestown. A former heroin addict, Kelly said the opioid problem plagued his neighborhood for at least 15 years before the broader epidemic began receiving widespread media attention.
“When I was an addict, because I was from Charlestown, I never felt that we were treated like it is today — like a public health issue,” Kelly said. “Most of my friends who were hooked on drugs went to jail.”
Kelly, who served on Mayor Martin Walsh’s substance-abuse task force, said he has a double-edge view of the Narcan figures from Charlestown — an increase to 48 from 26 the year before.
“On one hand, it’s good that Narcan use is up; it means that people are being saved,” he said. “On the other hand, it tells me from a treatment perspective that we do not have enough resources to treat people.”
Mark Libon, vice president of behavioral health services at Dimock, said the current scrutiny is welcome, whether or not opioid addiction has been overlooked in the past in some Boston neighborhoods.
“The response is, ‘Thank you, it’s finally getting the attention,’ ” Libon said.
James H., a recovering heroin addict from Roxbury, said he hopes the recent focus will lead to more long-term residential treatment. James, who lives at Dimock, said he cycled through seven programs until he finally found effective help.
He has been clean for a year now. In his view, Narcan is a critical piece of the path from death’s door to meaningful, sober living.
“Everybody needs to be educated in Narcan — everybody,” James said.