Deaths by opioid overdose fell 8.3 percent last year in Massachusetts
For the first time since the opioid crisis gripped the state five years ago, Massachusetts health officials on Wednesday brought forth some unequivocal good news: The number of overdose deaths fell by 8.3 percent in 2017, compared with the previous year.
At a meeting of the Public Health Council, Dr. Monica Bharel, public health commissioner, displayed a graph of annual overdose death rates with the line swooping upward to a peak in 2016 and then taking its first downturn in 2017.
Quarterly data released throughout the year had hinted this might be happening. But Bharel previously resisted calling the reduction in mortality a “trend.” On Wednesday, however, she found herself telling the council, an appointed board of physicians, academics, and consumer advocates, “Hopefully this trend will continue.”
The number of confirmed and estimated deaths for 2017 was 1,977, down from the 2,155 tally for 2016 — but still more than 200 deaths greater than the 2015 toll.
The last time the annual number of Massachusetts opioid-related deaths fell was a slight dip in 2010.
The state’s efforts to widely distribute the overdose-reversing drug naloxone (commonly known by the brand name Narcan) has likely played a role in shrinking last year’s death rate. Police and firefighters throughout the state now carry the drug, and anyone can buy it at a pharmacy.
Such widespread use of naloxone “is going to hide the real problem,” said Gabrielle “Abby” Dean, clinical director of Right Turn, a Watertown provider of outpatient addiction treatment.
The numbers released Wednesday do not reveal how many people survived overdoses or how many continue to suffer from addiction.
“I’m glad [deaths] are down,” Dean said, “but I’m worried that they’re only down because people have been saved by Narcan. . . . Once it feels like it’s not a crisis, people are going to feel like, ‘Oh, we’ve got this.’ ”
But Dean said she has seen no drop-off in the need for addiction treatment, or in the prevalence of the emotional pain that fosters drug use.
Dr. Michael F. Bierer, president of the Massachusetts Society of Addiction Medicine, said he was encouraged by the trend in opioid deaths but hasn’t seen any changes in his practice at Massachusetts General Hospital.
“We still have a ton of people coming in with opioid use disorder, with overdoses, with complications of injecting,” Bierer said. “People who are doing this work are still shouldering a very heavy load and facing tragedy and struggle.”
Lydie Ultimo-Prophil, vice president of addiction services at Bay Cove Human Services in Boston, said that while naloxone use was clearly a factor, the state’s other efforts, such as increasing access to treatment, also played a role in saving lives. “There’s been a lot of work done to get to this point,” she said. “We are on the right path here.”
Bay Cove continues to face high demand, possibly in part as a consequence of lower mortality, she said. “When we see deaths going down, we see an increase of people going into treatment,” Ultimo-Prophil said.
At Gosnold, a Cape Cod treatment provider, a shift has already occurred in the clientele, with a slight drop-off in those addicted to opioids and an increase in people struggling with alcohol, said Richard Curcuru, president and CEO. (People with alcohol use disorder have always accounted for the majority of Gosnold’s clients, he said.)
Curcuru said the latest data on opioid-related deaths leave him “cautiously optimistic.”
“Those numbers are good. I love the 8.3 percent drop. I’d like to see an 18.3 percent drop,” he said. “It’s encouraging and exciting that all the efforts that everyone is doing is starting to make a difference.”
The month-by-month figures show an accelerating decline in the number of people dying over the course of last year. The deaths tallied in October, November, and December of 2017 were lower than in any month in 2016.
But the rise in deaths had happened quickly, soaring 39 percent from 2013 to 2014, 30 percent from 2014 to 2015, and 22 percent from 2015 to 2016.
“While there is still a lot of work to do,” Governor Charlie Baker said in a press release, “this report is encouraging news that gives us hope that we are beginning to bend the curve of this epidemic.”
The synthetic drug fentanyl, often mixed with heroin and other drugs, continues to be a major killer; it was detected in 83 percent of overdose deaths last year in which the victim was screened for the drug. Prescription opioids were present in only about a fifth of the cases, and heroin is found less and less often.
Hispanics are disproportionately affected. In 2017, 11 percent of those who died of opioid overdoses were Hispanic, compared with only 4 percent of all those who died of all causes. The opioid-related death rate among Hispanics doubled from 2014 to 2016, a situation that Bharel called “alarming.”
The data also show a 30 percent decrease in opioid prescribing in the last quarter of 2017 compared with the same period in 2016.