Massachusetts, New Hampshire, and Rhode Island are among only five states that did not experience an increase in opioid overdoses last year, according to data released Tuesday by the US Centers for Disease Control and Prevention.
The CDC tallied the number of people who came to emergency departments after overdosing on opioids from July 2016 through September 2017. The data came from 16 states, which on average saw a 35 percent increase in overdoses.
But Massachusetts, New Hampshire, and Rhode Island instead recorded slight declines in overdoses, too slight to be statistically significant.
Those three states already had very high overdose rates, and it’s not clear “whether we’re seeing real, true, persistent declines or statistical fluctuations,” said Dr. Anne Schuchat, the CDC’s acting director. It’s also possible, she said, that efforts to address the problem and increase access to medication-assisted treatment are bearing fruit.
Massachusetts, Rhode Island, and New Hampshire all had previously reported declines in deaths from overdoses from 2016 to 2017. Those numbers showed only fatalities, raising questions about whether the decrease merely reflected the many rescues by the overdose-reversing drug naloxone, rather than any decline in drug use.
The CDC data, however, include people who survived overdoses and still found no increases in those three states.
“For every fatal case, there are many more nonfatal cases, each one with its own emotional and economic toll,” Schuchat said.
Among the other states that provided data, some saw startling increases: 109 percent in Wisconsin, 105 percent in Delaware, 81 percent in Pennsylvania.
Maine saw a 34 percent increase. Data were not available for Vermont and Connecticut.
Kentucky, another state hard hit by the opioid crisis, experienced a statistically significant 15 percent decline, which may reflect fluctuations in the illicit drug supply. West Virginia logged a slight decline, not statistically significant.
“We’re currently seeing the highest drug overdose death rates ever recorded in the United States,” Schuchat said.
In addition to the data from the 16 states, the CDC analyzed a separate database from 52 jurisdictions in 45 states, encompassing 60 percent of emergency department visits. This showed a 30 percent increase in overdoses from July 2016 through September 2017, occurring across all regions and among every demographic group. Large metropolitan areas experienced the biggest increases in overdose rates.
Schuchat called on emergency departments to directly connect overdose survivors with treatment or provide “navigators” who visit them afterward.
Dr. Melisa Lai-Becker, president of the Massachusetts College of Emergency Physicians, said emergency departments around the state are trying to find ways to connect patients with addiction treatment. A few have hired recovery coaches and navigators. Some hospitals are exploring establishing specialty clinics to treat addiction, similar to those that treat diabetes or asthma.
She compared the emergency department to the fire department, charged with stopping an immediate calamity. “Similar to fire departments that engage in fire prevention strategies,” she said, “we’re trying to figure out what we can do to reduce harm and to prevent these patients from having to present to the emergency department at all.”