Deaths from opioid overdoses continue to decline in Massachusetts, but a troubling reality lurks behind that good news, according to a report released Wednesday: Progress against opioid-related fatalities has been starkly uneven, with the crisis actually worsening in certain pockets.
One of the hardest hit regions is Hampden County, which encompasses Springfield and Holyoke, according the Department of Public Health’s quarterly report on opioid-related deaths.
In that county, opioid overdose deaths increased a stunning 84 percent from 2017 to 2018, more than double the number in 2015 and, at 208, the highest count ever recorded there. In Springfield alone, the number of deaths doubled last year.
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In contrast, Plymouth County, which includes Brockton and Bridgewater, experienced a 26 percent drop in overdose deaths from 2017 to 2018, vastly better than the statewide decline of barely 1 percent during that time.
“The data is constantly teaching us something about the nature of the opioid epidemic across the Commonwealth, and it allows us to target our resources,” said Dr. Monica Bharel, state public health commissioner. It can also, she said, prompt local officials to ask themselves, “What do we need to do differently?”
Plymouth County, Bharel said, is reaping the benefits of a strong collaboration among police, addiction treatment providers, and health care workers. “I’m hopeful that [other] local communities can use this information to also do the same,” she said.
In Springfield, opioid-related overdose deaths more than doubled among that city’s residents, spiking to 80 in 2018. Just as bad are the numbers of people who died while in Springfield, regardless of where they live. Last year, 108 fatal overdoses occurred in Springfield, up from 56 the previous year.
Springfield Mayor Domenic Sarno, in a statement e-mailed late Wednesday, said the city “has been committed to combating the opioid epidemic . . . but obviously there is more work to do.”
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Katherine Cook, vice president of behavioral health services at the Springfield-based Center for Human Development, said the city sits on the Route 91 drug-trafficking corridor, putting it at greater risk. Additionally, she said, there has been a focus on the plight of rural communities, when urban areas such as Springfield also need attention. That’s starting to happen with several state-funded recovery centers scheduled to open in the region, Cook noted.
Dr. Peter D. Friedmann, an addiction specialist and chief research officer at Baystate Health, said that Springfield “has only recently accelerated its efforts to address the crisis.” The city’s first syringe exchange, a program that offers free needles and access to health and addiction-treatment services, opened in 2018. Friedmann said the city needs more such sites.
“We need more aggressive naloxone distribution and more physicians willing to prescribe buprenorphine,” a drug that treats opioid addiction, Friedmann added.
Only this past March did the Springfield Police Department begin carrying naloxone, the overdose-reversing drug, widely used by first responders throughout the state.
In contrast, Brockton — where fatal overdoses fell from 71 in 2017 to 51 in 2018 — was the first city in the state to have all first responders carry naloxone — not just emergency medical services, but also police officers and firefighters. They typically reverse about 1,000 overdoses a year, according to Mayor Bill Carpenter.
“A number of our initiatives over the past few years are having an impact,” Carpenter said.
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For example, he said, the city’s Champion Plan, which started in February 2016, enables anyone to walk into the Police Department and ask for a referral to addiction treatment. A Plymouth County program pairs recovery coaches with police officers who visit people a few days after they overdose, to offer treatment.
But while fewer people are dying, overdoses overall are down only slightly, Carpenter said. “We’ve become better at preventing deaths,” he said, “but we don’t for a second believe we’ve turned the corner on this public health crisis.”
The health department’s report identified several cities and towns with a change in fatal overdoses of 20 percent or more from 2017 to 2018.
Attleboro, Brockton, Medford, Peabody, and Weymouth all saw significant declines in overdose deaths among their residents.
In contrast, Chicopee, Framingham, Lawrence, Lowell, Springfield, and Worcester saw major increases.
Boston has seen declines in fatal overdoses: they dropped from 195 in 2017 to 180 in 2018 among city residents; the number of opioid-related deaths occurring in the city fell from 276 to 242.
Among counties, Barnstable, Berkshire, Franklin, Hampshire, and Worcester counties (in addition to Hampden) saw increases in opioid-related deaths from 2017 to 2018. Decreases occurred in Bristol, Essex, Middlesex, Norfolk, and Suffolk (in addition to Plymouth). Numbers from Dukes and Nantucket counties were too small to establish trends.
Statewide, the total number of confirmed and estimated opioid-related overdose deaths was 2,033. That’s 17 fewer deaths than in 2017, a drop of less than 1 percent. By comparison, there were 2,100 confirmed opioid-related overdose deaths in 2016, making for a 4 percent decline over two years.
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For the first quarter of 2019, preliminary data show 497 confirmed and estimated opioid-related overdose deaths. That’s about 5 percent fewer deaths than in the first quarter of 2018.
Synthetic fentanyl acquired illegally continues to play a major role in the deaths, with the drug found in 89 percent of those screened. Among those who died, cocaine and amphetamines are increasingly common, while heroin continues to decline.
Other findings in the report:
■ The percentage of opioid-related overdose deaths involving prescription drugs declined from 2014 to 2016 and has remained stable since then. In the fourth quarter of 2018, approximately 13 percent of those who fatally overdosed had prescription opioids in their bodies.
■ In the fourth quarter of 2018, cocaine was present in about 39 percent of opioid-related overdose deaths and amphetamines were present in approximately 9 percent.
■ While 72 percent of those who died of opioid overdoses were men, the death rate for women has been increasing.
■ After a sharp increase in 2017, fatal overdoses among black men fell back to the 2016 level.
Felice J. Freyer can be reached at felice.freyer@globe.com. Follow her on Twitter @felicejfreyer.