The number of people who died of opioid-related overdoses fell nearly 11 percent in the first six months of 2019, compared to the same period last year, continuing a downward trend that started in 2017, according to the latest quarterly report from the Massachusetts Department of Public Health.
The decrease follows a 4 percent decline from 2016 to 2018, according to the report, released Wednesday.
But the statistics don’t tell the whole story, said Dr. Dustin Patil, director of addiction psychiatry at Tufts Medical Center. “When you look at the absolute numbers, we’ve gone from horrible to less horrible,” Patil said. “So many people are still dying.”
In the first six months of 2019, there were 938 confirmed and estimated opioid-related deaths in Massachusetts, 112 fewer than the 1,050 deaths between January and June of 2018.
Those numbers are still exceedingly high. In 2011, by way of comparison, there were 656 opioid-related fatal overdoses throughout the entire year.
“On the ground, in the hospital,” Patil said, “it feels as if the opioid crisis is still impacting our patients and our community as hard as it ever has.”
The data, described as preliminary, show that deaths continue to decline despite the growing presence of illicit fentanyl in the drug supply.
Fentanyl was found in 92 percent of the people who died of overdoses and were tested, the highest rate to date. Manufactured illegally and mixed with various street drugs, fentanyl is many times more powerful than heroin and more likely to lead to overdoses.
“Fentanyl keeps making our jobs harder,” said Dr. Monica Bharel, the state’s public health commissioner.
State health officials have worked to ensure widespread distribution of naloxone, the overdose-reversing drug often referred to by the brand name Narcan. Many first responders throughout the state carry it, and anyone can buy naloxone from pharmacies without a prescription. Pharmacies dispensed more than 42,000 naloxone kits last year, Bharel said.
Additionally, since 2007, the state’s Overdose Education and Naloxone Distribution program has been providing naloxone training and kits to people at high risk of experiencing or witnessing overdoses, engaging drug users themselves in saving lives. Since the program’s inception, bystanders used naloxone to reverse an overdose some 16,000 times, and 89 percent of those performing the rescues were people who use drugs.
But even as more people are rescued, has there been any change in the number who overdose in the first place?
Plymouth County police chiefs track both fatal and nonfatal overdoses, and their data are encouraging. Fatal overdoses in the county fell 18 percent from 2017 to 2018 — and nonfatal overdoses fell 13 percent.
First responders throughout the county carry naloxone. Additionally, several police-sponsored programs aim to address the crisis. Overdose survivors receive a visit the next day from a plainclothes policeman and a recovery coach, who offer to help connect them to treatment.
When that effort started, said Plymouth Police Chief Michael E. Botieri, he expected half the people to turn them away. Instead, “Everyone lets us in,” he said.
Additionally, a person suffering from addiction or a relative can call or visit a police station seeking help finding treatment. These “self-referrals” doubled from 2017 to 2018.
Asked if these programs are responsible for the decline in overdoses in the county, East Bridgewater Police Chief Scott Allen said, “It’s a little early to be taking credit. We still recognize there’s a lot of work left to do.”
Patil, the Tufts addiction psychiatrist, agrees that — statewide — more needs to be done.
The state has done a good job of getting people into treatment for the short term, but has failed to reconnect them to society and help them achieve meaningful lives, Patil said. “I see people who are hospitalized all the time as a result of their substance use disorder,” he said. “They tell me they want to work. But they have no idea where to start in that process. . . . They have no avenue out of addiction.”
The health department’s report also showed that amphetamines are increasingly found in the bodies of those who died; it was present in about 8 percent of those who underwent a toxicology screen in the first quarter of 2019.
Meanwhile, heroin is declining; it was found in about 30 percent of deaths, down from a peak of about 75 percent in 2014.
Prescription opioids continue to be a minor factor in deaths, found in only 15 percent of opioid-related overdoses in the first quarter of this year. Doctors are also prescribing less: Opioid prescriptions have declined 40 percent since 2015.