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The number of people dying of opioid-related overdoses in Massachusetts has continued its slow and steady decline, even amid the growing prevalence of illicit fentanyl, the state Department of Public Health said Monday.

The agency’s quarterly report on opioid-related deaths shows that 1,460 people died of an opioid-related overdose between January and September, down by 6 percent from 1,559 deaths in the same period last year.

“This is progress and this is significant, and I’m encouraged by it,” said Dr. Monica Bharel, the state’s public health commissioner. “This means that our public health approach to this medical illness is working. We still have a lot of work to do but we’re heading in the right direction.”

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The death rate has been dropping slightly since 2016, but the numbers are still high, with more people dying in the first nine months of 2019 than in all of 2014.

The report, however, shows continuing trends in terms of the drugs used by people who died. Fentanyl, a synthetic opioid, played a role in 93 percent of opioid-related overdoses from January to June, up from 89 percent in the same period last year, the department said. Overdose deaths involving prescription drugs have remained at a steady, low level, accounting for fewer than 1 in 5 since 2017.

The report also reveals a sharp increase in the number of emergency medical services calls for opioid-related problems during the first half of 2019, from 5,057 in the first quarter to 5,712 in the second, a 13 percent increase.

Bharel said the EMS numbers include not just people who overdosed but those exhibiting symptoms of withdrawal, and the state has been fine-tuning its data collection, Bharel said.

It’s not clear whether the numbers reflect an increase in drug use or overdoses, better incident reporting, or merely a greater willingness to call for help. “People are coming in the EMS to get the care they need,” she said.

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Additionally, Bharel said, a six-month period is too short to draw any conclusions. “We need to see more quarters,” she said.

The latest opioid report includes two new sections: One details opioid and benzodiazepine use during pregnancy and substance exposure in newborns.

It found that 1.5 percent of hospital births in 2019 were to women who were using opioids or benzodiazepines during pregnancy and 1 percent of babies were born exposed to controlled substances.

(The discrepancy reflects the fact that some babies don’t exhibit withdrawal symptoms even if their mothers used, and possible record-keeping quirks.)

There was wide variation across the state. In Bristol and Berkshire counties, more than 8 percent of mothers who delivered babies in 2019 used opioids or benzodiazepines; in Suffolk County it was less than half of a percent.

Many of the women who took opioids during pregnancy were not using illicit drugs but rather prescribed medications to treat their addiction.

The new data, Bharel said, are intended to raise awareness.

“We are advocating for the screening of all pregnant women for addiction,” she said.

“Moms who use opioids and their infants born exposed to them are one of our highest-risk groups,” Bharel added.

The second new set of data focuses on emergency department visits related to opioid use, showing that men were more than twice as likely as women to go the emergency department with opioid or heroin-related issues.

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Bharel noted that state law requires emergency departments to initiate treatment for addiction and connect patients with ongoing care.

“It’s another opportunity to get an individual with opioid use disorder the treatment and opportunity for recovery that they need,” she said.


Felice J. Freyer can be reached at felice.freyer@globe.com and Alyssa Lukpat at alyssa.lukpat@globe.com. Follow them on Twitter @felicejfreyer @AlyssaLukpat.