Wednesday, December 14, 2022

Massachusetts opioid-related overdose death rate declines 1.5 percent in the first nine months of 2022

Boston — Opioid-related overdose deaths in Massachusetts decreased in the first nine months of 2022 compared to the same time last year, according to preliminary data released today by the Massachusetts Department of Public Health (DPH). In the first nine months of this year, there were 1,696 confirmed and estimated opioid-related overdose deaths, approximately 25 fewer deaths than in the first nine months of 2021, or a 1.5 percent decrease.

The decline in opioid-related overdose deaths in the state occurred despite a drug

supply that is heavily contaminated with illicit fentanyl, a potent synthetic opioid detected in the toxicology of nearly every opioid-related fatal overdose in the first half of the year.

The preliminary data also show that in 2021, there were 2,301 opioid-related overdose deaths, a 9.4 percent increase over the previous year. The 2021 opioid-related overdose death rate of 33.1 per 100,000 people was 11 percent higher than in 2020 (30.0 per 100,000).

The Baker-Polito Administration has long prioritized fighting the opioid epidemic on multiple fronts and has maintained that focus throughout the COVID-19 pandemic. Working closely with the Legislature, the Administration’s Fiscal Year 2023 (FY23) budget invests $597.2 million in total funding for a wide range of harm reduction, treatment, and recovery programs to support those struggling with substance use disorder, and programming that mitigates substance addiction, including through prescription monitoring and education for providers and communities.

“Since taking office in 2015, our administration made the opioid epidemic an urgent priority, signing two landmark laws to strengthen and expand efforts addressing this public health crisis and working with the Legislature to exponentially increase funding to support prevention, intervention, treatment, and recovery services in the Commonwealth,” said Governor Charlie Baker. “We are proud of our efforts to make these services more accessible and available to individuals and their families across Massachusetts, but also recognize that the work must continue, especially given the challenges created by the COVID-19 pandemic which has exacerbated substance misuse here and across the country.”

“Our administration’s work in fighting the opioid epidemic has always been informed by the valuable insight shared by families directly impacted by this crisis, individuals with substance use disorders, service providers, recovery coaches, and first responders,” said Lt. Governor Karyn Polito. “That insight helped us build a foundation of policies and community-level supports aimed at tackling an epidemic that has devastated too many Massachusetts families.”

Since the start of the COVID-19 pandemic, the Administration has expanded existing substance use disorder treatment and overdose prevention initiatives to help ensure uninterrupted support for individuals, families, and communities.DPH has distributed more than 210,000 naloxone kits to opioid treatment providers, community health centers, hospital emergency departments, and county houses of correction since March 2020. Federal flexibilities put in place at the start of the pandemic for take-home doses of medication for opioid use disorder (MOUD) have allowed 37 percent of Massachusetts opioid treatment program patients to receive this life-saving treatment as of October 2022, more than double the pre-pandemic average of 16 percent in December 2019.

Funds from the state’s Opioid Recovery and Remediation Fund are being invested to support prevention, treatment, and recovery programs, including $1.7 million to expand access to naloxone, approximately $3 million to increase access to MOUD, and $5 million to increase access to low-threshold housing for homeless or housing unstable individuals struggling with substance use disorder. 

“We have created a framework of evidence-based harm reduction tools, clinical treatment, low-threshold housing and recovery supports across communities to ensure access for every individual with substance use or co-occurring illness in the Commonwealth,” said Health and Human Services Secretary Marylou Sudders. “Our efforts are rooted in destigmatizing addiction and increasing public awareness that substance use is an illness and that treatment works.”

“Every life lost to opioid overdose is its own tragedy,” said Public Health Commissioner Margret Cooke. “With this report, we are encouraged by the decrease, however modest, in opioid-related overdose deaths in Massachusetts so far this year. We will continue to build on our data-driven and equity-based public health approach as we address the impacts of the opioid epidemic and the COVID-19 pandemic, especially among vulnerable populations.”

As part of the Administration’s commitment to transparency and data sharing, DPH’s Bureau of Substance Addiction Services (BSAS) launched a new dashboard to report data from BSAS-licensed or -funded programs providing services to people with substance use disorder. The dashboard will be updated semiannually and allows individuals to navigate data broken out by year, geography, and demographic characteristics.

Fentanyl continues to be the main driver of opioid-related overdose deaths in Massachusetts. In the first six months of 2022, fentanyl was present in 94 percent of opioid-related deaths where a toxicology report was available, preliminary data show. Two milligrams of fentanyl can be lethal, according to the US Drug Enforcement Administration, which issued a warning to states in the spring of a nationwide spike in fentanyl-related mass-overdose events. Since August, DPH has distributed 100,000 rapid test strip kits that detect the presence of fentanyl in drugs to providers and organizations as a tool to help reduce the chances of overdose among people who use drugs.

Cocaine is the next most prevalent drug among opioid-related overdose deaths, present in 53 percent of toxicology reports in the first six months of 2022. This marks a 6 percent increase over the first half of 2021. The presence of cocaine in toxicology has increased about 2 percent each quarter since 2014.

Alcohol was present in 28 percent, benzodiazepines in 26 percent, prescription opioids in 11 percent, and amphetamines in 9 percent of opioid-related deaths in the first half of 2022. The rate of heroin or likely heroin present in opioid-related overdose deaths was 7 percent and has been declining since 2014.

The veterinary sedative xylazine, a non-opioid, was present in 5 percent of opioid-related overdose deaths since June 2022, when it began to be routinely reported in toxicology.

Among the other findings of the latest opioid report:

  • Males comprise 72 percent of all opioid-related overdose deaths occurring in the first nine months of 2022.
  • 48 percent of all opioid-related overdose deaths in the first nine months of 2022 were between 25 and 44 years old; 42 percent were between 45 and 64 years old.
  • Between 2020 and 2021, the confirmed opioid-related overdose death rate per 100,000 decreased slightly for all Black non-Hispanic residents and remained stable or slightly increased for all other race/ethnic groups.
  • In the same time period, the confirmed opioid-related overdose death rate per 100,000 for Black non-Hispanic men decreased slightly.
  • Females comprise 28 percent of all opioid-related overdose deaths occurring in the first nine months of 2022.
  • Between 2020 and 2021, the confirmed opioid-related overdose death rate among all females increased from 16.4 to 17.2 per 100,000.
  • In the same time period, the confirmed opioid-related overdose death rate decreased for American Indian/Alaska Native non-Hispanic women.
  • Males aged 35-44 accounted for 21 percent of opioid-related incidents with a known age and sex treated by Emergency Medical Services (EMS).
  • Naloxone was administered in 97 percent of acute opioid overdoses during the first nine months of 2022. Of all opioid-related EMS incidents in that time, 58 percent were categorized as acute opioid overdoses.
  • The rate of individuals with multiple provider episodes (when a person uses multiple prescribers and pharmacies to obtain controlled substances) decreased over 95 percent from 14.3 to 0.7 per 1,000 individuals between 2013 and the first nine months of 2022.
    • Between 2020 and the first nine months of 2022, it went from 4.2 to 0.7 per 1,000 patients, a decrease of nearly 83 percent.

The following cities and towns experienced a notable decrease in opioid-related overdose deaths in 2021 compared with 2020.

Towns Experiencing a Notable Decrease in Opioid-Related Overdose Deaths from 2020 to 2021 that Meet Criteria*

Town

Residence

Occurrence

Both

Framingham

X

  

Weymouth

 

X

 

The following cities and towns experienced a notable increase in opioid-related overdose deaths in 2021 compared with 2020.

Towns Experiencing a Notable Increase in Opioid-Related Overdose Deaths from 2020 to 2021 that Meet Criteria*

Town

Residence

Occurrence

Both

Attleboro

X

 

 

Burlington

 

X

 

Lawrence

 

X

 

Lowell

 

 

X

Lynn

 

 

X

New Bedford

X

 

 

Pittsfield

X

 

 

Taunton

X

 

 

Templeton

 

X

 

Ware

X

 

 

Westfield

X

 

 

* Criteria: the difference in the number of deaths between 2020 and 2021 is 10 or more higher in absolute number and 20% or higher in percent change.

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