The opioid epidemic continues to take a toll, as fentanyl-related deaths continue to rise, according to the state Department of Public Health's quarterly report on opioid overdose deaths released Monday.
The state DPH released preliminary 2016 third-quarter and updated 2015 data on opioid-related deaths in Massachusetts. According to the report, there were 1,005 confirmed cases of unintentional opioid overdose deaths for the first nine months this year, with an estimated 392 to 470 suspected opioid-related deaths that may be added to that total. That's a pace higher than the first nine months of 2015.
In addition, there has been a continued drop in death rates involving heroin, which have decreased at about the same rate that fentanyl-related deaths have increased. Almost three-quarters of deaths in the third quarter had a toxicology screen showing a positive result for fentanyl.
Fentanyl is a synthetic opioid that has effects similar to heroin. It can be prescribed for severe pain.
While pharmaceutical fentanyl is diverted for abuse in the United States at small levels, much of the fentanyl available in Massachusetts is due to illicitly produced fentanyl, not diverted pharmaceutical fentanyl, according to the U.S. Department of Justice, Drug Enforcement Administration's 2015 Investigative Reporting.
"The main takeaway is that the numbers are not going down," said Bill Garr, CEO of Lowell House.
"The numbers are going up, so we need something very dramatic to get this under control," he added.
Middlesex District Attorney Marian Ryan said officials here are using a multipronged approach to tackle the problem, working with a task force on prevention and education while using prosecution to target dealers.
"We're certainly interested in the piece only we can do, which is investigating the fentanyl that's coming into the area and trying to stop the supply," Ryan said.
Ryan said that despite the drop in heroin overdoses, the increase in fentanyl overdoses has pushed the overall number of fatalities higher already this year than it was in all of 2015.
She said there were 185 fatal overdoses in Middlesex County in 2015, and that there have already been 204 in 2016, with nearly two months left in the year.
"We're looking to reduce fatal overdoses across the board, regardless of whether they involve pure heroin or heroin laced with Fentanyl," Ryan said.
The report also includes the following data:
n A quarterly decline this year in the number of prescriptions and patients receiving schedule II and III opioids, when compared to the same three-month period in 2015.
n A steady increase in the number of opioid-related EMS transports, with a parallel increase in the number of transports requiring more than one naloxone. or narcan, administration in an effort to reverse the overdose.
"In our commitment to combat the opioid epidemic, we believe the constant release of data is a powerful tool to help us better understand the trends of this public-health crisis," Gov. Charlie Baker said in a statement. "We will continue to utilize every tool available from prevention to treatment to break the cycle of addiction to support healthy families and communities across the commonwealth."
During the three months covered by the quarterly portion of the report, the administration has rolled out several new opioid-prevention, intervention and treatment initiatives including:
n Expanding first-in-the-nation core competencies for safe prescribing of opioids to community health centers, advanced nursing, physician assistant and dental schools.
n Launching MassPAT, an online prescription awareness and monitoring tool.
n Approving new standing orders that allow EMS providers to administer a higher dose of naloxone to counteract overdoses. The change was in response to the need for stronger, multiple doses required for overdoses caused by fentanyl, which is far more potent than heroin.
n Adding 75 treatment beds in Taunton and western Massachusetts.
n Releasing an unprecedented report using advanced data to further understand the underlying causes of opioid-related deaths.
"While we continue to see a decline in the number of deaths involving heroin, the data released today are a sobering reminder of why the opioid crisis is so complex and a top public-health priority," Secretary of Health and Human Services Marylou Sudders said in a statement. "This is a crisis that touches every corner of our state, and we will continue our urgent focus expanding treatment access."
Health officials cautioned that the opioid crisis had been building for years before escalating dramatically in 2014, and noted that addressing its effects will take a long period of sustained effort.
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