Unintentional opioid-related overdose deaths were on the rise in Massachusetts in 2015, according to data released by the state Department of Health this month. The single exception to the trend was Hampshire County, the only county in the commonwealth to see a drop in opioid-related overdose deaths last year.
Statewide, there were 1,379 confirmed overdose deaths in 2015. This indicates an 8 percent increase from the previous year when the death toll stood at 1,282.
The data show opioid-related overdose deaths across the state have risen steadily over the course of five years, from 526 in 2010 to 1,379 in 2015. The latest numbers are anticipated to rise as the department works to confirm the cause of death in additional cases.
Hampshire County saw 17 opioid-related overdose deaths in 2015, a decrease from 25 deaths in 2014 and 28 deaths in 2013.
According to Hampshire HOPE Program Coordinator J. Cherry Sullivan, the shrinking death toll in Hampshire County does not mean the epidemic has gone away.
“We want to be able to celebrate the lower death rate,” Sullivan said. “But we have to recognize that (opioid addiction) is still impacting people at high rates.”
Sullivan said the increased use of Narcan by first responders and people close to those struggling with addiction may have helped bring the number of deaths down in 2015, but she does not believe it lowered the number of nonfatal overdoses.
“My theory is that all the intervention program opportunities to increase Narcan in our community help to decrease death rates,” Sullivan said.
One of the goals at Hampshire HOPE is to create a “data surveillance system” to track overdoses and deaths related to opioids in the Pioneer Valley.
Sullivan cited the Tapestry Health needle exchange, the Learn to Cope support network in Northampton and access to Narcan at pharmacies such as CVS, Walgreens and Rite-Aid as steps in the right direction toward lowering opioid-related overdose deaths. She said increased access to medication-assisted treatment to battle addiction using Suboxone is another factor.
According to the statewide data, Narcan, known generically as naloxone, was administered a total of 1,2982 times in 2015. It was administered in a single use 9,127 times and it was administered more than once in 2,976 incidents.
Since the beginning of 2016, the Northampton Police Department responded to 19 overdoses they believe were heroin-related, according to Chief Jody Kasper. In 16 cases Narcan was administered by a police officer, firefighter or bystander and was effective. In the remaining cases, two resulted in death and one person refused medical treatment at the scene.
In neighboring Franklin County, opioid-related overdose deaths rose from 11 in 2014 to 16 in 2016.
Franklin County Opioid Task Force Co-Chairman John Merrigan said the task force ensures police departments report to the sheriff monthly about opioid-related overdoses and Narcan administration.
“We’ve made sure we have stayed focused on our region … every month police departments report to the sheriff on overdoses so we can track when Narcan is used,” Merrigan said.
But tactics to prevent addiction and remove stigma are not always a match for potent heroin and community resistance to acknowledging the problem.
“It’s a supply thing,” Merrigan said. “There’s going to be an impact if there is a powerful fentanyl-laced batch of heroin coming through … people start to wake up when it happens.”
Merrigan said the task force will get warnings from cities like Worcester and Springfield when a particularly potent batch of heroin comes through the region. A spike in overdoses in the smaller towns of Franklin County is expected two to three weeks later.
Heroin that causes deadly overdoses is often laced with fentanyl, Merrigan and Sullivan both said. The claim was confirmed by the Department of Public Health study, which said 57.2 percent of opioid-related overdose deaths where a toxicology screen was available had positive screen results for the narcotic.
Fentanyl, a schedule II prescription drug, is an opioid drug prescribed for pain, sometimes in the form of a patch that adheres to the skin. Sullivan said fentanyl carries a high risk of addiction.
However, dealers often supplement or “cut” their heroin with fentanyl to make it more potent, according to Sullivan. Fentanyl added to heroin does not typically come from a prescription, but from manufacturers outside the country, usually in Mexico.
Across the state, the data found opioid-related overdose deaths were highest in the eastern part of the state, specifically in Essex, Plymouth, Barnstable, Bristol and Dukes counties.
The three largest cities in the state saw deaths increase in 2015. Boston had 126 opioid-related overdose deaths in 2015, Springfield had 36, and Worcester had 57.
The statewide death rate for opioid overdoses was 22.6 per 100,000 Massachusetts residents in 2015, which was a 12.4 percent increase from the 20.1 deaths per 100,000 residents in 2014.
The data track opioid-related overdose deaths rather than strictly heroin-related overdose deaths because heroin can be hard to track as it metabolizes quickly into morphine in the body, the brief explained.
Of the opioid-related overdose deaths in 2015, 76 percent of victims were male and 24 percent were female, totaling to 1,048 and 331 people, respectively.
Of the 1,379 deaths in the state, more than three-quarters were white non-Hispanics, totaling 1,162. Hispanics accounted for 125 deaths, black non-Hispanics had 63 deaths, Asian non-Hispanics had six deaths, and 23 people died with their race unknown.
Adults ages 25 to 34 were the most impacted by opioid-related overdose deaths in 2015 with 437 deaths. Following behind were adults ages 35-44 with 350 deaths and adults ages 45-54 with 302 deaths. There was one death in the 0 to 14 age range, 142 deaths in people ages 15-24, 132 deaths in people ages 55-64 and 15 deaths in people over 65.
The brief also included county-level data from the Department of Public Health’s prescription drug monitoring program for the first quarter of 2016.