BOSTON — Hampshire County experienced a steep drop in fatal opioid-related overdoses in 2023, mirroring a trend statewide and forging a potential turning point after the state’s fatality count hit a record high the previous year.
State officials say there were 2,125 confirmed and estimated opioid-related overdose deaths last year, or 30.2 per 100,000 residents. That marks a 10% decline compared to 2022.
Hampshire County was among the areas recording the steepest drop in fatal overdoses in 2023 — 29, compared to 37 in 2022 and 44 in 2021. The 2023 fatality rate is the lowest since 2017.
Overdose deaths in Franklin County nudged up to 28, while Hampden County fatalities hit a new high at 231, one more than in 2022.
Taylor McAndrew, coordinator at Hampshire Hope in Northampton, said there was reason to be cautiously optimistic about the trend here.
At the same time, she said, “There’s no reason to slow down on the work we’re doing.”
That has included distribution of more than 550 kits of the overdose-reversal drug Narcan, generically known as naloxone, through the Northampton health department. Hampshire Hope has put up outdoor Narcan cabinets and indoor “NaloxBoxes” so people can take a kit any time they want, she said.
“We know how much Narcan goes out, but we don’t know how much has been used,” McAndrew said.
Additionally, she said, Hampshire Hope provides fentanyl testing strips, which can detect the presence of the deadly opioid when mixed with other drugs, and Tapestry has made drug checking available for people who want to know what’s in their drugs.
“We’re trying to be proactive, and connect with people in the community before overdoses happen,” she said.
While many cities and towns saw “notable” decreases in deaths in 2023 compared to the prior year, deaths in Holyoke rose by 10 to 37, the highest yearly total ever reported in the city. Fatalities in Springfield fell slightly to 102.
Attempts to reach an official in Holyoke to respond to the overdose data were unsuccessful Wednesday.
Fentanyl was present in 90% of deaths where a toxicology screen was available, and cocaine was present in 54% of cases. Alcohol and benzodiazepines were factors in approximately one quarter of deaths. Amphetamines were present 11% of the time, xylazine 9%, prescription opioids 7% and heroin 5%.
The Department of Public Health notes that, when cocaine and fentanyl are found together, it is not possible to tell whether the drugs were combined purposefully or whether the cocaine was mixed with fentanyl prior to sale.
During a briefing with reporters Tuesday, Public Health Commissioner Robbie Goldstein said the fatality rate decrease represents the “largest single year decline in opioid-related overdose deaths we’ve seen in 20 years.” The trend is expected to continue this year, based on initial data from the first three months of 2024, officials say.
Opioid-related overdose fatalities have exceeded 2,000 since 2016.
Health officials said 48% of all opioid-related overdose deaths in 2023 occurred among individuals ages 25 to 44, and 43% of deaths were among those ages 45 to 64. Men accounted for 72% of deaths.
Goldstein attributed the declining fatality rate in 2023 to the state’s distribution of naloxone as well as syringe service programs, an overdose prevention hotline, and a drug-checking program that allows officials to understand the lethality of the drug supply here.
“We have one of the best naloxone distribution programs in the country, and we have naloxone everywhere in every community, so that people can use it,” Goldstein said.
DPH said it has distributed more than 196,500 naloxone kits, with each kit containing two doses, since 2023. The effort has led to at least 10,206 overdose reversals, officials said. Officials said the department has also distributed more than 504,000 free fentanyl test strip kits to providers and community organizations.
DPH in December released a report saying health officials were in support of overdose prevention centers, also known as supervised injection sites, where medical professionals are on hand to intervene in potential overdoses. Legislation creating a path for municipalities to open the centers is before the House and Senate Ways and Means committees.
Mobile clinics that provide methadone in the Quabbin, Greater Springfield, Greater Boston, Worcester and Wellfleet regions have been another critical tool in curbing overdose deaths, said Deirdre Calvert, director of DPH’s Bureau of Substance Addiction Services. She also mentioned the importance of investing in low-threshold housing.
Goldstein said DPH’s efforts to address the maternal health crisis, including increasing the use of birth centers and growing the doula workforce, is connected to substance abuse work.
“Over 40% of severe maternal morbidity events in the state are related to substance use disorder. It’s the single largest driver of maternal morbidity in the state,” he said.
Goldstein and Calvert were in Greenfield Wednesday to meet with the Opioid Task Force of Franklin County and the North Quabbin Region. Representatives gave a rundown on the successful prevention, intervention, treatment and recovery programs and initiatives the wide-ranging coalition had brought into the region since its founding in 2013.
“It’s been very impactful for us as a community,” said Franklin County Sheriff and task force co-chair Christopher Donelan, adding he suspects the opioid epidemic would have been drastically worse without the task force. “We’re the model that people have followed and we’re very proud of that.”
In 2013, there were no residential treatment beds in the region. Now, in 2024, there are 324.
Additionally, Dr. Ruth Potee and Donelan worked in 2019 to secure a license for the Franklin County House of Corrections to be one of the first jails in the United States to administer methadone to inmates.
Kat Allen, coalition coordinator with Franklin Regional Council of Governments, said the partnerships they’ve formed with schools and community agencies with regard to prevention programs have seen youth substance abuse plummet from 53% in 2003 to just 25% today.
Goldstein praised the task foce’s efforts.
“Since September 2013, the task force has worked diligently with its partners to address the devastating impacts of opioid misuse through prevention, intervention, treatment, and recovery support,” he said. “And it’s consistently championed effective, evidence-based solutions to prevent opioid-related overdoses, becoming a national model for delivery of substance use care in rural communities.”
Material from the Greenfield Recorder was used in this report.