The already-devastating opioid crisis is getting worse.
Massachusetts experienced 2,357 confirmed and estimated fatal opioid-related overdoses in 2022, a new record high, according to data the state Department of Public Health published Thursday, June 22. The fatality rate of 33.5 per 100,000 people reflects a 2.5 percent increase over 2021 and a 9.1 percent increase from 2016, the pre-pandemic peak.
The crisis was especially pronounced among non-Hispanic black residents, for whom overdose deaths increased 42 percent. The most rural areas of the state had the highest overdose death rate, compared to more densely populated regions.
State public health officials said a major factor driving the jump in fatalities is the increasingly common presence of multiple substances, especially fentanyl, contaminating the drugs a person might use.
The state Department of Public Health planned to release the latest opioid report at a Public Health Council meeting Thursday afternoon. Robbie Goldstein, the commissioner of the state Department of Public Health, and other Healey administration officials briefed reporters beforehand about the trends and their response efforts.
The Healey administration signaled it will pursue several strategies to try to limit the damage, including creating a statewide overdose prevention hotline and instructions for the state Department of Public Health to craft a “comprehensive plan” to prevent overdoses.
That plan will analyze the “feasibility” of overdose prevention sites, where individuals can use pre-acquired drugs free of legal consequences under the supervision of medical professionals, who can intervene to prevent an overdose from turning fatal.
‘We Have A Poisoned Drug Supply’
Since 2012, more than 20,000 people have died of opioid-related overdoses in Massachusetts, roughly equivalent to the population of mid-sized towns such as Hudson or Marblehead.
Despite hitting a new record high, the jumps in 2022 were not uniform across Massachusetts.
Worcester County experienced nearly 18 percent more deaths in 2022 than it did in 2021, followed by a roughly 14 percent increase in Plymouth County and a 7.5 percent increase in Barnstable County. Overdose deaths fell 25 percent in Franklin County, 22.6 percent in Berkshire County, and nearly 16 percent in Hampshire County, all in western Massachusetts.
Law enforcement officials regularly announce arrests of alleged drug dealers who have mixed fentanyl, a powerful synthetic opioid, and other substances into the supply they sell to users, but enforcement efforts are not capturing all of the supply. Most fentanyl in Massachusetts is “illicitly produced,” not diverted from authorized pharmaceutical uses, according to state Department of Public Health.
Fentanyl was present in 93 percent of the fatal opioid overdoses last year where a toxicology screen took place, according to the latest report. Cocaine was present in 53 percent of those deaths, followed by alcohol in 28 percent, benzodiazepines in 27 percent, prescription opioids in 11 percent, amphetamines in 9 percent, heroin in 6 percent, and xylazine in 5 percent.
“We have a poisoned drug supply, and that poisoned drug supply is resulting in an increase in overdose deaths,” Goldstein said.
The state’s public health agency first began tracking xylazine in its last biannual overdose report published in December 2022. The substance, a sedative sometimes referred to as “tranq,” has been receiving national attention as it appears in more and more overdose cases and makes overdoses more difficult to reverse.
“We know that we’re starting to see xylazine in overdose-related deaths, and that may be playing a role here,” Goldstein said. “One of the biggest messages we have from the Department of Public Health is to make sure that first responders, those on the scene, are providing naloxone and also providing oxygen because we know there’s xylazine in the drug supply and naloxone alone will not reverse the effects of xylazine.”
Goldstein said the state has distributed 50,000 doses of naloxone to 10,000 people since Healey took office in January, adding that “we estimate that we have prevented at least 700 overdose deaths because of that.”
This summer, the department’s Bureau of Substance Addiction Services plans to kick off an effort to launch a statewide overdose prevention hotline.
The state Department of Public Health will also be tasked with identifying “deserts” where Bay Staters face the biggest obstacles accessing opioid treatment programs, especially on the Cape and Islands and in rural areas.
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