December 5, 2018

Mass. overdose death rate far exceeds national average

Photo/Courtesy/Flickr-Cindy Shelby
Synthetic opioids have been a major contributor to rising fatal overdose rates in Massachusetts and nationally.

The death rate from drug overdoses in Massachusetts far exceeds the national average, in large part to the state's opioid crisis, according to a new federal report.

Massachusetts had 31.8 drug overdose deaths per 100,000 people last year, compared to a national average of 21.7, the Centers for Disease Control and Prevention reported Nov. 29. The Massachusetts rate was 10th worst in the nation.

Both in this state and across the country, rates have risen sharply in recent years as opioid overdoses, especially from synthetic opioids such as fentanyl, have skyrocketed.

Fatal overdoses from synthetic opioids, excluding methadone, rose nine-fold from 2013 to 2017, CDC data shows.

The latest federal report adds to existing data showing how much the opioid crisis has worsened. Prescription opioid deaths were five times higher in 2016 than in 1999, according to a study published in March in the American Journal of Public Health.

In 2017, doctors prescribed 59 opioids per 100 patients, lower than the rate of 81 prescriptions per 100 patients in 2012 but still far above rates from two decades ago, according to CDC data.

The Massachusetts Department of Public Health does not specify synthetic opioid overdoses, but opioid overdoses overall in the state have numbered more than 1,500 through the first nine months of this year.

The Massachusetts Medical Society, responding to the report, said although its advocacy work is continuing, it is encouraged opioid prescriptions in Massachusetts have fallen by what it says is 35 percent in the last three-plus years.

"We must continue to work to expand the availability of appropriate treatment, including expanded coverage for evidence-based non-opioid pain treatment options," the society said. "Fentanyl is present of 90 percent of fatal drug overdoses in our state, so we will continue to work with all concerned parties on increasing efforts to prevent fentanyl-induced overdoses."

The society has advocated for expanded access to naloxone, the opioid overdose-reversing medication, and has even said the state should have a pilot supervised injection facility for more responsible use.

Steve Walsh, the president and CEO of the Massachusetts Health & Hospital Association, said the group and its member hospitals are committed to easing and ultimately ending the opioid crisis, including by issuing new guidelines for emergency department and in-patient opioid misuse prevention. He cited recent state data showing the drop in opioid prescriptions.

"But even one death is too many, and there is still more to be done to defeat this scourge," he said. "Hospitals across the commonwealth remain on the front lines of the opioid battle and are among those leading the charge."

The Massachusetts Department of Public Health said the state is continuing an aggressive response to the opioid crisis with first-in-the-nation limits on opioid prescribing, the creation of a prescription monitoring program and mandated addiction education curriculum in medical, dental and social work schools. Among other initiatives, the state has also increased access to medication for opioid use disorder programs in the community and in some houses of correction, the department said.

The new CDC report highlighted opioid deaths but didn't detail other drugs factoring in the total drug overdose rates.

For Massachusetts, its national rankings have slowly improved even as the total overdose death rate has risen sharply. The rate was 11.0 fatal overdoses per 100,000 residents in 2010 before starting a fast climb.

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