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The State of the Opiate Epidemic in MA (2018)

The current opiate epidemic in the United States dates back to the late 1990s when pharmaceutical companies assured health care providers and the public that opioids were not addictive pain relievers. As a result, healthcare providers prescribed them at higher rates, and people did, in fact, become addicted to them. As more prescriptions were handed out, misuse of opiate painkillers increased, and the use of non-prescription opiates grew as well.

The opioid epidemic was declared a national public health emergency by the U.S. Department of Health and Human Services (HHS) in 2017. Opioids included in the statistics of the epidemic include heroin, opioid-based prescription painkillers, non-prescription opioid painkillers, and synthetic opioids.

HHS has provided the following statistics of opioid drug use across the U.S. in 2017:

  • Approximately 11.4 million people have misused prescription opioids.
  • About 2.1 million people have an opioid use disorder.
  • More than 130 people die every day from opioid-related overdoses.
  • More than 42,000 people died from opioid overdose.
  • About 2 million people misused opioids for the first time.

The opioid epidemic is not only concerned with the people misusing opioids but also by the family, friends, and communities affected by the user’s actions. Health care providers, for example, have observed a steep increase in the number of newborns who experience withdrawal symptoms just after birth because their mothers used opioids during pregnancy. 

Opiate Use in MA

opiate use

As of February 2018, Massachusetts was one of the top 10 states in the U.S. for the highest rate of deaths caused by opioid overdose. In 2016, more than 1,800 people died from opioid overdose in Massachusetts alone.

Opioid use in Massachusetts is considerably higher than the average rate of opioid use across the country. The National Institute on Drug Abuse (NIDA) reports that in 2016, Massachusetts saw almost 30 deaths from opioid overdose per 100,000 people compared to the national average of just more than 13 deaths per 100,000 people.

In addition to higher rates of opioid abuse in Massachusetts compared to the rest of the country, the state has seen dramatic increases in the different types of opioids being consumed. Deaths related to heroin overdose have increased from 246 deaths to 630 deaths per year since 2012.

The greatest increase, however, was seen in deaths related to synthetic opioids. In 2012, 67 deaths were attributed to synthetic opioid overdose, but synthetic opioids caused 1,550 deaths in 2016. 

While NIDA helps to track and distribute data about national drug use, the Massachusetts Department of Public Health collects even more detailed and up-to-date statistics about opioid use in the state. From January to June 2018, the Massachusetts Department of Health collected the following numbers about opioid drug use in the state:

  • There were 657 total deaths related to opioid overdose.
  • There were 488 male deaths and 169 female deaths.
  • Among opioid-related deaths, 61 percent were individuals ages 25 to 44.
  • Among opioid-related deaths, 81 percent were individuals who were white/non-Hispanic.

Opioid abuse is also not spread out evenly across the state, according to the Department of Health’s data. Of 15,859 deaths that occurred between 2000 and 2017, Middlesex saw more than 2,900 deaths, Suffolk saw 2,058 deaths, and Essex County saw 2,061 deaths. The counties with the lowest opioid-related death rates were Nantucket at 12 deaths, Dukes at 29 deaths, and Franklin at 115 deaths.

The varying rates of opioid abuse across the state indicate that opioid drug use is not consistent throughout every county, and intervention programs need to be created accordingly. 

Why Is the Opioid Epidemic Worse in Massachusetts?

Researchers recognize that opioid abuse is nearly twice as bad in Massachusetts as in the rest of the country, but they struggle to understand exactly why that is. It is important for researchers to gain an understanding of why opioid abuse is so problematic in the state, so appropriate and effective interventions can be designed and implemented.

While researchers and health care professionals do not have an answer for the current opioid health crisis in Massachusetts yet, they have gathered data that provide possible explanations for why opioid use is so high in the state. Researchers have found that the use of fentanyl, a type of opioid that is roughly 100 times stronger than morphine, has become commonplace in Massachusetts.

Additionally, the use of illegal fentanyl, which is often manufactured and laced with other potentially more dangerous substances, is on the rise. Accidental overdose can occur when people purchase illicit fentanyl and are unaware of what other substances could be mixed in with the drug.

Experts also have identified drug trafficking routes that cross through Massachusetts. Various types of synthetic opioids are produced in New England and then trafficked across the country. Well-established drug routes in Massachusetts have made the state particularly vulnerable to the opioid epidemic. Fentanyl, cocaine, and heroin manufacturing sites have all been seized by governmental agencies in Massachusetts since 2016. 

Other risk factors, such as high heroin use, high rates of doctor-prescribed opioids, and economic hardship, play a role in the high rates of opioid abuse across the state. These risk factors are observed throughout other parts of the country, however, so they do not explain why Massachusetts has more opioid problems than the rest of the U.S. Ultimately, there is some effect of being geographically located in this region of the country that is causing Massachusetts to experience such a challenging time with the opioid epidemic.

Prevention Efforts in MA

The U.S. Centers for Disease Control and Prevention (CDC) is committed to bringing an end to the opiate crisis across the country. It has developed a three-pronged approach to tackling the crisis and providing states with the resources they need to address the epidemic as it affects each state individually. The three programs the CDC has developed are called Prevention for States, Data-Driven Prevention Initiative, and Enhanced State Opioid Overdose Surveillance.

Massachusetts has benefited from the Prevention for States program that provides funding and support to states so they can be up-to-date on and implement the most advanced opioid use interventions available.

The four types of support provided through this program include:

  1. Prescription drug monitoring programs. Goals include universal registration of use, timely collection of data, and the identification of unsafe prescribing patterns
  2. Community, insurer, or health systems interventions. Goals include improving the use of interventions by insurers and health systems, providing technical assistance to highly affected communities, and using more evidence-based guidelines for safe prescribing practices
  3. State policy evaluations. Goals include providing resources to evaluate the effectiveness of interventions for the prevention of overdoses
  4. Rapid response projects. Goals include developing innovative projects aimed at opioid crisis intervention and response to new crises as they arise.

Since 2015, states have received between $10 million and $19 million per year for the evaluation and execution of opioid use and overdose prevention strategies. Efforts include encouraging safe prescribing practices by health care providers as well as education on and prevention of opioid abuse and overdose.

The Massachusetts Department of Public Health has launched many campaigns to educate parents and individuals about opioid drug use, and to help end the stigma around being an addict and seeking treatment. The ultimate goal of these campaigns is to bring an end to the opioid epidemic that threatens thousands of lives each year. 

Getting Help for an Opioid Addiction

It can be a challenging experience to know you need help for an opioid addiction or to recognize a loved one who needs intervention services. There are many types of treatments that are used to address opioid addictions. Medications combined with counseling and behavioral therapies are often used to provide comprehensive treatment. Well-rounded inpatient and outpatient programs provide a wide range of services that can equip you with the skills necessary to live a long and healthy life free from substance use once you exit treatment. 

Even if you’ve decided to get help, it can be overwhelming to start the search for the right treatment program for you. Fortunately, local, state, and federal governments have been working together to provide addiction treatment services with the goal of ending the opioid overdose epidemic. National and state programs have been established specifically to help people who struggle with opioid addiction.

If you are living in Massachusetts, the Massachusetts Substance Use Helpline provides online resources about addiction treatment and can provide you with a list of programs in your area specific to your needs. You just need to answer a few short questions online. If you prefer, you can also call toll-free at 1-800-327-5050 to speak with someone. 

If you do not live in Massachusetts but are in search of opioid addiction treatment, the U.S. Department of Health and Human Services offers an online treatment locator. By entering your location, the site can provide you with resources and treatment centers available near you. You can also call their national helpline toll-free at 1-800-662-4357 to speak with someone about your situation. 

Sources

Current Opioid Statistics. Massachusetts Department of Public Health. Retrieved October 2018 from https://www.mass.gov/lists/current-opioid-statistics#updated-data—q2-2018—as-of-august-2018-

(February 2018). Massachusetts Opioid Summary. National Institute on Drug Abuse. Retrieved October 2018 from https://www.drugabuse.gov/drugs-abuse/opioids/opioid-summaries-by-state/massachusetts-opioid-summary

(October 2018). Opioid Abuse and Addiction Treatment. Medline Plus: US National Library of Medicine. Retrieved October 2018 from https://medlineplus.gov/opioidabuseandaddictiontreatment.html

Opioid Addiction Is a National Crisis and It’s Twice as Bad in Massachusetts. Boston Indicators. Retrieved October 2018 from http://www.bostonindicators.org/reports/report-website-pages/opioids-2018

(October 2017). Prevention for States. Centers for Disease Control and Prevention. Retrieved October 2018 from https://www.cdc.gov/drugoverdose/states/state_prevention.html

(September 2018). What Is the US Opioid Epidemic? US Department of Health and Human Services. Retrieved October 2018 from https://www.hhs.gov/opioids/about-the-epidemic/index.html

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