State health officials: Fentanyl, cocaine fuel 'concerning trends' in opioid epidemic

State public health officials say they observed "concerning trends" in the opioid epidemic last year, particularly driven by the rising prevalence of fentanyl and cocaine in overdose deaths.

While the state Department of Public Health does not expect to publish the latest estimate of fatal opioid overdoses until its next regular report in May, Commissioner Margret Cooke told lawmakers this week that worrying signs remain amid significant efforts to blunt the damage.

"We've seen concerning trends in 2021. We've seen an increase in fentanyl, an increase in cocaine in opioid overdose deaths, an 8% increase there," Cooke said at a Ways and Means Committee hearing. "This crisis is not going away."

The department's report due out in May will for the first time include data on opioid-related overdose deaths where alcohol was also detected, Cooke said, forecasting that 32% of fatalities feature alcohol in a person's system as well.

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Preliminary state data published in November tracked an estimated 21 more opioid overdose deaths in the first nine months of 2021 than during the same period last year, for a total of 1,613 fatal overdoses from January through September of this year. In 2020, 2,106 people died of overdoses in Massachusetts.

Opioid overdose deaths across the state had been on a slow rise between 2000 and 2012, going from 375 deaths to 733 deaths, and then a sharp rise, hitting a high of 2,110 deaths in 2016.

Plymouth County had a suspected 132 fatal overdoses in 2021, down from 165 in 2020 and 143 in 2019, according to data from the district attorney's office. The data includes all suspected overdose deaths, not only those involving opiates.

Data for Norfolk County was available for only opioid-related overdoses up to 2020. In 2019, Norfolk County had 129 opioid-related overdose deaths, and in 2020 there were 156 deaths, below the peak in 2016 of 213 deaths.

Nationally, deaths from opioid-related overdoses surged during the COVID-19 pandemic. The U.S. Centers for Disease Control and Prevention reported that total fatalities in the 12-month period ending in April 2021 surpassed 100,000, a 28.5% increase from the same stretch one year earlier.

Total opioid overdose deaths in Massachusetts climbed to a record high of 2,104 in 2020. In the first nine months of 2021, the Department of Public Health reported a roughly 1% increase in fatalities compared with the first nine months of 2020.

Cooke said Monday that several factors helped Massachusetts avoid as potent a spike in deaths as the rest of the country, including a state push starting in March 2020 to distribute 134,000 additional kits of the overdose-reversal drug known as Narcan.

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The Department of Public Health has been using federal money to distribute test strips that detect fentanyl in other drugs. Fentanyl is a synthetic opioid far more potent than heroin and is present in many overdose deaths.

Cooke said the state has worked with Boston to address the epicenter of homelessness and addiction near Massachusetts Avenue and Melnea Cass Boulevard by offering more methadone take-home doses, boosting outreach staff in the region and designating more available slots in low-threshold housing.

In Massachusetts, autopsy reports are not public records. The only public record of a person's cause of death is a death certificate, which lists a general cause such as "overdose" or "heart attack," but not the underlying data and information that goes into declaring a cause of death.

State House News reporter Katie Lannan and The Patriot Ledger reporter Wheeler Cowperthwaite contributed to this report.

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This article originally appeared on The Patriot Ledger: Fentanyl, cocaine fuel 'concerning trends' in opioid epidemic