BOSTON — Loneliness, isolation and a lack of access to services -- these things all likely contributed to what looks to be a record number of deaths from opioid overdoses in Massachusetts last year.
A state Department of Public Health report officially logs 2,035 deaths in 2020. But it’s likely dozens more will be added to that total once the Office of the Medical Examiner completes its work.
“It’s not a surprise to many of us that work in addiction,” said Dr. Jessica Taylor, an addiction medicine specialist at Boston Medical Center. “We’ve really seen that people are socially isolated, having really profound stressors around jobs, around finance, illness of friends and family.”
And to top that off, it was hard to find help when many needed it.
“A lot of harm reduction services and treatment programs really had to change how they practice,” Taylor said. “And that disconnected people with substance use disorders from care -- and from care that can be life-saving in terms of preventing overdose.”
Taylor said compared with other states, the increase in overdose deaths in Massachusetts was small -- though still alarming.
The state’s Commissioner of Public Health is troubled by the rise, as well.
“For the first time really since 2016 we see an increase from 2019 to 2020 of about five percent in our opioid overdose death rate,” Bharel said. “This is significant to us because we have been pouring so much effort and resources into addressing the opioid epidemic even during the Covid-19 pandemic.”
But last spring, effort and resources were not enough to overcome the unparalleled challenges presented by the draconian measures needed to contain the virus.
“A lot of harm reduction services and treatment programs really had to change how they practice,” Taylor said. “And that disconnected people with substance use disorders from care -- and from care that can be life-saving in terms of preventing overdose.”
Something else that may have boosted the overdose death toll: impostor drugs. Taylor said it’s to the point that drug users have to assume if it didn’t come from a pharmacy, any drug product could very well be laced with fentanyl -- including pills.
“We’re seeing a surge in what are called ‘pressed pills’ or ‘pressies’ is the common street word,” Taylor said. “Where illicitly manufactured fentanyl is compressed into the shape of a pill that can look unbelievably similar to the actual pharmaceutical prescription pill.”
And, needless to say, illegal drugs are also commonly laced with fentanyl.
“We know that people who are, say, using cocaine or something else aren’t always aware that it may be laced with fentanyl,” Bharel said. “So it’s really important for the public to know that no matter what you’re using, there may be fentanyl or another opiate in it. And part of our campaign has been making sure that naloxone or Narcan, the reversal for overdose, is broadly available.”
In fact, as part of that campaign, Bharel said during the pandemic, DPH handed out 110,000 naloxone kits.
One troubling aspect to the DPH report: the disparities in dying.
“I think one thing we were seeing before the pandemic that has gotten worse during the pandemic, but would have probably continued, is the really substantial disparities in access to addiction treatment and in overdose by race and ethnicity,” Taylor said.
In fact, while the report shows fewer than 200 Black/Non-Hispanics dying of opioid overdose in Massachusetts last year, that number accounted for nearly five percent of deaths in the entire black community -- an overdose death rate almost twice that of whites.
And last year, the overdose death rate in black males soared.
“When we look at the black male opioid overdose rate it has increased 69 percent,” Bharel said. “And it’s completely unacceptable.”
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