New Data: Illegal Drugs Drive Massachusetts’ Opioid Overdose Epidemic

September 27, 2016

New data show that street drugs, not prescription opioids, directly caused 85 percent of opioid overdose deaths in Massachusetts during 2013 and 2014. The state has seen a 350 percent increase in opioid-related deaths since 2000. The Massachusetts Department of Public Health report casts new light on the state’s high-profile struggle – and demands a renewed look at how policymakers and law enforcement should respond.

Massachusetts Department of Public Health Data

Under a cooperative approach made possible by state law, the report synthesizes various government data sets to analyze the state’s overdose epidemic. Findings include:

  • Illegal drugs such as fentanyl and heroin are most closely linked to overdose deaths.
    • 85% of overdose death toxicology reports showed the presence of heroin or fentanyl
    • Only 8.3% of people who died of an overdose had filled a prescription for opioids in the preceding month, but a majority had filled a prescription during the previous four years
  • Nonfatal overdoses may present an opportunity for treatment
    • 8% of those who died had experienced an overdose before
    • People who undertook opioid antagonist treatment using medications like methadone and buprenorphine had half the risk of going on to a fatal overdose than those who did not receive treatment
  • Women are more likely than men to die from prescription opioid-related overdoses
    • Though 85% of the deaths reported were from illegal drugs, those who did die from prescription opioid overdoses were more likely to be women
  • Youth and former prison inmates are most likely to die from overdose
    • Recently released inmates are 56 times more likely to die from an opioid overdose
    • Opioids contribute to one-fourth of all deaths for youth ages 18-24 and a third of all deaths for people 25-34 years old.

Impact & Policy Implications

The report’s authors suggest more attention to medication-assisted treatment opportunities, describing a “short window of opportunity” to help people before a non-fatal overdose leads to a fatal one. The report also suggests educating prescribers and pharmacists about potential biases toward prescribing opioids to females, who are both more likely to fill prescriptions at multiple pharmacies and more likely than men to die of a prescription opioid overdose.

Massachusetts’ recent policy responses to the state epidemic have focused on prescription opioids. Earlier this year, Governor Charlie Baker signed into law legislation that limits first-time opioid prescriptions to seven days, requires overdose patients seeking emergency room care to be evaluated in 24 hours and gives physicians information about non-opioid pain treatment options.

The governor also signed a fentanyl trafficking bill, which makes trafficking the substance a crime punishable by up to 20 years in prison. The state’s new data suggest that law enforcement provisions may continue to be pivotal in addressing Massachusetts’ opioid overdose epidemic.

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