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Opioid deaths down last year in Mass. but up in Worcester

Telegram & Gazette - 7/1/2018

July 01--WORCESTER -- The number of Massachusetts residents who died from an opioid-related overdose and the number of fatal overdoses occurring in the state both decreased by an estimated 10 percent in 2017, compared with the previous year, according to statistics compiled by the Massachusetts Department of Public Health.

But Worcester bucked those trends, with both the number of fatal overdoses occurring in Worcester and the number of Worcesterites who died in a fatal overdose increasing last year -- albeit very slightly -- state health workers reported.

And so far this tear, the number of overdose responses for the Worcester Fire Department has continued to rise each month, and overdose 911 calls are on their way to exceeding last year's number.

It appears the epidemic is not abating.

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"We're still in it," said Dr. Matilde Castiel, the city's commissioner of health and human services. "We're trying to turn the corner -- I think we've made some incredible headway -- but there's a whole lot more we are going to need to do."

There is some good news, however.

So far this year, fatal overdoses in the city are on track to decrease, according to the statistics from the Worcester Police Department.

And naloxone (often referred to by the brand name Narcan) which can successfully reverse opioid overdoses, is widely -- and successfully -- being used by the Worcester Police and Fire departments.

But saving an overdose victim's life doesn't necessarily cure them of their addiction.

"It's reversing that (overdose), and that's fine -- that's what CPR does," Dr. Castiel said, comparing naloxone treatment for an overdose to CPR for those whose heart has stopped.

"But that doesn't mean that they're being treated."

And treatment is often in short supply.

"We're saving lives but we're also continually advocating for more treatment," Dr. Castiel said.

The DPH compiles statistics on the municipality of residence for each overdose decedent and -- beginning this quarter -- the overdose deaths reported in each municipality. The statistics are updated each quarter and may change in the most recent years as death certificates are finalized. The data were last updated April 20.

The Worcester Police and Fire departments also keep monthly statistics including confirmed and suspected heroin/opiate related overdoses, doses of naloxone administered, success rate of naloxone, all incidents reported as overdoses, and data on the victims.

According to the data:

Opioid-related overdose deaths for Worcesterites peaked in 2015, with 81 city residents dying -- a 45 percent increase from the 56 deaths in 2014, according to DPH.

Seventy-four Worcesterites fatally overdosed in 2016, and 77 fatally overdosed in 2017, according to the latest figures from DPH.

The number of overdose deaths occurring in Worcester also peaked in 2015 with 118 people dying -- a 37 percent increase from the 86 deaths recorded in Worcester in 2014, according to DPH.

Meanwhile, 108 fatal overdoses occurred in Worcester in 2016, and 109 were recorded in the city in 2017, DPH said.

Two out of three people who overdosed in Worcester in 2017 and through the first half of 2018 were men; the average age was 37, and more than half -- 55 percent -- were white, according to Worcester Police.

So far this year, the city's police and fire departments have recorded 638 emergency 911 calls as overdoses (both fatal and non-fatal) as of June 29, putting this number on track to slightly exceed the 1,238 overdose calls in 2017.

But while difficult to determine any trends based on half a year's worth of data, the number of fatal overdoses appears to be on track to decrease this year.

According to statistics from the Worcester Police Department, there have been 32 confirmed or suspected fatal opioid overdoses in the city recorded through June 27. This is on track to be significantly less than the 109 fatal overdoses recorded in the city last year.

So why are the number of overall overdoses up but fatal overdoses, so far, down?

One contributor is naloxone, which is carried by all police and fire personnel.

Although many overdose calls do not result in naloxone being used -- the Fire Department, for instance, did not use naloxone in 223 of 330 responses to overdose calls -- when the opioid reversal is used, it is effective.

In fact, of the 106 patients to whom the Fire Department administered naloxone so far in the first five months of 2018, 102 -- or 96 percent -- were responsive when transferred to the hospital, according to fire department statistics.

In 45 incidents to which police responded so far this year through June 28, 44 resulted in reversals, according to police statistics.

But naloxone is just one part of public safety officials' response to the opioid epidemic.

A Buyer Diversion program diverts first-time opiate offenders from the criminal justice system into treatment. The Worcester Program for Addiction Recovery aligns police with volunteers to help, support, and engage individuals who would benefit from addiction treatment. And the Crisis Intervention Team follows up with individuals who struggle with mental health and addiction.

In addition, the police have installed a prescription box in their lobby for people to dispose of unwanted medications, and regularly collect unwanted prescriptions at neighborhood Crime Watch meetings.

Dr. Castiel said the city has educated fire personnel and staff at Recreation Worcester on addiction, is working to incorporate social and emotional learning programs in the schools to help address childhood trauma that can lead to addiction, and is partnering with other communities and community organizations to address treatment for at-risk populations such as the homeless and those who have been incarcerated.

Dr. Castiel also hopes to soon establish a "bridging clinic" connecting patients who have been treated for an overdose in the emergency room with mental-health services, medically-assisted treatment, recovery coaches, and other care. All in the hope of not just saving lives, but ending an epidemic.

"We need the hospitals to be a part of this, physicians to be a part of this ... we're bringing behavioral health as a part of the process, advocating for this in schools," Dr. Castiel said. "We need all hands on board."

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(c)2018 Telegram & Gazette, Worcester, Mass.

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