Opinion

Mixed bag in state’s opioid report

The latest data from the state Department of Public Health on overdose deaths is hardly cause for celebration.

The fact that 1,460 people are confirmed to have died, or were suspected of dying, from opioid-related overdoses during the first nine months of the year is noteworthy because it’s about 100 fewer cases than reported in the first nine months of 2018.

But 1,460 is still a grossly large number — more than five overdose deaths per day, on average. It puts the state on track to end the year with about 1,950 deaths from overdoses, which would be fewer than the 2,095 recorded at the deadliest point of this crisis, in 2016.

Then one considers that each of those 1,460 deaths is an individual tragedy affecting families, friends and neighbors, and the depth of loss dulls any glimmer of good news.

Still, there is good news.

That things are improving at all is due in large part to a focused effort to expand the availability of overdose-reversing drugs. While the state estimates overdose deaths, we don’t know how many non-fatal overdoses happened in the first nine months of the year. That’s to say, we don’t know how many times a shot of naloxone brought someone back from the edge.

We do know that the drugs at play in overdose cases are more potent, more often. During the first six months of this year, fentanyl was present in 93% of overdose-related deaths — a four point increase from 2018. Were it not for more widely available supplies of naloxone, for first-responders and family members of addicts, the crisis doubtless would be more fatal than it is.

And that’s just one factor. A Department of Public Health press release on Monday noted the impact of other strategies in blunting the overall crisis, including more behavioral and medication-based treatment programs, more recovery programs and more treatment beds. The state has been pouring resources into preventing and treating substance abuse — $246 million in the latest budget alone, according to the press release. “Today’s report affirms that our multi-pronged approach to the opioid epidemic is making a difference,” Gov. Charlie Baker said in the statement.

The numbers truly worth cheering are signaled further upstream in the cycle of opioid addiction, where state intervention really does seem to be making a significant difference. That’s in monitoring opioid prescriptions — the well-meaning pain management that has started many an addiction.

In July, August and September of this year, providers searched the state’s prescription monitoring database 2.2 million times. That represented a 10% increase in queries from the previous three-month period. Providers are referring to the database more often, using the tool to research how often patients are given what kind of drugs, and in what quantity. Apparently providers armed with this knowledge are writing fewer prescriptions as a result.

The July through September period saw about 500,000 prescriptions for Schedule II opioids, which include oxycodone and prescription fentanyl, written across the state. That was 40% fewer than the 842,000 prescriptions written in the first three months of 2015. The number has been in steady decline over that period.

Prescriptions for painkillers may not be an exact predictor of opioid use and abuse, but they are related. Prescription drugs were found in about 13% of the cases of opioid-related overdose deaths in the April through June period of this year — a rate that’s held steady for the past couple of years, according to the Department of Public Health.

The bottom line is that measures of the state’s opioid problem are a mixed bag. As Beacon Hill, cities and towns, and service providers pour ever more resources into this crisis, we are seeing tangible results. Yet far too many people are still succumbing to this deadly disease.

The drumbeat of tragedy may be slowing — but it’s not stopping.

This editorial first appeared in the Newburyport Daily News on Nov. 27.

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