Fentanyl continues to drive overdose deaths in 2016

For the Gazette
Friday, August 05, 2016

The presence of fentanyl, a synthetic opioid considered to be about 50 times as powerful as heroin and 100 times stronger than morphine, has emerged as the major culprit in opioid-related overdose deaths statewide, according to state data released this week.

The drug, which officials say has been finding its way from manufacturers in China to drug cartels in Mexico before being mixed into batches of heroin in the United States, was found to have been present in 66 percent of overdose death cases in the first six months of this year.

That’s up 9 percent from 2015.

“It’s the deadly cousin of heroin,” said Northwestern District Attorney David Sullivan of the drug. “It’s a really deadly cocktail that gets mixed in with heroin, and there is no way anyone knows if it’s in there or how pure it is.”

For just the first half of 2016, 504 people have been confirmed to have died of opioid-related overdoses, with an estimated 482 unconfirmed deaths on top of that.

Sullivan said batches of heroin mixed with fentantyl were “almost definitely” the culprit behind a series of recent overdoses in quick succession that prompted the Greenfield Police to issue a public warning. Early this year, batches marked “Hollywood” elicited a similar warning.

“It’s in so many batches, and just a few micrograms can create that overdose effect,” Sullivan said.

The data shows that fentanyl has outstripped both heroin and benzodiazapines — drugs like Valium — in becoming the most common substance present in cases of opioid overdose. Rates for heroin and prescription drugs in those cases have been decreasing at roughly the same rate that fentanyl has been increasing.

Sullivan said that years ago, heroin addicts typically had some measure of time to be able to seek treatment and kick their habit before experiencing a fatal overdose, but the introduction of fentanyl has substantially reduced that window.

“It’s become quite discouraging,” Sullivan said, noting that local and regional efforts to beat back the addiction crisis have been hampered by the stealthy drug.

He said fentanyl’s combined qualities of being extremely potent and quite inexpensive make it an appeal option for dealers looking to stretch their supply.

“It’s greedy people who don’t care if people live or die at the end of their supply route,” he said.

Earlier this year, the state passed a law making trafficking fentanyl a crime. The penalty is 20 years behind bars.

Overdose deaths continue to mount

The data also shows rates of opioid-related deaths are also up overall.

In 2015, the estimated rate of unintentional opioid-related overdose deaths was 24.6 deaths per 100,000 residents statewide, a 23 percent increase from the rate of 20 deaths per 100,000 residents in 2014.

In total, 1,658 people died from overdoses last year. That number is expected to rise as more suspected overdose cases are closed by the Chief Medical Examiner’s office.

Franklin County ranked ninth out of the state’s 14 counties in terms of opioid-related overdose deaths rates. With a population of around 71,000, the county lost 17 residents, or roughly two people for every 10,000, in 2015.

In western Massachusetts, only Berkshire County had a higher rate per 10,000 residents. Hampshire County had the second lowest number of deaths in the state after Nantucket County.

Of the 2016 deaths, three-quarters were men. Sixty-eight percent of victims were under the age of 44, according to demographic data released among the statistics. Eighty percent were white, while Hispanics were the next highest demographic at 14 percent.

Data from the state’s Prescription Monitoring Program, which serves as a repository of data for all prescription drugs dispensed statewide, including those prescriptions that are sought after for illicit and non-medical use and thus represent the highest potential for abuse, shows the total number of opioid Schedule II prescriptions and the number of individuals receiving Schedule II prescriptions were both at their lowest level since at least the first three months of 2015.

Under new state opioid abuse prevention legislation passed earlier this year, all medical providers are now required to check the system when prescribing opioids.

Use of Narcan by emergency medical first responders is also rising.

At the state level, legislators, experts and agencies have worked to address the growing addiction crisis, in May passing landmark legislation aimed a curbing overprescription and stopping abuse before it starts.

Locally, officials continue to work on their own initiatives, including the recent openings of a 64-bed detox center in Greenfield and a Family Drug Court — the state’s first — which aims to give substance abusers with families an alternative to the court system while addressing the traumatic effects their use could be having on their children.