BOSTON, MA — Opioid-related overdose deaths in Massachusetts decreased slightly in the 12-month period ending September 30, 2023, compared to the same period last year, according to preliminary data released today by the Massachusetts Department of Public Health (DPH). Between October 1, 2022 and September 30, 2023, there were 2,323 confirmed and estimated opioid-related overdose deaths, eight fewer than the same time last year. Massachusetts had a record 2,359 opioid-related overdose deaths in all of 2022.
The preliminary data show that fentanyl was detected in 93 percent of all opioid-related overdose deaths in the first three months of this year. The increasingly toxic drug supply in the United States and ongoing opioid epidemic have claimed the lives of more than 25,000 people in Massachusetts since 2000.
The reports are being released today alongside a feasibility report recognizing that the establishment of overdose prevention centers (OPCs) in Massachusetts would be an effective intervention to combat preventable overdoses and decrease fatal overdose rates in the state.
“The overdose crisis continues to devastate our communities and families throughout Massachusetts. When I read these numbers, I’m heartbroken to think about the lives connected to each one and their loved ones who are enduring this tragic loss,” said Governor Maura Healey. “Our administration is combating this crisis by continuing to invest in community supports aimed at destigmatizing substance use disorder and reducing the negative effects of substance use. Together, we can advance harm reduction and prevention efforts through evidence-based strategies, including low-threshold access to services and long-term solutions for treatment and recovery.”
“Every year, sadly, we lose thousands of Massachusetts residents to drug overdose, underscoring the tragic impact of the opioid crisis on communities across Massachusetts,” said Lieutenant Governor Kim Driscoll. “By collaborating with municipalities across the state and investing in innovative efforts like peer-recovery support centers, we are helping municipalities and community organizations offer crucial and responsive care to residents struggling with addiction.”
The Overdose Prevention Center Feasibility Report, compiled as part of the administration’s Opioid Epidemic Strategy, recognizes the establishment of OPCs in Massachusetts as an evidence-based, life-saving tool that aligns with DPH’s approach to reduce the harms of substance use. OPCs are facilities where people who use drugs can consume pre-obtained substances under the supervision of trained staff who can administer overdose reversal medication when necessary. Other services at OPCs commonly include access to sterile supplies, first aid administration, drug-testing services, infectious disease testing, and referrals to health and social services including substance use disorder treatment.
The findings of the OPC feasibility report support those made in 2019 by the Massachusetts Harm Reduction Commission that called for the state to expand harm reduction resources, including by pursuing the establishment of one or more overdose prevention centers. After a review of available data, DPH has concluded that the establishment of OPCs in supportive communities is an evidence-based, valuable harm reduction service that could be feasible in Massachusetts pending legislative action to extend state-level legal protections.
No overdose death has ever been reported at a sanctioned OPC, as highlighted in the report. OPCs have operated for more than 30 years in Canada, Australia, and much of Europe, and are in place or being explored in New York City, Rhode Island, Minnesota, and Philadelphia.
“We are determined to reduce and eliminate fatal overdoses in our state, and yet, the numbers keep climbing,” said Secretary of Health and Human Services Kate Walsh. “Each number represents a person who was beloved and whose death was preventable, and we will make use of every tool at our disposal to fight this opioid epidemic that has claimed too many lives in Massachusetts. We will continue to support bold, innovative solutions to help us turn the tide of this crisis and prevent any additional fatal overdose deaths.”
“Far too many Massachusetts families have been shattered by the trauma, grief, and heartbreak of losing a loved one to overdose,” said Department of Public Health Commissioner Robert Goldstein, MD, PhD. “Overdose deaths are preventable and that is why we should – and we must – continue to forge a culture of harm reduction by initiating and expanding services and programs that have been shown to work. We know most overdose deaths occur in private and go unwitnessed. Overdose prevention centers, therefore, can be lifelines, serving not only as places of intervention, but as places of empathy, understanding, and healing.”
DPH continues to support a wide range of harm reduction strategies. DPH is working with syringe service providers (SSPs) to explore opportunities to provide services through harm reduction vending machines as an additional component of harm reduction programming. DPH will continue to identify communities with high overdose incidence and with limited naloxone distribution to support further access to these types of harm reduction services.
For the first time, DPH also released data today detailing non-fatal opioid-related overdose (NFO) rates in Massachusetts. From 2013 through 2021, a total of 133,295 NFOs involving 72,018 Massachusetts residents were reported. Public health surveillance of NFOs is limited to events during which a patient receives medical services (such as ambulance trips, emergency department visits, or hospitalization), so the true number of NFOs in Massachusetts may be greater. People who survive one opioid overdose are more at risk for another opioid overdose. The data released today show that one of every 11 people who had one NFO from 2013 through 2021 (6,404 out of 72,018) later experienced a fatal opioid overdose.
The Healey-Driscoll administration continues to address the state overdose crisis by investing in evidence-based prevention, intervention, treatment, and recovery support services for individuals with substance use disorder, including an expanded 24/7 overdose prevention helpline, increased access to low-threshold housing and services, and increased distribution of the overdose-reversal drug naloxone and fentanyl test strips. Working closely with the legislature, the Healey-Driscoll Administration’s Fiscal Year 2024 (FY24) budget invests more than $700 million in substance addiction prevention and treatment programs.
Learn more about the Healey-Driscoll Administration’s actions and initiatives to address the opioid epidemic.
Key Findings from December 2023 Opioid-Related Overdose Deaths Report:
- There were 1,718 confirmed and estimated opioid-related overdose deaths in the first nine months of 2023, approximately 32 fewer deaths than in the first nine months of 2022.
- The rate of opioid-related overdose deaths in Massachusetts has increased at a rate of 3 percent per year on average from 2015 (25.6 per 100,000 people) to 2022 (33.6 per 100,000).
- Cocaine has increased at a rate of 6 percent per quarter on average since 2016 and was present in a record high 60 percent of opioid-related overdose deaths in the first three months of 2023 for which a toxicology report was available.
- Alcohol was present in 29 percent of toxicology reports in the first quarter of 2023, benzodiazepines in 24 percent, prescription opioids in 11 percent, amphetamines in 10 percent, xylazine in 7 percent, and heroin in 4 percent.
- Males comprised 72 percent of all opioid-related overdose deaths in the first nine months of 2023.
- 47 percent of all opioid-related overdose deaths in the first nine months of 2023 were among people aged 25-44.
- Naloxone was administered in 97 percent of acute opioid overdoses treated by Emergency Medical Services during the first nine months of 2023.
Key Findings from Non-Fatal Opioid-Related Overdose Data Brief:
STATEMENTS OF SUPPORT
Massachusetts Public Health Association
“MPHA applauds the Healey-Driscoll administration for centering public health strategies and leadership in its response to record high overdose deaths and widening racial disparities. Overdose prevention centers are an evidence-based tool that will save lives and make progress in this public health crisis.”
Dr. Barbara Spivak, President, Massachusetts Medical Society
“On behalf of our physician members and their patients, we thank DPH for investing its expertise and resources into conducting this feasibility study. OPCs irrefutably save lives and the alarming overdose data reported today underscores the dire need to authorize OPCs in the Commonwealth as a critical harm reduction tool. Building upon this important study, we urge legislative action to establish the necessary legal and liability protections to ensure this vital public health approach can become a reality.”
Dr. Sarah Wakeman, Senior Medical Director, Mass General Brigham
“An estimated 2,323 of our neighbors died from a preventable cause of death in the past year, which is a tragic reminder of the need for every tool possible to reduce overdose deaths, including overdose prevention centers. The choice is not between having overdose prevention centers or people not using drugs — the choice is between creating centers where people can not die from overdose versus the status quo, where people will continue to die behind bedroom doors down the hall from their parents, in public restrooms, and alleyways. Amidst the worst overdose crisis in history, Massachusetts should join other states and lead by passing legislation to allow for overdose prevention centers. We owe it to the thousands of people who lost their lives to overdose, to their families, and to our communities.”
Dr. Julia Fleming, Medical Director for Public Health, Fenway Health
“In this data, we are witnessing a public health crisis, which calls for a public health solution. OPCs are a proven method to reduce deaths from overdose and provide a low threshold access point for people who use drugs to connect to healthcare. We need legislation that supports communities that are ready to add this intervention to their toolbox.”
Joanne Peterson, Founder and Executive Director, Learn to Cope
“Overdose deaths are not slowing down much, even with all the effort we have already put in. We have to start changing our approach. Many overdose prevention center sites go beyond harm reduction services and offer food, wound care, professional medical attention and the opportunity to go to treatment when ready. They might just be the key to changing this epidemic. It’s time to add more tools to the toolbox. If we meet people where they are and give them a chance to live (and someday hopefully seek treatment), we may finally see a light at the end of the tunnel.”
Julie Burns, President and CEO, RIZE Massachusetts Foundation
“The Department of Public Health’s report on overdose prevention centers is critical because it underscores the need for a legislative solution that provides a legally protected pathway for providers and property owners who are ready to set up programs here in Massachusetts and for individuals who will use the services. The data released today makes clear that we need to utilize every available option to end fatal overdoses, and these centers have already been shown, in other states and countries, to prevent deaths and increase access to treatment.”
Steve Walsh, President and CEO, Massachusetts Health and Hospital Association
“The evidence is clear: overdose prevention centers represent an important, proven part of our response to the substance use crisis in Massachusetts. MHA and our members fully support these new DPH recommendations, including the need to protect the caregivers at the heart of harm reduction care. OPCs give our commonwealth an opportunity to, once again, step up and address this crisis with the innovation and urgency it deserves.”
Lydia Conley, President and CEO, Association for Behavioral Healthcare
“The primary goal of Overdose Prevention Centers is to prevent fatal overdoses and provide people who use drugs with accessible health services. As overdose rates remain at unprecedented levels, there is an urgent need to implement evidence-based solutions like OPCs that keep people alive and that can serve as a linkage to further treatment and care. They represent one of many harm reduction tools that should be made available within the continuum of substance use care, which must also include robust prevention, treatment and recovery services.”
Jim Stewart, SIFMA Now Steering Committee
“Recognizing the evidence that supports overdose prevention centers will only be meaningful if it comes with leadership to help authorize and support the implementation of OPC to reduce preventable overdose death and support the health, wellbeing, and lives of people who use drugs.”
Maryanne Frangules, Executive Director, Massachusetts Organization for Addiction Recovery
“The Massachusetts Organization for Addiction Recovery (MOAR), a collective voice for individuals, families, and communities educating the public about the value of living in recovery, thanks the Massachusetts Department of Public Health for issuing the Overdose Prevention Center Feasibility Study recognizing the value of supporting the path of those using drugs to have a safe place to use pre-obtained drugs, and receive health care, social services, and referral options. With so many fatal overdoses, let’s make this move to save lives a reality.”
Dr. Mattie Castiel, Commissioner of Health and Human Services, City of Worcester
“This new report from the state has shown that overdose prevention centers (OPCs) are a safe and effective form of harm reduction. This finding, with continued state support and direction, may offer new avenues to address the epidemic and improve outcomes.”
Jessie Rossman, Legal Director, ACLU of Massachusetts
“Public health crises require public health solutions. It is within the state’s purview to set public health policy to protect its residents, and an important part of that is the legislature’s express authorization of overdose prevention centers. We thank the Department of Public Health for its commitment to addressing the overdose crisis and look forward to partnering with the legislature to enable cities and towns to establish these life-saving facilities.”