Opioid deaths decline a bit as harm from fentanyl grows

While opioid overdose deaths in Massachusetts declined for the second year in a row, prevalence of the powerful synthetic opioid fentanyl has continued to climb to the point where it is now present in almost every death that’s screened for drugs.

The latest state overdose data, released last Wednesday, showed fentanyl was present in 92 percent of opioid deaths where a toxicology screen occurred in the first quarter of 2019, up from 89 percent in 2018.

“The real killer in this is the presence of fentanyl, which unfortunately is at an all-time high,” said Public Health Commissioner Dr. Monica Bharel.
The new data landed as White House officials highlighted their efforts to go after fentanyl traffickers.

Bharel highlighted the data at a Public Health Council meeting, where she said “too many people” are still dying from opioid overdoses, but that there are “signs of progress” in fighting the epidemic.

There were 938 confirmed and estimated opioid-related overdose deaths – or more than five a day – in the first half of 2019, a figure the Department of Public Health said represents a decline of more than 10 percent from the 1,050 deaths logged in the first half of 2018.

Bharel said total overdose deaths dropped by an estimated 3 percent between 2016 and 2018, and that the rate of deaths per 100,000 fell by 4 percent in that same time period.

“Really to me what this means is fewer families will have to endure the heartbreak of losing a loved one to this epidemic,” she said.

The Department of Public Health also released new data on rescues using the overdose reversal drug naloxone, also known as Narcan. In 2018, a total of 4,079 rescues were reported to the DPH’s Overdose Education and Naloxone Distribution program.

From 2008 through 2018, more than 16,000 rescues were reported by bystanders who administered naloxone to a person who was overdosing, and 89 percent of those rescues were reported by people who identified themselves as drug users.

“When naloxone is used for rescue, those are 16,000 times somebody could have been one of those statistics in our opioid overdose death reports and instead are hopefully kept alive to have an opportunity for treatment and recovery,” Bharel said.

Unintentional overdoses have become the leading cause of death on the job, according to a new state report on fatal injuries in the workplace. From 2016 to 2017, 54 people, mainly in the construction and food service industries, died of overdoses on the job, the report said, and 85 percent of those deaths involved fentanyl.

About 32,000 Americans died from fentanyl or other synthetic opioids last year, White House senior counselor Kellyanne Conway said Wednesday on a briefing call with reporters, and fentanyl has grown in prominence as the national rate of drug overdose deaths has ticked down for the first time since the 1970s.

Also on Wednesday, the White House announced that it was issuing four advisories through the Office of National Drug Control Policy to businesses as it looks to partner with the private sector to combat trafficking of fentanyl and synthetic opioids. The advisories each hit upon a particular aspect of the synthetic opioid market – manufacturing, marketing, movement and money – and are intended to “highlight the risks that fentanyl traffickers pose to American firms and their brands’ reputations,” Conway said.

“Fentanyl traffickers have become incredibly sophisticated in leveraging otherwise honest elements of our markets against us,” Conway said, describing how clandestine operations use factories producing legitimate fentanyl to manufacture their illicit product to avoid detection and use online commerce and cryptocurrencies to conduct business.

“The illicit opioid trade offers a different model of drug trafficking. The use of online marketplaces, international mail, express consignment, virtual currency payment, small-scale distribution and the manufacturing of counterfeit pills all enable this new model of 21st-century drug trafficking,” said ONDCP Director Jim Carroll. “Private sector business platforms are vulnerable to being exploited by these drug trafficking organizations because of the way that they operate. These businesses can and should be a critical partner in this fight.”

As part of the White House’s strategy to combat the opioid crisis and the growing prevalence of fentanyl, Conway said President Trump has been trying to make more people aware of the powerful and deadly substance. “As part of the president’s effort to stop opioid abuse and reduce drug supply and drug demand, the president and first lady and other principals have tried to interject into the everyday lexicon the word ‘fentanyl’ because fentanyl is incredibly lethal in tiny doses,” she said. “When it can kill by just a grain, it poses a threat to any handler or intended recipient of a package.”

Most of the fentanyl in America originates outside the country’s borders. The Department of Homeland Security seized more than 5,000 pounds of fentanyl at US ports of entry in fiscal year 2018 – enough for about 1.2 billion lethal doses of the drug, or enough to kill every American citizen four times over, Conway said.