Hampshire Hope Column: Opioid overdose data suggest local prevention efforts having impact

  • Damasco Santiago, an employee of Tapestry Health, takes down information before handing out a safe-use kit containing water, alcohol pads and naloxone to someone he encounted while doing a needle pickup in Holyoke. GAZETTE FILE PHOTO

For the Gazette
Monday, July 19, 2021

Recent news reports indicate that opioid overdose rates across the United States and in Massachusetts have increased at alarming rates during the year-plus that the COVID-19 pandemic shut down many sectors of society.

The national Centers for Disease Control and Prevention reports that opioid overdose death numbers increased from 49,000 in 2019 to a predicted 69,287 in 2020 (the numbers are still being tallied, so those are preliminary figures.) That increase prompted the CDC to issue a health alert in December 2020 warning people about alarming increases in overdose death rates across the country, with the primary driver being opioids.

Meanwhile, the state Department of Public Health reported 2,103 opioid-related overdose deaths across the state in 2020, up from 2,000 deaths in 2019.

While local data largely doesn’t show such increases, they are not surprising. Over the past year, as the country responded to the COVID-19 pandemic, communities were impacted at every level: Recovery support services, mental health resources and other programs that provide support closed or suspended services. Uncertainty brought on by the pandemic — its direct impact on families, employment and housing — added additional stress.

As people across the country were advised to isolate and quarantine, and thereby reduce engagement with family, friends and support networks, the added stress and separation placed a strain on people in recovery. They became disconnected from their usual networks of support just when they needed them most.

Meanwhile, by mid-2020, many agencies shifted services to telehealth, loosening restrictions and guidelines to accessing care. While that move was certainly welcome, unfamiliarity and technological barriers at times hampered access and engagement, making conditions ripe for increased drug and alcohol use.

Amid the increases in deaths at the national and state level, preliminary data from the Northwestern district attorney’s office indicate that in 2020 the suspected unintentional opioid overdose deaths in Franklin and Hampshire counties and the town of Athol totaled 63 deaths — the same number reported in 2019. (That represents a rate of 25.86% per 100,000 people, based on 2018 census figures.)

Athol had the largest increase in opioid overdose fatalities — from six in 2019 to 13 in 2020. Franklin County’s overdose death numbers dropped from 22 to 18, and Hampshire County’s from 35 to 32 between 2019 and 2020. Towns that stood out with decreases in overdose deaths between those years past included Amherst (from three to one); Belchertown (five to three); Granby (two to one); Northampton (16 to six); and South Hadley (five to four.)

Drilling down into the data shows changes in the demographics in terms of gender and age. While historically, local data indicates men have died at three times the rate of women, in 2020, that gender gap began to close. Within Hampshire and Franklin counties and Athol, 38% of opioid overdose deaths were females and 62% were males.

The age bracket with the largest number of deaths also shifted: The majority of deaths in 2019 came within the 45-54 age bracket at 19 deaths, while in 2020 the majority of deaths, at 25, fell in the 35-44 age bracket. The number of deaths within the 25-34 age bracket stayed constant at 17 deaths.

Because overdose deaths don’t follow county boundaries, it’s important to take a wider view when diving into data. To that end, the Northampton Health Department, through the Regional Opioid Data Collaborative, is working with opioid prevention organizations to expand a regional Health Information Exchange database, funded in part by the Young Adult Empowerment Collaborative grant.

By compiling county, regional and state aggregate data related to opioid use, vital public health indicators can more rapidly become available, allowing access to key data points that will aid decision-making and lead to quicker analysis of the effectiveness of interventions.

The CDC’s health advisory urged communities to expand education and prevention efforts and increase distribution of the overdose reversal drug naloxone, alert the community to the presence of fentanyl in counterfeit drugs that appear to be legal prescription medications, and educate people about access to telehealth therapy.

Well before the CDC issued its health alert, local prevention efforts largely mirrored the recommendations in its advisory because those are evidence-based strategies that work.

For example, some 600 doses of free naloxone were distributed throughout the county; Hampshire HOPE and the Drug Addiction & Recovery Team (DART) program continued to provide free access to recovery coaching; and Tapestry Health mobilized efforts to take harm reduction resources into local communities. Many other agencies worked diligently to maintain connection and access to services for their participants. It is only because of the coordinated efforts, before, during, and into 2021, that deaths from overdoses were not higher.

And still, we enter the second half of 2021 with caution. As restrictions begin to lift, we are just beginning to see the longer-lasting effects of the isolation. In addition, we can’t settle for overdose death numbers staying the same. The goal of any opioid prevention coalition is to reduce overdose numbers and prevent overdose deaths.

Austin Sanders is the regional database project manager for the Western Mass Regional Health Information Exchange, and Trevor Dayton is a full-time staff member at the Northampton Recovery Center. Both are part of the Hampshire HOPE opioid prevention coalition, run out of the city of Northampton’s Health Department.