Massachusetts officials continue fight against opiates


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FITCHBURG, Mass. (AP) — In the past six months alone, Kevin MacLean has seen more drug-overdose deaths on the streets than he did in the previous five years.

"In 2015, we're going to be shocked by the numbers," said MacLean, who directs the homeless services at Fitchburg's Our Father's House.

Fatal opiate-overdose figures released by Gov. Charlie Baker earlier this month back up the hard truth MacLean is telling: 2014 will likely be the deadliest year since the opiate epidemic was recognized as a health care crisis in 2012.

The Baker Administration's figures show the number of local deaths in 2014 exceeded those in 2013, even with no firm numbers for the last quarter of the year.

"(Addicts) just aren't slowing down," said MacLean.

Fitchburg reported seven opiate-related deaths in 2013 and eight through the first three quarters of 2014. Leominster had six in 2013, with seven during the same period. Shirley had none in 2013 and three during the first nine months of 2014. Ashburnham had one death in 2014 and none the prior year, according to data from the state's Department of Public Health.

Two local communities, Gardner and Lunenburg, had slightly fewer opiate-related deaths between the two reporting periods, with Gardner reporting four in 2013 and three in 2014, and Lunenburg reporting two in 2013 and one in 2014.

Westminster and Lancaster had no opiate-related deaths during the reporting period.

The state Department of Public Health had previously estimated that 1,008 people statewide had died from opiate overdoses last year, but after completing a review of potential cases, the agency announced the real death toll could top 1,256 — almost triple the number from a decade before.

Statewide, the rate of 18.6 deaths per 100,000 residents for 2014 is the highest ever, and represents a 251 percent increase from the rate of 5.3 deaths per 100,000 residents in 2000.

In the first three months of 2015, there were 312 confirmed fatal opiate overdoses, and that number is likely to rise as medical examiners confirm the cause of death in cases that are yet to be determined.

MacLean said heroin is easy to purchase on the streets. He gave an example of a conversation he had recently with a 19-year-old addict.

When MacLean asked the teenager why he continued to use when he might die every time he shot up, the teenager told him he didn't believe he would end up dead from using.

John Latimer, chief of emergency medicine at HealthAlliance Hospital in Leominster, like MacLean, said he also had a sense the numbers of opiate-related deaths may be increasing.

However, emergency-room admissions related to opiate addiction were down by 22 patients between January and July 2015, including only five in March, compared to the same period in 2014.

"My suspicion is this may have to do with multiple factors, including increased awareness and Narcan," said Latimer. "It would be nice if this reflected less heroin use, but I doubt it."

Because the administration of Narcan, a drug that can reverse the effect of an overdose, has only become widely available over the last year, comparisons of its use on a year-to-year basis are limited.

Randy Girouard, manager of Medstar, a local ambulance service that fills in for the city-operated ambulances in Fitchburg, Leominster and Gardner, said his personnel have administered 80 doses in Fitchburg between January and July 2015, 30 in Leominster, 37 in Gardner, and six in Lunenburg.

The doses don't necessarily represent each overdose victim, because more than one dose can be administered to one patient, said Girouard.

Fitchburg Fire Chief Kevin Roy said his ambulance personnel have administered 37 doses to 24 overdose patients between January and July 2015.

Officers with the Fitchburg Police Department began carrying Narcan on June 1, said Chief Ernest Martineau.

"We've had six saves since June 1, and those could have accounted for six deaths," said Martineau, adding that Narcan is not a "panacea" but a piece in the puzzle of addressing the issue.

Latimer agreed Narcan is making a difference, but added its increased availability is also keeping some overdose victims from making a trip to the emergency room and potentially driving down the opiate-related admissions, which, from his perspective, is troublesome.

"After a Narcan dose, we usually like to watch them for a couple of hours to make sure they don't stop breathing," he said.

The state's Opioid Abuse Prevention Collaborative of Fitchburg, Athol, Gardner and Leominster, which is a program of the Montachusett Public Health Network and LUK Inc., has trained more than 500 people to administer Narcan since it was awarded a state grant last year to help reduce opiate deaths.

"I think it's super-important because it will potentially save someone's life and give them an opportunity to seek treatment and change," Lauren Saunders, who directs the collaborative.

Latimer said he would like to see a program that would allow overdose survivors to get what he described as a "free pass" to the nearest detox center upon release from a medical facility.

Baker's plan calls for 100 new short-term recovery beds within the next year to help with the waits addicts have when seeking help, and a larger expansion of short- and long-term beds within three years, accompanied by greater flexibility in the treatment paths addicts can take.

Going forward, education, particularly of youth, will be an integral part of the Baker's complex plan to curb the death toll, his administration has said. Preventing vulnerable populations like high-schoolers from taking opioid pills or injecting heroin is cheaper and more effective than treating addiction.

The Department of Public Health has kicked off a $800,000 public-awareness campaign — through TV ads, a new website, and social media — to educate the public on the dangers of opiate addiction.

Baker speaks at the UMass Lowell Inn & Conference Center on Sept. 10 and is expected to expand on this administration's efforts to fight the epidemic.

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Information from: Sentinel & Enterprise (Fitchburg, Mass.), http://www.sentinelandenterprise.com

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