While opioid-related deaths in the state have declined for two years in a row, drug use still is devastating families throughout Berkshire County, addiction specialists warn.
Opioid-related deaths in Massachusetts dropped 4 percent — or by 82 people — in 2018, according to a Department of Public Health report released Wednesday. There was a 2 percent decline from 2016 to 2017, when the epidemic was at its peak.
Still, fentanyl, a dangerous synthetic opioid that the Drug Enforcement Administration says is 80 to 100 times stronger than morphine,was found in nine out of every 10 of last year's deaths and is on the upswing statewide, according to the report.
"Part of treatment for many of our clients, especially those requiring medication as treatment and those in our residences, is doing urine screens," said Megan Wroldson of the Brien Center. "For those who are testing positive for drug use, they're often testing positive for fentanyl."
There were 1,617 confirmed opioid-related overdose deaths in Massachusetts in 2018. Of the 1,445 such deaths that year for which a toxicology screen was available, 89 percent had a positive screen result for fentanyl, according to the DPH report.
Figures provided for the third quarter of the year showed cocaine present in 48 percent of the screens and heroin in 34 percent, according to the DPH.
"Cocaine is on the rise," Wroldson said of the opioid-related deaths. "It was heroin also, but [fentanyl] is also mixed with cocaine."
These days, people need to expect to be exposed to fentanyl with any illicit drug they use because most drugs can be laced with the substance, she said.
About 95 percent of urine tests completed at the Brien Center on people reporting that they used heroin are positive for fentanyl, Brien Center Medical Director Jennifer Michaels said.
"Sometimes there is no heroin in the heroin," Michaels said. "Some are surprised. Sadly, it doesn't create enough concern for people to alter their use."
Gov. Charlie Baker's fiscal year 2020 budget, filed last month, includes $266 million to fund treatment and opioid-related services, and the governor also has proposed spending $5 million on a Regional Fentanyl Interdiction Task Force to limit the spread of the substance.
While the death rate is significantly higher than it was before it began climbing at the start of the decade, Michaels and Wendy Penner, of the Northern Berkshire Community Coalition, find that the statewide numbers for 2018 are a sign that addiction interventions and efforts to support treatment programs are working and need to continue.
"I'm excited about any decrease in the numbers," Michaels said. "In our state, in many ways, our government has created interventions that have helped us deal with this epidemic."
But that doesn't mean the work is done.
Opioid-related overdoses account for almost 40 percent of all deaths for adults ages 25 to 34, and recovery has been uneven across demographic groups. According to the report, opioid-related deaths among black males statewide increased from 2014 to 2017.
Penner, director of prevention and wellness at the NBCC, also noted that the numbers don't include hepatitis C deaths or deaths from other illnesses that individuals might have been exposed to through drug use.
"It's great to see a decrease in these numbers," but the last thing the community needs is complacency, she said. "There are still a lot of people in our community whose lives are being devastated by drug use."
"In a small community, which I consider Berkshire County to be, it's important to remain hopeful," Wroldson said. "But every death impacts a family and neighborhood and a community, so I think we're going to be dealing with the effects of the death we've experienced over the last few years for a long time."
Berkshire District Attorney Andrea Harrington said the decrease in deaths is proof that "harm reduction strategies," like the use of overdose-reversal medication, are saving lives.
"But we have to remain vigilant by treating opioid abuse as a public health problem," Harrington said in a statement. "Families across Berkshire County have been devastated by the opioid epidemic. That's why, to promote a healthy community, I support expanding training in the use of naloxone, and will focus on providing prevention and treatment services to non-violent offenders with substance use disorders."
State House News Service contributed to this report.
Haven Orecchio-Egresitz can be reached at firstname.lastname@example.org, @HavenEagle on Twitter and 413-770-6977.