A groundbreaking medical study conducted by Massachusetts Health Commissioner Monica Bharel found that for those who have died from an opioid overdose, the average survival time from their initial prescription to their death was just 36 months.
Bharel presented this research at the Massachusetts State House on Feb. 1 using pulled data from the most recent quarterly opioid-related deaths report, in addition to the chapter 55 report. The experiment followed opioid naïve patients for 66 months after their preliminary prescription.
Ann Scales, the director of media relations for the Massachusetts Department of Public Health, wrote in an email that most individuals are unaware of substance use disorder, a condition in which the use of a substance leads to clinically significant impairment or distress.
“For too long, SUD was seen as a morale choice or character flaw and we therefore didn’t have much data to help us understand the trajectory of the disease,” Scales wrote. “In Massachusetts, we are in our third year of looking at this medical decision through a precision public health lens in order to improve our understanding of who is at greatest risk and where the critical points of intervention are.”
Scales wrote that Bharel’s data represents a need to swiftly help those who are struggling with addiction or at risk of an overdose, especially when the average time period between first exposure to an opioid and death is very short.
“This serves as an important reminder that we have to screen individuals to identify those at greatest risk, balance the risk of opioid misuse with the need for pain management and provide treatment and recovery in an expedited manner,” Scales wrote.
The Department of Public Health will work tirelessly with their community partners until the issue subsides in the state, no matter how long it takes, Scales wrote.
“It will take a sustained, comprehensive effort to bend the curve of this epidemic, including strengthening our efforts around prevention, intervention, treatment and recovery,” Scales wrote.
Eighteen years ago, the state reported a mere 379 opioid-related deaths, while 2016 saw an estimated 2,190 deaths. The first nine months of 2017 saw 932 confirmed opioid overdose deaths.
Autumn Beaudoin, 22, of Jamaica Plain, said the issue goes beyond those who are overdosing on the drug, as it can stretch all the way to the doctors prescribing or distributing the drugs.
“There could be a lot of interventions that could be beneficial for these people,” Beaudoin said. “There are just so many different variables involved with people making those decisions and there are so many different ways that we can tweak the human experience that would eventually decrease that statistic.”
David Rosenbloom, a professor of health law, policy and management at Boston University’s School of Public Health, said this information is coming out now because the technology to do so was only passed through legislation a couple of years ago.
“The state now has … the capacity to bring lots of different databases together, which, for the first time, allows for this kind of analysis,” Rosenbloom said. “It was just impossible to know until very recently what happened to a person who had an overdose — what were the arrest records, what were the prescription records, what were the insurance claims, etc.”
Rosenbloom said tackling the problem will include greater access to hospice care for those affected.
“I think it’s going to be a multi-pronged attack,” Rosenbloom said. “There should be a significant expansion of access treatment immediately on demand so that any individual who suffers from an overdose, or recognizes that he or she has a problem, will get treatment immediately.”
Throughout the past 20 years, the total number of opioid-related deaths has increased five-fold. To put this into perspective, Massachusetts hasn’t seen such an increase in a single category of deaths since the AIDS epidemic in the 1980s and 1990s.
Richard Ruggiero, 27, of Fenway, said as a former mental health clinician, he used to deal with opioid and similar trauma cases regularly.
“I feel like it’s something that was being pushed, and before we were able to do anything about it, it just got out of control and now it’s just everyone pointing the finger at each other,” Ruggiero said. “I think legalizing marijuana is going to help, I definitely think that people will turn to that as a better alternative to opioids.”
Nyle Rioux, 26, of East Boston, said he knows opioid addictions are an issue in Massachusetts because of the media attention the drug has gotten in recent years.
“I think a lot of people start off because they’re in pain, but then they just get addicted to it,” Rioux said. “I think there should be more oversight of the pharmaceutical industry because they’re incentivized to push the drug on people.”
Solange Hackshaw and Laura Al Bast contributed to the reporting of this article.
