MA: Drop in fatal overdoses is largest decline in Massachusetts in 13 years

DPH Report: Massachusetts Opioid-Related Overdose Deaths Decreased 10 percent in 2023

Opioid-related overdose deaths in Massachusetts decreased by 10 percent in 2023 – the largest singleyear decline since 2009-2010 – according to preliminary data released today by the Massachusetts Department of Public Health (DPH).

There were 2,125 confirmed and estimated opioid-related overdose deaths in 2023, which is 232 fewer than in 2022, when Massachusetts had a record 2,357 fatal opioid-related overdoses. Last year’s opioid-related overdose death rate also decreased by 10 percent to 30.2 per 100,000 people compared to 33.5 in 2022.

“While we are encouraged by the overall decrease in overdose deaths, this report also is a reminder of the work that we still need to do to bring deaths down for all people and all areas of the state,” said Governor Maura Healey. “Our administration remains committed to prioritizing prevention, treatment and recovery efforts to address the overdose crisis that continues to claim too many lives and devastate too many families in Massachusetts.”

“Our administration continues to invest in community-level supports rooted in destigmatizing substance use disorder by meeting people where they are and understanding the ways in which factors such as housing and economic insecurity intersect with health,” said Lieutenant Governor Kim Driscoll. “We are hopeful that the numbers released in today’s public health report signal a downward trend for fatal overdoses statewide.”

Preliminary data from the first three months of 2024 indicate a continued decline in opioid-related overdose deaths in Massachusetts, showing 507 confirmed and estimated deaths, a 9 percent drop compared to estimates from the same time last year.

The decline in opioid-related overdose deaths last year was significant among white non-Hispanic men, whose overdose death rate declined 16 percent between 2022 and 2023, from 48.2 to 40.4 per 100,000 people. The data also show Black non-Hispanic residents continue to be disproportionately impacted by fatal opioid overdoses. Among Black non-Hispanic men, the rate of opioid-related overdose deaths increased from 80 per 100,000 in 2022 to 84.6 in 2023. American Indian non-Hispanics, along with Black non-Hispanic men and women, had the highest opioid-related overdose death rates last year among all racial/ethnic groups.

Looking at geographic diversity, the state’s most rural areas continue to record the highest opioidrelated overdose death rate at 35.6 per 100,000 residents compared to urban, suburban, and less rural areas.

The Healey-Driscoll Administration continues to build on its robust opioid overdose prevention efforts and investments to support communities with a wide range of resources. This includes initiatives to address the disproportionate impacts of fatal opioid overdoses on communities of color and in the most rural areas of the state. These investments include increasing access to peer-led spaces to support those in recovery, funding for low-threshold housing and services, expanding access to medications for opioid-use disorder, expanding the Black and Latino Men’s Re-entry program, and developing a women’s re-entry component. The administration’s Fiscal Year 2025 budget proposes investments of more than $700 million for programs focused on substance addiction prevention, treatment, and harm reduction.

Drug overdose deaths in Massachusetts trended lower than nationwide figures last year, according to preliminary data released last month by the Centers for Disease Control and Prevention (CDC). Nationwide, overall drug overdose deaths in 2023 were estimated to have dropped 3 percent compared to 2022, and 11 percent in Massachusetts. Deaths from opioid overdoses nationwide fell an estimated 4 percent in 2023, according to CDC.

The decline in opioid-related overdose deaths in Massachusetts in 2023 occurred despite a drug supply that continues to be heavily contaminated with fentanyl. Fentanyl, a powerful synthetic opioid, was present in 90 percent of fatal opioid-related overdoses where toxicology was available, preliminary data show. The US Drug Enforcement Administration has called fentanyl the greatest and most urgent drug threat in the nation. Fentanyl is increasingly being mixed with the veterinary sedative xylazine (“tranq”), which continues to be detected in the state’s street drug supply and was present in 9 percent of opioidrelated overdose deaths in 2023, up from 5 percent in 2022.

“Every overdose death is tragic, preventable and unacceptable,” said Secretary of Health and Human Services Kate Walsh. “While we are proud and encouraged that fewer Massachusetts residents were lost to overdose last year, we know that inequities persist, and our work is not done. Our understanding of where gaps in treatment and services occur, and the people who we are not yet reaching, drives our work and helps focus our efforts. That said, we are heartened by these results and will continue to build on our evidence-based approach as we build a network of community-based, low-threshold harm reduction treatment and recovery programs across our state. I want this decrease to offer hope not only to the people struggling with these diseases and their families and loved ones, but also to the committed and expert workforce across our state who do this important work every day.”

“It is heartening to see this significant decrease in fatal overdoses – a direct result of the ongoing hard work in our communities to reach those struggling with substance use disorder,” said Department of Public Health Commissioner Robbie Goldstein, MD, PhD. “To sustain these hard-won gains, we must focus even more deeply on the populations that have not yet seen such dramatic improvements. This means doubling outreach efforts in communities of color, particularly for Black residents, and people living in our most rural communities, who, as the data show, are most disproportionately impacted by overdose deaths.”

Massachusetts continues to invest in evidence-based harm reduction interventions to reduce fatal overdoses, increase awareness around the tainted street drug supply, and increase access to lowthreshold services. This includes expanding access to naloxone, fentanyl test strips, and sterile consumption supplies. In 2022, DPH launched the Community Naloxone Purchasing Program to increase distribution of free naloxone through organizations, and directed funding to expand the state’s overdose prevention helpline, SafeSpot (1-800-972-0590, www.safe-spot.me).

As part of DPH’s ongoing commitment to transparency and data-sharing, the Opioid-related Overdose Deaths reports will be transitioned from their current format and incorporated into public-facing online dashboards. This update will bring the data together in an interactive way and enable a more comprehensive, in-depth view of overdose risk and substance use services at the community level to inform decision-making on policy and interventions. More information about the dashboards will be available at a later time.

Learn more about the Healey-Driscoll Administration’s opioid overdose strategy.

Key Points and Interventions:

  • Since 2023, DPH has distributed more than 196,500 naloxone kits (two doses per kit) via nearly 100,000 encounters with members of the community and conducted by more than 200 community-level naloxone distribution programs. This has resulted in at least 10,206 overdose reversals.
  • Since 2023, DPH has distributed more than 504,000 fentanyl test strip kits at no cost to providers and community organizations. Single-use fentanyl test strips help reduce the chances of overdose by allowing people who use drugs to test their supply prior to consumption to determine if it is tainted with fentanyl.
  • DPH’s ongoing investments in temporary and permanent low-threshold housing for homeless or housing unstable individuals struggling with substance use disorder have led to the placement of about 600 people since 2021.
  • $2.9 million in grants were awarded this year to 20 organizations led by Black, Indigenous, and People of Color (BIPOC) to address substance use in BIPOC communities.
  • DPH funded five mobile Opioid Treatment Programs (OTPs) serving rural, urban, and suburban areas.

Among other findings of the report:

  • Cocaine was present in 54 percent of opioid-related overdose deaths where a toxicology screen was available, alcohol in 26 percent, benzodiazepines in 25 percent, amphetamines in 11 percent, prescription opioids in 7 percent, and heroin in 5 percent.
  • 48 percent of all opioid-related overdose deaths were between 25 and 44 years old; 43 percent were between 45 and 64 years old.
  • Males comprised 72 percent of all opioid-related overdose deaths in 2023.
  • In 2023, men aged 35-44 accounted for the greatest number of suspected opioid-related incidents with a known age and sex treated by Emergency Medical Services (EMS) at 20.4 percent.
  • 58.7 percent of all opioid-related incidents treated by EMS in 2023 were acute opioid overdoses and 1.7 percent were dead on arrival of an opioid overdose.
    • More detailed information on opioid-related incidents reported by EMS is available in the interactive EMS Regional Opioid Related Incident Dashboard.
  • The largest opioid-related overdose death decreases in 2023 were seen in Essex County (-21.7 percent), Middlesex County (-20.8 percent), Plymouth County (-18.9 percent), and Worcester County (-16 percent).
  • Cities and towns that experienced a notable decrease in opioid-related overdose deaths in 2023 compared with 2022 were: Brockton, Cambridge, Falmouth, Lawrence, Leominster, Lynn, Pittsfield, Randolph, Waltham, and Wareham.
  • Cities and towns that experienced a notable increase in opioid-related overdose deaths in 2023 compared with 2022 were: Holyoke and Taunton.

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