The number of opioid-related deaths on Cape Cod has risen to its highest mark in the past 5 years.
New data released by the state’s public health department finds that nearly 80 Barnstable County residents died from an overdose in 2021.
The Cape’s death rate coincides with an increase also seen across the state. The death rate from opioids in Massachusetts increased 9 percent in 2021 compared to 2020.
Public Health Commissioner Margret Cooke presented the latest overdose data at a recent Public Health Council meeting, calling it “problematic.”
Nearly 3,000 overdose deaths were reported in Massachusetts last year. Most were males, and about half were between the ages of 30 and 50.
Clinicians in the substance abuse field on Cape Cod and the South Coast say that several factors caused by the coronavirus pandemic could be leading to an increase in opiate-related deaths.
Nancy Regan, Substance Use Disorder Program Manager at the Community Health Center of Cape Cod, says the rise in fatalities from opiate-related overdoses was not unexpected.
"COVID has taken over in the forefront of all of our minds and understandably so, but we in the addiction community are not surprised," she told CAI. "We are disheartened but this crisis is, unfortunately, alive and well, and it’s taking the lives of both young and old."
She says that the isolation and other stresses caused by the COVID pandemic only intensified a growing problem.
“Over the last 10, 15 years, of the OxyContin crisis, I think this has been brewing into this perfect storm where we are seeing the unfortunate fallout,” Regan said.
Regan said that supply chain issues during the pandemic could have been a factor in the overdose increase. With the supply cut off for many users, their body's tolerance to opiates likely decreased. When the supply returned, that could have caused fatal overdoses with users expecting to have the same tolerance as before the pandemic.
But also social and economical pressures intensified by the pandemic may have led to an increase in overdoses. These include stresses such as the lack of stable and available housing. Regan also suggested that inadequate public transportation — especially for parts of the Outer Cape — could be an impediment to getting the needed help for users or those in recovery.
On the South Coast, People Acting Against Chemical Addiction, or PACCA, executive director Carl Alves says those pressures play a large role in addiction. So did the isolation caused by the pandemic. Connection to other people, he says, can help people with recovery. Also, using heroin or other opiates alone can be problematic, because there's no one there to call for help or administer Narcan. That likely increased in the early days of the pandemic.
But Alves is cautious about coming out of the coronavirus too optimistic, with lockdowns no longer the norm. He says that addiction and opiate use started to trend downwards about 10 years ago. But when fentanyl — a powerful synthetic opiate — was introduced, deaths from overdoses started to climb again. He says while we may be coming out of the COVID pandemic, we may not have seen the peak of fatal fentanyl overdoses.
But there are some reasons to be optimistic.
Massachusetts cities and towns will split more than $210 million to be paid by opioid manufacturers and distributors, while the state government will get another $310 million. That's from a settlement reached with major manufacturers earlier this year.
Over $8 million of that will be distributed to Cape towns over the next 15 years. Barnstable, for instance, will get nearly $2 million; Falmouth more than $1 million.
Kate Lena, Program Manager for Substance Use Prevention at Barnstable County, says the county is currently coming up with recommendations for how that money should be spent.
She says the county Regional Substance Addiction Council is collecting feedback from towns on specific needs before making a final recommendation. But she says working collaboratively is a good idea.
"There is a possibility to pool even some of the towns' resources in a way that can provide services to as many towns as possible no matter how big the individual settlement payment is," she told CAI.
And she says towns should take their time deciding. “There isn’t a rush to spend this money right away," Lena says. "It is a good idea to have a thoughtful approach and to make sure it’s really addressing a gap in services.”
The funding ultimately will go to overdose prevention, harm reduction, and addiction treatment to abate a crisis that has killed some 23,000 Massachusetts residents since 2000.
