BROCKTON – In a surprising but hopeful finding, Plymouth County District Attorney Timothy Cruz has announced that fatal overdoses in the county were down significantly in 2021 compared to 2020 and 2019. 

In 2021, there were 132 suspected fatal overdoses in the county, compared to 165 in 2020 and 143 in 2019. These numbers were compiled from suspected fatal overdoses that Massachusetts State Police troopers responded to, the DA's Office said. 

“We are pleased that the number of suspected fatal overdoses was down in 2021, but one overdose is still one too many,” Cruz said. “This coming year, we will continue our work with the Plymouth County Drug Abuse Task Force to get help and resources to those addicted and their families.”

The downturn is somewhat counterintuitive given that many professionals who work with people dealing with substance use disorder attributed the increase in overdose deaths in 2020 to the pandemic, which we are still dealing with. 

Countering the COVID effect

Victoria Butler, program director of Plymouth County Outreach, a collaboration between all the police departments in Plymouth County that tries to increase access to substance use disorder resources, said COVID-19 and the subsequent lockdowns led to a sharp increase in relapses and fatal overdoses in 2020. 

"When you take away resources and access to care, especially for individuals who might not have access to the internet, to virtual resources, it's going to have a catastrophic impact," she said.

But given those difficulties last year, Butler said, many organizations working on this issue learned a lot from 2020, and found ways to adapt to the pandemic and make resources more accessible. 

"Going into 2021, the world was able to open back up a bit. And not only that, but we were able to get creative with the resources we offered," she said. "So, having more virtual options available, or getting creative with how we can offer the same services."

Fighting fentanyl

Butler said another reason overdoses might have gone down is education over the last few years about fentanyl – an opiate that's much stronger and cheaper than heroin or prescription opioids.

She said many non-opiate drugs sold on the street, such as cocaine, are now being laced with fentanyl and causing overdoses. Additionally, she said, pressed fentanyl can look just like a prescription drug. 

In response, she said, organizations tackling substance use disorder have been educating the people they care for about this problem and giving out fentanyl test strips to keep people from accidentally taking fentanyl. 

Another change that might've helped, Butler said, was that organizations such her own and others fighting this issue got continued and increased funding, which has allowed them to do more outreach, expand services and collaborate effectively. 

Allyson Pinkhover, director of substance use services at Brockton Neighborhood Health Center, said another reason overdose deaths might have gone down is a continued increase in the accessibility of Narcan – an emergency drug that can reverse the effects of an overdose. 

Treatment and harm reduction 

Pinkhover said it also helps that there's been an increase in acceptance of harm reduction strategies such as carrying Narcan, safe-use sites and fentanyl testing strips.

Similarly, she said, there's been increased acceptance of medication-assisted treatment such as methadone, as well as more people coming in for treatment. 

Worrying trend

Still, Pinkhover said, increased access to treatment and overdose death decline isn't consistent across all demographics. According to state data, while there were fewer overdose deaths among non-Hispanic white people in 2020, overdose deaths among non-Hispanic Black people increased twofold. 

"We want fewer people to die of an overdose, but we want to make sure that those effects are for everyone," she said. 

What can be done

Both Butler and Pinkhover said more can be done to prevent opioid overdose deaths. 

Butler said there's still a lot of stigma around drug addiction, which makes it harder for people to ask for and access treatment, so combatting the stigma will go a long way.

Additionally, Butler said organizations can do more to break down barriers to care, such as lack of insurance.

Pinkhover said one way to increase accessibility to treatment is to make sure there is language equity with online and in-person resources. She said organizations should also increase access to treatment services with an eye toward health equity. 

Pinkover said more research into current risk factors could also help professionals figure out the most impactful ways they can help. 

"A few years back the Department of Public Health put out a report...that gave us some really good information about groups of people that were at very high risk for a fatal overdose, and so that was where a lot of the programming and emphasis was, for pregnant and postpartum women, people released from incarceration and people experiencing homelessness...We knew where to focus," she said. 

"But we haven't gone back and looked now...Is there still a risk? Have we made improvements? And we haven't broken down some of those categories by risk of different racial and ethnic groups."

Most of all, Pinkhover and Butler said, organizations tackling substance use disorder should continue their current efforts such as distribution of Narcan, increasing access to treatment and decreasing stigma. 

"We have to continue to constantly push forward a treatment and harm reduction approach, as opposed to an incarceration and penal approach," she said. "I think those things are going to be the most important going forward in the next few years."