The latest overdose numbers, released by the Department of Public Health Wednesday, anticipate a grim milestone for Massachusetts. The state is projecting that the number of deaths caused by opioid overdoses topped 2,000 in 2016 for the first time.
That means that each day an average of nearly six men and women inject or snort a drug and never wake up again.
There are, however, some hopeful signs. The rate at which deaths increased from 2015 to 2016 was 16 percent as compared to 31 percent between 2014 and 2015 and 40 percent between 2013 and 2014.
"But the fact that the absolute number would appear to be just over 2,000 in 2016 is a sobering reminder that we still have a lot more work to do to bend the trend of opioid deaths," said Health and Human Services Secretary Marylou Sudders.
A key reason deaths continue to rise is fentanyl. Seventy-eight percent of those who died after an overdose had the powerful, fast-acting opioid in their system.
With more deaths from fentanyl, a growing number of doctors, nurses, counselors and family members say it's time to try new ways to combat the epidemic. The Massachusetts Medical Society is lobbying for the state to try supervised injection sites. Some overdose prevention workers are giving users rapid tests to check for the presence of fentanyl in their drugs. At least one community is testing the idea of putting emergency response boxes with the overdose reversal drug naloxone in them on city streets.
The Baker administration is not endorsing any of those ideas yet, but Sudders says she's looking into new approaches.
"We need to think bolder and with different strategies. There's a lot of discussion around safe injection sites, about increasing warming centers, looking at having Narcan in emergency boxes. We are open to all of these ideas," Sudders said. "We obviously need to study them to ensure that wherever we go next in addressing the opioid epidemic we can do it legally, safely and in an evidence-based manner."
It's not clear if more patients revived in emergency rooms across the state are seeking treatment. As part of the new law, doctors and nurses are supposed to assess patients in the ER to see if they will go into treatment, but there are no numbers on the impact.
For the first time, the state is posting town-by-town information about EMS calls and overdoses. Eighty-six percent of the state's 351 cities and towns had an opioid-related call last year. The number of opioid-related EMS transports across the state increased by 22 percent last year compared to 2015, and EMTs used 1.4 doses of naloxone on average for each opioid-related incident.
Seven of the state's counties are now considered hot spots for overdose deaths.
The data sheds light on many areas of this deadly epidemic, but also raises some questions. Why, for example, do so many more men than women die of an overdose?
The Baker administration says monitoring trends and targeting services will help break "the negative momentum of this crisis."