This story was originally published in the Somerville Journal.
For the past several years, opioid use has increased throughout the state of Massachusetts and the country.
In 2014, former Mass. Governor Deval Patrick declared a public health emergency, calling the situation an “opiate epidemic.”
In Somerville alone, opioid-related deaths increased from five in 2012 to 19 in 2015. And according to recent data, those tolls spike in the spring months.
To raise awareness, the Somerville Police Department hosted a “How to Save a Life? Reducing Fatal Overdoses” workshop. The discussion focused on recent data and trends for opioid use and resources for recovery.
Breaking down opioid use in Somerville
Since 2013 the Somerville Police Department has been watching opioid-related death trends.
According to Senior Crime Analyst Christopher Wendt, during the spring months they see an average of seven deaths, as opposed to an average of three in the summer months.
“Fatal overdoses peak in the spring,” he said. “There’s an average of seven fatal overdoses in the spring versus three in the summer. Reported fatalities increase mid-March and peak at the end of March to mid-April.”
Analysts currently are unsure why this is happening, explained Wendt, but are investigating theories.
The majority of both non-fatal and fatal overdoses, in the city and the state, are between 25-34 years old, which Wendt says matches Somerville incident trends.
“Somerville is largely 26-35 years old [population wise],” said Wendt. “[These trends] make sense when you think about the life cycle of someone receiving prescription opiates and going into heroin and riskier behavior.”
Though the average age is somewhere between this range, Wendt said the older a user is, the more likely Somerville paramedics, police and fire are to respond to a reported overdose.
In Massachusetts, however, first responders are more likely to respond to a 25-year-old overdose and slow down as people get older.
“In Somerville it picks up as you age. We might not see those people who are older a lot, so we go,” explained Wendt. “There a lots of different groups in our community…risks might be different coming from certain places.”
Almost all reported overdoses are in a residence, somewhere people feel safe, and people are more likely to be found by a close family member or significant other, said Wendt.
Somerville Police Chief David Fallon said though the rate of opioid and other drug use is increasing, there are ways to intervene. Through programs like this, he said, and through collaborative work, the community can fight addiction.
“I don’t think there’s anything that we can’t accomplish,” he said. “[When we’re] moving together as a community and as a group…there’s no problem we can’t solve. Somerville police are in the fight for the long-run.”
Adding fentanyl to the mix
Over the past few years, fentanyl has become an increasing problem within the opioid epidemic.
According to Dr. Daniel Karlin, chief medical officer at Column Health, fentanyl is almost 1,000 times more potent than morphine. And carfentanil, he added, is almost 10,000 times more potent. Rather than having to extract the drug from poppy seeds, like heroin, he said, fentanyl can be made in a lab.
A smaller dose activates more receptors and is cheaper to acquire, from a dealer’s perspective, which is when it gets mixed with heroin, he explained.
“When you introduce potent powders into mixing powders…the mix could be…just about anything,” said Karlin. “You’re taking this really, really potent thing and mixing into something else…this is fatal.”
If a grain of carfentanil is in a bag of mixing powder, he explained, then one dose taken from that bag could have a higher potency than another—everything is far more unpredictable.
“The little things folks try to do to keep themselves safe while seeking the substance, those safety measures aren’t working,” Karlin continued.
AIDS Action Committee’s Needle Exchange and Overdose Prevention Program outreach coordinator Kristin Doneski said a lot of clients are starting to talk about fentanyl.
“The fentanyl hitting the streets right now is really scaring [users]. We’ve heard this kind of fear…of whether it’s safe or not, whether they like it or not,” she said.
The response time for a fentanyl overdose is so much shorter than other opioids, she continued.
As part of their harm-reduction program, Doneski said the center encourages active users to sniff their drugs and see if they have a tolerance, especially in the case of fentanyl. Even people who have been using heroin for years have overdosed with this drug, she said.
A main problem with fentanyl overdoses, she said, is that those people need more Narcan.
Narcan or naloxone, is a drug that counteracts overdoses. All first responders are equipped with Narcan and patients, family and friends can carry the drug after proper training.
A new approach to policing
Over the past few years, Somerville Police have been trying to highlight community interaction and train officers to work with behavioral health problems, like mental illness or addiction.
With Community Outreach, Help and Recovery (COHR), directed by Patricia Contente, Somerville Police are taking a new approach to handling drug and substance abuse.
In an interview, Contente said over 30 percent of officers are trained in Crisis Intervention Training (CIT). Rather than strictly criminalize substance users, officers direct them to help.
“We’re facilitating better engagement and more reconnection,” she explained. “How do we work [in recovery] and follow-up with people?”
Fallon said the department tells officers “arrest should be your last resort.” When someone is struggling with addiction, the last thing you want to do is place them in a holding cell, he explained. Once they make bail, he said, they’ll most likely be out in the street, getting into the same cycle all over again.
“How officers handle mental illness, education issues, addiction issues…that’s how we judge,” said Fallon. “It’s how you interact with people in the community that are most at need.”