Data shows local opioid deaths soaring amid pandemic

Robert Daignault can remember driving his wife, Amanda, from hospital to hospital in 2020, looking for a doctor to prescribe pain medication for her recurring bout of shingles.

Amanda Daignault, who was battling an opioid addiction, was often overlooked as someone trying to get her hands on prescription drugs. The stigma of addiction, her husband said, led to her death later that year as her experiences discouraged her from seeking care for an infection that eventually spread to her blood. She was 32.

“She just lost all faith that the health system would help her,” said Robert Daignault, a peer recovery coach with The RECOVER Project in Greenfield, who is also in recovery himself. “She was stigmatized as an addict. … When she was known as an addict, they wouldn’t do anything.”

Robert, 36, and Amanda Daignault are just two of the countless people who have had their lives catastrophically altered by the ever-worsening opioid epidemic tearing families and lives apart across the country and state. In new data from the U.S. Centers for Disease Control and Prevention released earlier this month, 2021 marked the worst year for fatal opioid overdoses recorded, with more than 107,000 deaths across the country and 2,500 deaths in the state of Massachusetts.

Franklin County and Athol were not spared the brunt of it, as 44 people in the region experienced unintentional fatal overdoses in 2021, a 52% increase from 2020 and a 132% increase from 2019, according to the Northwestern District Attorney’s Office. Data from the Opioid Task Force of Franklin County and the North Quabbin Region shows non-fatal overdoses have also increased, with nearly 280 non-fatal overdoses in 2020 compared to 209 in 2019. Full-year data for non-fatal overdoses in 2021 is not yet available.

Athol alone accounts for one-quarter of fatal overdoses in the region, with 11 people dying in 2021.

The rates of unintentional fatal overdoses in the region also far outrank the rest of Massachusetts. Greenfield and Athol saw unintentional fatal overdose rates of 67.54 and 95.25 per 100,000 people, respectively, which both outrank the state’s rate of 30.2.

Preliminary statistics from the Northwestern District Attorney’s Office for the first quarter of 2022 paint a more optimistic picture for the year ahead, however, with five unintentional fatal overdose deaths in Franklin County and Athol. At this point in 2021, the region had already seen 14 fatal overdoses.

For Northwestern District Attorney David Sullivan, the rising number of deaths directly correlates with the “manifestation of fentanyl in our community” as the “perpetual” epidemic continues.

“It impacts every community and strata of society,” Sullivan said in a phone interview. “It’s replaced heroin and it’s far more lethal — that’s what really created the spike in the last two years.”

According to the data, fentanyl was detected in 44% of fatal overdose cases in 2020, while fentanyl was detected in 81% of overdoses in 2021. Sullivan said he suspects that number may even be “closer to 90 to 95%.”

Franklin County’s location along the Interstate 91 corridor — and Athol’s proximity to Fitchburg — are what Sullivan sees driving the spread of opioids in the community as they enter the country in New York City and travel from there.

Compounding the increased circulation of fentanyl in the community is the ongoing mental health struggles brought on by the pandemic, which Sullivan said has “fed the beast” of addiction and other mental health illnesses.

“It’s a sad state of affairs, but I think COVID has created another state of concerns,” Sullivan said.

In analyzing deaths, Sullivan said he saw a “concerning” trend in the number of deaths coming from the 35 to 44 age range because it indicates that people managing long-term addictions are overdosing with the introduction of fentanyl to the drug supply.

“What that tells me is they probably had a long-term addiction and now they’re really facing the toxicity of fentanyl,” he explained.

With increasing mental health and addiction needs, the county’s resources have been working overtime, but economic factors weigh down those efforts.

“It’s rural isolation. … There are huge health care deserts in western Massachusetts,” he said, adding that a town like Athol is not seen as an economically viable place for a health care organization to open a treatment center, even if it is needed. “We’ve neglected our community health care for so long and it’s really coming home to roost that these vulnerable patients don’t have the in- or out-patient treatments to address their addictions.”

Debra McLaughlin, coordinator of the Opioid Task Force, said the early stages of the pandemic saw treatment centers closed due to the governor’s shutdown order — peer recovery and other treatment centers were soon added to the list of essential businesses — and that short shutdown drastically affected people’s treatments. Now, she said, staffing shortages have hit these centers as well.

“It’s really painful to see our treatment and recovery system be impacted in this way,” McLaughlin said in a Zoom interview. “How can we continue to coordinate and offer hope and help to those who need it? That’s the continuing challenge right now.”

Athol, specifically, Sullivan said, is at the “crossroads” of opioid trafficking, with Fitchburg and Holyoke being the main sources. This, combined with the town’s low income limiting treatment, creates a larger vulnerable population. The state’s first rural methadone clinic opened at the Community Health Center of Franklin County in neighboring Orange in late 2021.

“There’s plenty of poverty there and a lot of other health risks,” Sullivan said. “When you combine a lack of employment and mental health challenges, it’s a community that is really struggling.”

With these difficulties, both Sullivan and McLaughlin emphasized the need for more treatment centers and reliable transportation. Despite the dire picture now, both said the methods and philosophy of addiction treatment have made significant strides in the region, especially in the form of the Opioid Task Force’s CONNECT program, which is a program that sends recovery coaches to people’s homes who have experienced or witnessed an opioid overdose within 72 hours.

“We want to treat addiction as a disease, as opposed to a criminal justice matter,” Sullivan explained. “There’s more outpatient beds now than there were back in 2013. We’ve come a long way and we’re fortunate to have really strong advocates.”

The Community Opportunity, Network, Navigation, Exploration and Connection Team (CONNECT) is a 24/7 rapid response team created by the Opioid Task Force and a partnership that includes The RECOVER Project, Tapestry, law enforcement from 30 area communities, the Children’s Advocacy Center of Franklin County and North Quabbin, and the North Quabbin Recovery Center, among others.

Sarah Ahern, also a peer recovery coach with The RECOVER Project, emphasized that numbers are more than just data — each point on a graph represents the end of a human life and the unquantifiable grief that shrouds families and communities in the wake of an overdose.

“You can look at data numbers — those are human beings, those are people, those are somebody’s brother, sister, mother, father, cousin, aunt, uncle, grandfather,” Ahern said sitting next to Daignault in The RECOVER Project’s office. “Those people were loved by their family and we talk about these losses. They’re human lives and the weight of that is heavy.”

Following an overdose, folks like Ahern and Daignault will stop by a home to check in on individuals and their families, and inform them of the numerous resources available for addiction treatment, mental health services and other outpatient services.

Both recovery coaches said their experiences on the ground helping people reflect what the numbers provided by the district attorney and Opioid Task Force show. Both shared their recovery journeys and how the pandemic made the situation more dire over the last two years.

“Isolation feeds our disease,” Ahern said. “The isolation of COVID corresponds directly with the amount of overdose losses because the connections are there.”

The key to being effective, Daignault said, is this lived experience he and Ahern have lived through in their own pathways to recovery, along with the human-to-human connections they can create.

“For me, I remember it was somebody with a clipboard asking me questions off a sheet, that didn’t really seem personable,” Daignault recalled. “To have somebody out there that wants to help out somebody … having someone come out and actually talk to me and get to know me and how much of a difference it would have made.”

McLaughlin said CONNECT’s role is invaluable in addressing the traumatic experience of an overdose by providing victims with the insight of someone who may have gone through a similar experience in battling their addiction.

“We need and must learn how people continue to be impacted and how to provide empathetic and trauma-informed ways to be supportive,” she said. “There’s no quick way to fix this; building relationships take time and we must do this necessary work to have the impacts we want to have.”

Ahern emphasized that harm reduction is a key strategy because everyone has a different route to recovery. In harm reduction, the goal is to guide someone to recovery on their own terms. She used an example of someone using heroin or fentanyl, who works their way off injecting the drug through a needle and instead begins to snort it instead.

“That’s a degree of wellness. You want to set people up for success and not failure,” she said. “When you start to put your own definition on somebody’s recovery and wellness, it doesn’t work. … It’s keeping people alive and letting them, with our support as coaches, create a wellness plan of their own that works for them.”

Despite the changes in society’s attitude toward addiction, the stigma remains.

“Stigma really keeps people from treatment. They don’t want to be labeled,” Sullivan said, noting that “almost 99%” of fatal overdoses happen when the person is alone. “We want as many people as possible to recognize the community is going to embrace you for getting treatment. … It’s something to be proud of for reaching out to these services.”

From this point, Sullivan, Ahern, Daignault and McLaughlin all said the main focus is to keep getting into the community and keep advocating for more funding and services. While funding can come from grants and government appropriations, communities are also receiving a windfall from the national opioid settlement, which is distributing $526 million to the more than 150 towns across Massachusetts that joined the lawsuit against Johnson and Johnson, Cardinal, McKesson and Amerisource Bergen.

In Greenfield, that means a total of $950,979 will be distributed to the city through 2038. The city is receiving $106,944 this year. Ahern is hopeful residents can provide input on where this money could be best used to mitigate the opioid epidemic.

While the community’s residents, governments and organizations all collectively push for continued treatment and care for those battling addiction, Sullivan said there is still a long, challenging road ahead.

“It’s just a really tragic crisis,” he said. “And I’m not sure where it’s going to end.”

Anyone struggling with drug addiction, including a loved one, can contact the Massachusetts Substance Use Helpline at 800-327-5050 or access the website at helplinema.org. Resources are also available in Spanish.

Chris Larabee can be reached at clarabee@recorder.com or 413-930-4081.