In Massachusetts, the only state in the nation with programs that have brought about a decline in opioid-related OD deaths, the introduction of large quantities of fentanyl into the illicit drug supply has recently caused the death rate to remain steady at about 1500 deaths, in contrast to the 5% decrease between 2016 and 2017. The state’s black communities are the hardest hit, according to the recently re-elected governor, Charlie Baker, under whose leadership a variety of well-funded and relatively effective programs have been implemented, vowed to continue to make these programs and priority and “to stay on it for quite a long time.”

Prescription painkillers, once the leading cause of OD deaths in the state, were found to be present in just 17% of those who died, while heroin was present in 37% of the cases, and illicit fentanyl in 90%. Fentanyl is a killer; it is inexpensive to produce, and is easily transported and added to other drugs. “Fentanyl just really wasn’t part of this conversation four years ago, and it has exploded on the scene in a way that completely changes the dynamic for practically everybody,” said Baker at a recent forum. The fentanyl-related death rate spiked among only one demographic group: non-Hispanic black men (a 44% increase in one year).

In spring, Baker signed a law to facilitate the prosecution of fentanyl traffickers; last month he sought $5 million from the legislature for regional coordination of police departments to fight the spread and use of fentanyl. The state’s public health commissioner intends to increase awareness campaigns, particularly in black communities.

As a clinical social worker, you may be seeing individuals and families dealing with addiction. Opioid-related deaths are at epidemic levels in most states. What is your state doing about this crisis—and what are you and your colleagues doing to educate and assist your clients and to pass new laws and affect public policy? The example of Massachusetts is available and exportable, and could save thousands of lives.


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