But just 8.3 percent of those decedents had an active opioid prescription in the same month as their death, DPH said, and in 83 percent of opioid overdose deaths that had a toxicology report completed the person who died had “illegally-obtained or likely illegally-obtained substances” in their system at their time of death.
BOSTON (STATE HOUSE NEWS SERVICE) – Authorized by a law signed last year to collect information from health care agencies, law enforcement departments, the court system and other state agencies, the Department of Public Health is working to demystify the data and identify previously unseen trends in the state’s opioid crisis.
In a preliminary report filed with the Legislature this month, DPH Commissioner Monica Bharel wrote that other states have already called Massachusetts to learn more about its approach to using data analytics to inform the state’s response to the scourge of opioid misuse and overdose.
“The ability to look as broadly and as deeply at public health data has been a unique challenge, but one that has given us a much greater understanding of the current opioid epidemic,” Bharel wrote. The approach “has enabled Massachusetts to serve as a national example for the possibilities of public health’s ability to leverage data warehousing to respond to pressing policy and health concerns by allowing existing data to be used in new and innovative ways to support policy and decision making.”
Working with the Center for Health Information and Analysis, MassIT, the Office of the Chief Medical Examiner, MassHealth, the Department of Correction and others, DPH has developed a model that allows for “simultaneous analysis of 10 data sets with information relevant to opioid deaths.”
The collaborative effort to link data sets has allowed DPH to dig into questions like, “Does an abnormally high number of prescribing physicians increase a patient’s risk of fatal overdose?”
The preliminary answer, DPH reported, is yes. The agency reported that the risk of a fatal opioid overdoses is seven times greater for individuals who use three or more prescribers within three months. DPH also reported that the concurrent use of opioids and benzodiazepines is associated with a four-fold increase in risk of a fatal opioid overdose.
The data analytics approach was also used to better understand the link between opioid overdose deaths and the legal use of prescribed opioids. DPH reported that “at least” two out of every three people who died of an opioid overdose had been prescribed an opioid between 2011 and 2014.
But just 8.3 percent of those decedents had an active opioid prescription in the same month as their death, DPH said, and in 83 percent of opioid overdose deaths that had a toxicology report completed the person who died had “illegally-obtained or likely illegally-obtained substances” in their system at their time of death.
In its report, DPH points to the information on illegally-obtained substances as “evidence to support an emerging hypothesis that illegally-obtained substances are the driving force behind” the state’s epidemic.
Since 2000, Massachusetts has seen a 350 percent increase in opioid-related deaths — from 338 in 2000 to an estimated 1,526 in 2015 — including record-setting numbers of deaths in each of the last four years, according to DPH.
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Using the criteria of multiple prescribing doctors can also be misleading. I have been seen at one clinic ONLY for the past 10 yrs but have averaged 3 providers or more per year because of the turnover in providers for this clinic! I tried to get my medical records and found that they only gave me 3 partial pages of information for the doctor that put me on my pain medication and that I saw for 3 years! I am certain that the folks doing these reports and studies do not look to see how many providers were in a particular practice during a given time period.
Good grief! Sad state of affairs.
This just show the war on opiates should not be against those who have legitimate severe chronic pain from being denied opiate medication. Many with chronic pain are really suffering because of all this going on and suicides among chronic pain patients are rising too. I am all for assists for addicts to get treatment but we should not forget those who need and use opiate medication in a responsible way for there pain.
And I’ll just add that if most of the overdose victims are obtaining their drugs illegally, then this is just further proof that the DEA is not doing its job. That the agency’s focus on doctors and chronic pain patients is not working — not helping to reduce the number of deaths, but actually increasing them.
The DEA will say that it’s patients who are allowing their medications to be stolen. And it’s doctors who are prescribing too much, creating a surplus in supply.
But, how can all this data — like autopsy results — show where someone purchased the drugs that killed them? And how do they determine which drugs were responsible? Should we assume that most victims of drug overdoses have both legal and illegal drugs in their systems? Like, when patients mix their prescription medications with alcohol, should we assume that it was the alcohol that killed them?
While I’m not a chemist, it’s my understanding that testing cannot always differentiate between legal and illegal opioids in our systems. So, while this looks like real medical research, it involves a lot of guesswork. They’re trying to make all this data mean something, but it’s all about correlation, not causation.
Does this mean we can stop scapegoating Doctors now?