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wbjournal.com | August 5, 2019 | Worcester Business Journal 7 Uncork Some Fun! Grand Tasting • September 14, 2019 Union Station, Worcester MA Tickets on Sale Now WorcesterWineFestival.com Taste 400+ Wines MEDIA PARTNER Source: Drug Enforcement Administration, U.S. Census Bureau (2018 population estimates) Worcester 49,100,976 185,877 38 Brockton 40,389,144 95,777 60 Springfield 37,863,030 155,032 35 Fall River 34,416,812 89,661 55 Cranston, R.I. 28,855,210 81,274 51 Warwick, R.I. 28,659,775 80,847 51 Bangor, Maine 27,394,830 31,997 122 Providence, R.I. 25,121,060 179,335 20 Manchester, N.H. 24,997,150 112,525 32 Boston 23,055,176 694,583 5 Portland, Maine 20,301,000 66,417 44 Bridgeport, Conn. 20,134,375 144,900 20 Nashua, N.H. 19,352,890 89,246 31 New Haven, Conn. 18,973,830 130,418 21 Pawtucket, R.I. 17,644,350 71,847 35 Lewiston, Maine 15,906,720 35,944 63 Auburn, Maine 14,848,200 23,196 91 Lowell 14,333,460 111,670 18 Leominster 13,385,954 41,823 46 Stamford, Conn. 12,567,655 129,775 14 MASSACHUSETTS 1,281,376,613 6,902,149 27 Pills per capita Location Number of pills Population per year More pills than any other city Worcester had by far the most opioid prescription pills distributed to its pharmacies of any city in New England from 2006 to 2012. W starting use and periodically during use. e agency cautions prescribers to avoid extended-release pills, and when opioids are prescribed for pain, doctors should give patients no more than needed. Deadly crisis e federal data shows in new detail how much legally obtained opioids contributed to a health epidemic that has killed 2,000 people in Massachusetts each of the last three years. Numbers peaked with 2,100 confirmed opioid-re- lated overdose deaths in 2016, with a 3% drop over the two years since. In 2018, there were an estimated 2,033 opioid-re- lated deaths. But in Worcester, deaths rates have never come down. Fatalities in the city hit 97 in 2018, up from 80 the prior year and 24 in 2012. e federal prescription opioids data doesn't capture more recent years, when those deaths in Massachusetts peaked. In 2006, when the first year of opioid prescription data is available, 660 opioid deaths were recorded in Massachusetts. A decade later, it was 2,100. By 2017, Massachusetts had the sixth highest rate in the country for opioid deaths as a share of the population, according to the Kaiser Family Foun- dation, with 28.2 deaths per 100,000 people. e national average was 14.9. Pills flood Worcester neighborhoods In Worcester, it's easy to see where tens of millions of prescription opi- oid pills make their way into the city's neighborhoods. In the span of one mile on Park Avenue, more than 4.2 million opioid pills were distributed to a Walgreens, according to the federal data, and more than 2.6 million to a CVS. A CVS at 500 Graon St. had the most opioids distributed in Worcester County and the seventh most in Massachusetts over that time – almost 5.2 million – and a Walgreens just over two-thirds of a mile away on the same stretch filled nearly 1.5 million. In all, Worcester had three of the state's top 11 pharmacies as measured by the number of opioid pills prescribed. A Leominster CVS had the seventh most, and a Gardner CVS the eighth most. Controlling the crisis Tighter prescription monitoring regu- lations in Massachusetts have been said by state officials to be partly responsible for the slightly better fatality figures. ose restrictions have led to a 38% drop in the number of opioid prescrip- tions in the first quarter of 2019 com- pared to a year prior, the Massachusetts Department of Public Health said in May. Providers under the Massachusetts Prescription Monitoring Program regis- tered nearly 1.9 million searches in the first quarter in an indication of thorough oversight, an increase of roughly 90,000 since the previous quarter. e state has instituted since 2016 a seven-day supply limit for first-time patients, and a requirement for prior authorization for higher dosage amounts and for any doses of methadone, which can be used to treat addiction. Some signs show over-prescribing is still taking place. Last November, U.S. Attorney for Mas- sachusetts Andrew Lelling sent letters to an unspecified number of prescribers who were found to have prescribed opioids to a patient within 60 days of that patient's death or to a patient who subse- quently died from an opioid overdose. Worcester County District Attorney Joseph Early Jr. lauded the state's better prescription monitoring but said more care still needs to be paid to keeping opioids in as few hands as possible. "Sometimes it's just one pill" that can get someone addicted, Early said. Now, Early said, public officials and their healthcare partners are focused more on fentanyl. "We're seeing a big increase in fentan- yl, a big increase in heroin. It's cheaper, more easily found," Early said. Addiction is "a very complex disease, and it's going to require a very complex solution, and that's all of us working together." e Massachusetts Medical Soci- ety helped develop the state's opioid prescribing guidelines and has worked to offer provider education and support the state's prescription drug monitoring program, said Maryanne Bombaugh, the society's president. "It is our belief that the practice of medically appropriate prescribing of opioids will continue in this trend," Bombaugh said. CVS, responding to the new opioid data, says its market share of opioid pre- scriptions dispensed is significantly less than its market share during the years covered in the DEA database and since. Opioid pills were a very small percentage of total prescriptions, the company said. Walgreens said it has tightened its own distribution of such medications, ending distribution of controlled sub- stances in 2014. Before then, it distribut- ed only to its own chain of pharmacies. It still allows the filling of prescriptions at its pharmacies. A growing concern Over a seven-year period ending in 2012, the number of opioid pills distributed across Worcester County rose by 41%. Source: Drug Enforcement Administration Number of pills distributed 15M 20M 25M 30M 35M '06 '07 '08 '09 '10 '11 '12 22M 31M