Connecticut’s opioid epidemic: A glimpse of the last five years

Various measures have been taken to alleviate the burden of opioid-related deaths in Connecticut in recent years. However, these efforts have yet to make a significant difference in terms of reducing the high death rates within the state.

There has been a steady increase in total overdose deaths among residents from 357 deaths in 2012 to 1,038 deaths in 2017. In 2016, Connecticut ranked 11^th among all states in highest rate of overdoses, with 27.4 deaths per every 100,000 people. Many of Connecticut’s neighbors were among the top 10, including New Hampshire (39 deaths/100,000 people), Massachusetts (33 deaths/100,000 people), Rhode Island (30.8 deaths/100,000 people), and Maine (28.7 deaths/100,000 people).

Those closely following the epidemic are aware of the fact that white residents are dying in greater numbers in Connecticut and throughout most of the nation. However, other populations are increasingly being affected at overwhelming rates as well.

The following report detailing demographic and geographic trends in opioid overdose deaths throughout the past several years is based on data from the Connecticut Office of the Chief Medical Examiner.

Who is dying from opioid overdoses?

In Connecticut, males have higher rates of overdose deaths than females.

In addition, from 2012-2017, those who died from an opioid overdose were mostly between 40-50 years old. However, these deaths ranged from as young as 14 to over 85 years old. The chart above shows the distribution of deaths by age, gender and race. The average age of deaths in Connecticut for males is significantly higher than that of females. The average death ages for males and females are 41.6 and 42.8, respectively.

The average age of deaths between whites, blacks, and Hispanics is also significantly different, with whites dying younger than blacks and Hispanics each year in Connecticut.

Which groups have experienced the greatest increases in overdose death rates?

Controlling for age differences in various racial/ethnic subgroups, gives additional information about the populations at risk in the epidemic. Those that have experienced the greatest increases in overdose deaths are whites (140 percent), blacks (133 percent) and Hispanics (100 percent) in Hartford County, Hispanics in Fairfield County (100 percent), and whites in New Haven County (117 percent).

Overall, those with the highest three-year average death rates are blacks (24/100k people) and Hispanics (16/100k people) in the “Other Connecticut” counties, as well as whites in New Haven County (13/100k people).

The striking rise in overdose deaths, largely among Hispanics and blacks in urban counties, is not just exclusive to Connecticut.

Recent reports from the Massachusetts Department of Public Health show an overall decline in opioid-related overdoses – except within the black community.

Urban areas across the U.S. have reported a similar trend in opioid fatalities within communities of color. In the nation’s capital, overdoses among black men, aged 40-69, increased more than 200 percent from 2014-2017. Additionally, a 31-state analysis of opioid-related deaths by the Centers for Disease Control and Prevention showed that the largest relative rate change in deaths from 2015-2016 occurred among blacks.

Have death rates increased faster in certain Connecticut towns more so than others?

Rather than looking at death rates on a county level, the Five Connecticuts classification system allows an analysis of trends based on different types of towns. This system groups towns into one of the following five categories: Wealthy, Suburban, Rural, Urban Periphery, and Urban Core. According to this classification, from 2012-2017 the cluster with the greatest increase (108 percent) in opioid-related deaths was the Urban Periphery. This group includes towns like West Haven, Bristol, Manchester, Stratford, Groton, and Naugatuck.

Which drugs were involved in most opioid-related deaths among Connecticut residents?

 More than half of all opioid-related overdoses involved heroin from 2012-2017. Additionally, fentanyl was involved in 36 percent of all deaths within this time frame.

Key points:

• Regardless of race, gender, and age, the epidemic continues to worsen in Connecticut.
• Urban regions have seen the largest increases in opioid-related deaths from 2012-2017.
• Heroin and fentanyl are involved in the vast majority of Connecticut overdoses.

In the past five years, there have been several changes in state laws regarding the opioid crisis. These include the Good Samaritan Law, passed in 2011, which encourages people to call 911 for emergency medical services in response to an overdose by protecting those who call from arrest due to drug possession. A year later, the Narcan Law was passed, which enables greater access to the lifesaving, overdose-reversal drug, Narcan by allowing providers to prescribe, dispense or administer the drug to any person. Another law passed in 2014 offers legal protection to anyone that administers Narcan for treatment purposes.

Also contributing to the response, the statewide public awareness campaign, Change the Script, has been busy creating and distributing mass communication materials to promote messages related to overdose prevention, treatment, and recovery.

In 2016, Gov. Dannel Malloy convened experts from Yale Schools of Medicine and Public Health to establish the Connecticut Opioid REsponse initiative (CORE). CORE’s three-year plan focuses on evidence-based strategies to reduce the burden of opioid overdoses in the state. Additionally, Waterbury and other cities are taking legal action against opioid manufacturers who have been accused of engaging in misleading marketing of Oxycontin and other opioids.

With these efforts in mind, the findings in this article show that the battle is far from won. Given what we know about who is dying from opioids, where these deaths are occurring, the types of drugs involved and the fact that there has not been any improvement in overdose death rates in the past five years in Connecticut, it is time to consider taking bolder strides toward unconventional prevention and treatment options. For example, measures such as establishing safe injection sites in urban areas, or ensuring equitable access to fentanyl test strips are worth discussing. Improving the quality of the data that is available is also another important step that can be taken. For example, reliable data for non-fatal overdoses would be beneficial in obtaining a more wholesome picture of the impact of the epidemic in the years to come.

*Opioid-related deaths include fatalities from prescription drugs, non-prescription drugs, and deaths involving a combination of narcotics and other drugs, like cocaine.

Number of opioid overdose deaths by CT county, race and year, 2012-2017

 ^Non-Connecticut resident deaths, cases with missing and “other” races are excluded from this table. Values less than five deaths per county are suppressed.

Average death rates (per 100k) for the Five Connecticuts

Josephine Ankrah is a research assistant at DataHaven, a New Haven-based nonprofit organization that collects, interprets and shares public data in Connecticut for effective decision-making.