Narcotics-related fatalities rise in Massachusetts

A decade-long epidemic of heroin-related deaths reached a new high in 2003, according to a state report released yesterday that offers the newest evidence of the toll exacted by the continued influx of cheap, pure drugs into New England.

The study, issued by the Department of Public Health, found that drugs were deadlier than motor vehicles: Narcotics caused 574 deaths, compared with 521 fatalities attributed to traffic accidents. In the last 13 years, drug overdoses have soared six-fold.

Substance-abuse specialists said that in many respects, the continued spread of heroin represents a classic example of market-driven economics. Today, a small bag of heroin can be purchased for as little as $4, cheaper than a six-pack of beer. And to entice young users, dealers sometimes offer free samples.

The result: Deaths from opiates have climbed markedly since 1990, when 94 people succumbed. The report released yesterday was the latest in a series of recent studies documenting the scope of addiction problems in the region.

''We have a major crisis," said Elizabeth Funk, president of Mental Health and Substance Abuse Corporations of Massachusetts, a trade group. ''One would assume that society sooner, rather than later, would be attentive to the situation. We don't put these people on barges and ship them off to the middle of the ocean. They're not going away."

The increase in deaths in 2003 happened as state government cut spending for substance-abuse treatment significantly. Between 2001 and 2004, the Department of Public Health cut nearly $11 million from what it devoted to treating drug users and to preventing narcotic and alcohol abuse.

The impact of those cuts was intensified by reductions in other state programs, particularly the MassHealth Basic insurance plan for the poor. The number of treatment beds for substance users needing urgent detoxification fell from nearly 1,000 statewide to 420, meaning patients waited weeks or months for a slot.

Lieutenant Governor Kerry Healey was put in charge of a commission to review the state of substance-abuse treatment in Massachusetts, and a May report from that commission called for better coordination of services among government agencies. It also championed prevention efforts.

In the wake of that report, the administration of Governor Mitt Romney increased by $9.1 million what it had committed for the current budget year for the Bureau of Substance Abuse Services. But drug-treatment specialists said that money only restored the bureau's finances to the 2004 level.

In an interview yesterday, Healey said her commission is trying to make sense of the bewildering web of treatment services.

''We want to make sure we have the right amount of funding in the right place," Healey said. ''This is an opportunity to build the system back and build it back in a more rational way than it existed previously."

The task force Healey presided over concluded that substance-abuse services were divided among too many agencies and that recovering addicts too often did not get the sustained help that would prevent them from returning to their drug of choice.

Executives with substance-abuse agencies estimate that the state needs to spend $50 million more for adequately addressing the medical needs of addicts and for prevention campaigns.

Nancy Paull has seen the face of heroin addiction in Massachusetts, and it is increasingly suburban, middle-class, and young. There was, for instance, the teenager who celebrated his 16th birthday in a detox bed at Stanley Street Treatment & Resources, the Fall River agency where Paull is chief executive officer.

That teenager's story, Paull said, was emblematic. He was hooked on the painkiller OxyContin, a potent prescription drug that has gained widespread illicit use.

''Kids are buying OxyContin on the street," she said. ''But it's quite expensive, and they quickly move to snorting heroin, and that moves to quickly injecting heroin."

As suburban parents began to recognize that the users of heroin and OxyContin looked a lot like their own children -- and that, sometimes, they were their own children -- that changed the political dynamics of substance-abuse treatment, Healey acknowledged.

''In the past in America, when there have been drug-abuse problems, it has been the government vainly trying to draw attention to why this is a problem for society," Healey said. ''Parents are extremely concerned that this is now a middle-class, upper-class issue."

Stephen Smith can be reached at stsmith@globe.com.