City reports growing number of opioid overdoses among Nubian Square cocaine users unaware their coke was cut with fentanyl

The Boston Public Health Commission yesterday alerted healthcare providers and community organizations about what it says is"concerning levels of presumed opioid-related overdoses in Nubian Square among individuals who believed they were using cocaine."

In February, Boston Emergency Medical Services responded to a series of presumed opioid overdoses. Most of the individuals who were impacted believed that they were using cocaine. The Massachusetts Department of Public Health identified that between 2010 to 2018 overdoses from stimulants like cocaine increasingly involved opioids. Toxicology screens from the first six months of 2022 showed that among 1,043 opioid-related overdose deaths occurring in MA, fentanyl was present in 94%, cocaine in 53%. ...

Although officials attribute some overdose deaths to the intentional use of multiple substance, agencies continue to monitor the extent fentanyl may contaminate the cocaine drug supply. In 2021, the State detection program found 12% of cocaine samples tested in Boston flagged positive for fentanyl.

The alert continues that providers and community organizations should encourage people who use cocaine to test their drugs first, if they are unwilling to begin a "harm reduction" program:

Providers should distribute strips and recommend people who use cocaine test their drugs in advance of using. The State offers fentanyl test strips to providers for free, through the Massachusetts Health Promotion Clearinghouse, along with bi-lingual instructions.

BPHC said because cocaine users are not expecting to get dosed with fentanyl, a potent opioid, they are less likely to carry or have access to Narcan, which can reverse what might otherwise be a fatal overdose. And unlike regular heroin or fentanyl users, their bodies likely have less of a tolerance for opioids, which means they could die from a lower does than people addicted to opioids.

BPHC says coke users and people around them need to be more aware of the symptoms of an opioid overdose and the need for Narcan. Longer term, BPHC says it can help people get into substance-abuse programs.

In the event of an overdose, call 911, administer naloxone, give rescue breaths, and monitor until breathing resumes, even if the person remains unresponsive. If someone is over-sedated, put them on their side in the recovery position, make sure their airway is clear, and monitor their breathing. Stay with them until EMS arrives

In a statement, BPHC Commissioner Bisola Ojikutu said:

If you believe that someone has overdosed, call 911 immediately and administer naloxone (Narcan). BPHC offers harm reduction services to reduce the risk of fatal overdose, including naloxone (Narcan) distribution, drug testing and trainings on how to respond to an overdose. All our services are offered in compassionate and judgement free environments.