Recent data from the Massachusetts Bureau of Substance Addiction Services and the Essex County Outreach Project offer a broad look at substance use, overdose response, treatment access, and emerging community needs across Essex County.
The data comes from two different systems and covers different periods. The state’s BSAS Community Profile includes county-level information on emergency events and services generally covering July 2024 through June 2025. The Essex County Outreach figures come from incidents entered into the Critical Incident Management System, or CIMS, between January 1 and June 30, 2026.
Together, these sources show both the scale of substance-related harm in Essex County and the growing network of treatment, harm reduction, outreach, and recovery services responding to it.
Emergency Department and EMS Activity in Essex County (Last Reporting Year)
Between July 2024 and June 2025, Essex County residents had 11,146 substance-related emergency department visits.
Those visits included:
- 8,695 alcohol-related ER visits
- 803 opioid-related ER visits
- 86 stimulant-related ER visits
Categories are not necessarily mutually exclusive, meaning one recorded visit could involve multiple substances. The dashboard also cautions that emergency department information is generally most useful for identifying trends rather than treating every number as a precise count. Reporting volume and the identification of acute versus chronic conditions can influence the totals.
Alcohol-related visits made up the overwhelming majority of substance-related emergency department activity shown in the dashboard. This demonstrates that although the overdose crisis often centers public attention on opioids, alcohol continues to create an enormous burden for individuals, families, hospitals, and emergency services.
The state also reported 1,367 opioid-related EMS incidents in Essex County during the same general period. An opioid-related EMS incident is a 911 response in which opioids were believed to be involved. The state cautions that these incidents are not all confirmed overdoses and are not necessarily all nonfatal events.
Treatment and Recovery Services
The county-level data also shows thousands of Essex County residents accessing treatment and recovery supports.
Between July 2024 and June 2025:
- 192 people were admitted to intervention and engagement services
- 2,113 people were admitted to treatment services other than medication-based treatment
- 3,964 people received methadone
- 5,983 people received buprenorphine prescriptions
- 612 people were admitted to community support services
These numbers reflect different parts of the continuum of care and should not be added together as a count of unique individuals. A person may receive more than one form of treatment or support during the same reporting period.
Still, the scale of participation is significant. Nearly 10,000 people received either methadone or a buprenorphine prescription, showing the central role that medications for opioid use disorder continue to play in the county’s response.
Treatment is rarely a single event. People may move among withdrawal management, residential treatment, outpatient care, medication treatment, peer recovery support, housing assistance, harm reduction, and long-term community-based recovery services.
Harm Reduction Across the County
Select programs distributed 18,903 naloxone kits in Essex County between July 2024 and June 2025.
They also distributed or provided 36,410 fentanyl test strips.
Naloxone can temporarily reverse an opioid overdose and create time for emergency medical care to arrive. Fentanyl test strips can help people identify whether fentanyl may be present in a drug sample and make more informed decisions to reduce risk.
These figures represent distribution from select reporting programs, not necessarily every naloxone kit or test strip distributed across Essex County.
The level of distribution reflects a substantial community-wide effort involving harm reduction organizations, treatment providers, public health departments, first responders, recovery centers, outreach teams, and other local partners.
What CIMS Shows in the First Half of 2026
More recent data from Essex County Outreach and partners provides a different view of local activity.
Between January 1 and June 30, 2026, participating Essex County municipalities and outreach teams entered 1,378 incidents into CIMS:
- 847 behavioral health incidents: 61%
- 317 at-risk incidents or referrals: 23%
- 189 nonfatal overdoses: 14%
- 25 fatal overdoses: 2%
CIMS is a shared incident and outreach database used by participating municipalities and agencies. These figures represent incidents reported and entered by participating communities. They should not be interpreted as a complete count of every overdose, behavioral health crisis, or at-risk situation that occurred throughout Essex County.
Overdose Incidents Continue to Decline
Compared with the first six months of 2025, the CIMS data showed:
- A 63% decrease in fatal overdoses
- A 26% decrease in nonfatal overdoses
- A 17% decrease in at-risk entries
There was an average of 4.2 fatal overdoses per month during the first half of 2026, compared with 11.2 per month during the same period in 2025.
Nonfatal overdoses averaged 31.5 per month, compared with 42.5 per month one year earlier.
These declines are encouraging and are consistent with the broader downward trend in opioid-related overdose deaths across Massachusetts. State officials estimated that Massachusetts recorded 978 opioid-related overdose deaths in 2025, a 27% decrease from 2024 and the first annual total below 1,000 in more than a decade.
At the same time, overdose data must always be understood as more than percentages. Every fatality represents a person, a family, and a community changed by loss.
Behavioral Health Incidents Are Rising Sharply
The most significant shift in the 2026 CIMS data was the increase in behavioral health incidents.
Participating agencies entered 847 behavioral health incidents during the first six months of 2026, an average of approximately 141 per month.
That was a 43% increase over the same period in 2025, when 591 incidents were entered.
Behavioral health incidents accounted for 61% of all CIMS entries, making them the largest category by a wide margin.
This reflects what outreach teams and first responders are increasingly seeing in the community. People may need help with substance use, mental health crises, suicidal thoughts, trauma, homelessness, family instability, or several overlapping challenges at once.
The data suggests that the role of community outreach is continuing to expand beyond overdose response into broader behavioral health engagement and navigation.
Follow-Up Outreach and Service Acceptance
The CIMS data also provides information about what happened after incidents and referrals.
For overdose and at-risk follow-ups:
- 750 follow-up contacts were attempted
- 534, or 71%, resulted in successful contact with the person, a family member or friend, or both
Among the successful contacts:
- 409 involved the individual
- 76 involved family or friends
- 49 involved both
There were 458 successful contacts that included the individual who overdosed or was referred.
Of those contacts:
- 369, or 80%, accepted services
- 26 declined services
- 17 were already seeking services
- 46 had no outcome recorded in CIMS
That 80% service-acceptance rate highlights the value of timely, compassionate follow-up. Many people are willing to accept support when outreach teams are able to reach them and offer practical options without judgment.
Behavioral Health Follow-Up
For behavioral health incidents:
- 372 follow-up contacts were attempted
- 176, or 47%, resulted in successful contact
Among those contacts:
- 101 involved the individual
- 52 involved family or friends
- 23 involved both
A total of 124 successful contacts included the person involved in the behavioral health incident.
Of those:
- 70, or 56%, accepted services
- 12 declined
- 38 were already seeking services
- Four had no outcome recorded
The lower successful-contact rate for behavioral health referrals may reflect a variety of factors, including incomplete contact information, individuals already being connected to services, or differences in how behavioral health incidents are reported and followed up.
The fact that nearly one-third were already seeking services also demonstrates the importance of coordination and continuity—not simply making an initial referral.
Naloxone Administration in Reported Overdoses
There were 214 reported fatal and nonfatal overdose incidents in CIMS during the first half of 2026.
Naloxone was administered in 166 incidents, or 78%.
Of those incidents:
- 154, or 93%, were nonfatal
- 12, or 7%, resulted in death
In 59 incidents, representing 36% of the cases in which naloxone was administered, it was given by a family member, friend, or other third party before first responders arrived.
This finding reinforces why community naloxone distribution remains so important. When family members, friends, and bystanders have naloxone available and know how to use it, they can begin lifesaving intervention before emergency personnel reach the scene.
Data Shows Incidents, Not the Entire Recovery Journey
The state dashboard and CIMS both provide valuable information, but neither system captures every part of the work happening after an incident.
A single referral may lead to months or years of recovery coaching. An outreach worker may help someone apply for insurance, locate treatment, arrange transportation, obtain identification, navigate housing, connect with a physician, rebuild family support, or return to care after several unsuccessful attempts.
Incident-based data may count the original event without fully capturing:
- Active recovery coaching caseloads
- Repeated contacts over time
- Transportation and appointment support
- Treatment and housing navigation
- Collaboration with hospitals and community providers
- Support provided to families
- Long-term engagement and relationship building
- People who accept services weeks or months after initially declining
For that reason, Essex County Outreach also uses internal monthly reporting to complement CIMS. CIMS helps identify incident patterns, while internal engagement data helps describe the sustained work that happens between and after those incidents. We post these data “recaps” every month, which you can find here.
A Changing but Hopeful Picture
The latest data presents a complicated but hopeful picture. Fatal and nonfatal overdoses reported through CIMS declined substantially during the first half of 2026. Thousands of Essex County residents accessed treatment, medications, and community support services. Nearly 19,000 naloxone kits were distributed through select programs, and community members administered naloxone before first responders arrived in dozens of reported cases.
At the same time, substance-related deaths, alcohol-related emergencies, and behavioral health crises remain serious concerns. The sharp rise in behavioral health entries demonstrates that outreach teams must be prepared to respond to increasingly complex and overlapping needs.
Progress is real, but it depends on continued collaboration among individuals in recovery, families, harm reduction organizations, treatment programs, recovery coaches, behavioral health providers, hospitals, first responders, municipalities, and community partners.
Every number represents a person. Every successful connection represents an opportunity for greater safety, stability, and recovery.