Back when now-Gov. Maura Healey was the Massachusetts attorney general, in July 2021, she sued opioid distributors, manufacturers, and pharmacies for their prescription practices, which the state argued contributed to a national opioid crisis.
What resulted was a settlement of more than $1 billion from opioid-makers Johnson and Johnson and opioid-distributors McKesson, Cardinal, and AmerisourceBergen. Of this total settlement, 60 percent goes toward statewide efforts to address opioid usage and recovery pathways through the Opioid Recovery and Remediation Fund, and 40 percent is designated to participating municipalities for prevention, harm reduction, treatment, and recovery related to substance use. Martha’s Vineyard is one area that receives a portion of this settlement.
The Martha’s Vineyard (MV) Opioid Abatement advisory board, made up of representatives from all towns except Oak Bluffs, meets all year to decide how to best spend the allotted money and support locals.
This year, the board conducted a survey called the Martha’s Vineyard Substance Use and Behavior Health Survey and collected data for a community health needs assessment, in collaboration with the Boston University School of Public Health and two Master of Public Health (MPH) candidates enrolled in the graduate program, Kalasiddhi Thapa and Jaden Thackston.
The assessment and survey results by Thapa, Thackston, and the MV Opioid Abatement Board found five areas that could be improved: access to and availability of substance use and behavioral health services; expansion of prevention, education, peer support, and stigma reduction; strengthened coordination, systems and referral; bolstered workforce; and addressing equity and social determinants of health.
The presentation stated that on the Island, there is a “need for a coordinated multi-pronged approach” that could address more of the intersectional aspects of substance use and behavioral health care.
Thapa presented the survey data and a community health needs assessment for the Island community on Thursday, Sept. 17. The survey was open to all residents for six months in 2026. Thapa and Thackston pointed to a few areas in local health that could be further bolstered.
“Across all of the interviews we conducted with our stakeholders, very, very few were able to tell us that they had a form of monitoring evaluation; a way of keeping track of the individuals who they serve, where they are, how they are doing, and whether or not they have been able to follow through with their care,” Thapa said. The stakeholders interviewed were Island health organizations and providers.
While there was not an overwhelming response to the survey from Islanders, with only 132 participants, the group collected additional data from centers and health officials to discern where there may be gaps in care on an island where mental health and substance use are considered top priorities of health providers.
According to state data from 2025, the Island recorded less opioid-related and alcohol-related deaths than the rest of the state. There were six alcohol-related deaths in 2025 and 228 substance use-related emergency room visits on the Island.
The suicide rate on the Island is the highest in the state, based on the most recent federally-collected data from 2019 to 2023. The self-inflicted death rate for Dukes County is 18.2 per 100,000 people, which for a population of 20,000, is at least four people a year.
According to local data, mortality rates and emergency room visits on the Island peaked from 2022 to 2023, and have declined since then.
The survey respondents, while a small sample size majority white, pointed to a need for more outpatient counseling and peer recovery support services. And the web of local services, while large, is not completely known to locals, the survey found.
“The general community tends to believe there is no support for them on the Island, and they are not aware of the strong existing network,” the presentation stated.
Another area of concern for locals is the cost of health care, as was highlighted by the survey and assessment. Health insurance rates have been historically high this year after the market was thrown into flux by a series of federal cuts and the non-renewing of a cost-subsidy program. Some locals saw their rates skyrocket last fall.
The decision on how the advisory board addresses gaps will be addressed with the funds must still be determined; the advisory board will also be applying for additional grants to further bolster services, according to Sarah Toste, West Tisbury assistant board of health agent and representative for the town on the MV Opioid Abatement advisory board.
