Early data suggest need to redouble efforts to expand access to treatment in Rhode Island
CRANSTON, R.I. – Governor Gina M. Raimondo, along with members of her health cabinet, announced that data for the first eight months of 2017 reveal a 9% decrease in drug overdose deaths in Rhode Island from that same period during 2016.

Between January 2017 and August 2017 there were 208 accidental drug overdose deaths in Rhode Island. Between January 2016 and August 2016 there were 227 accidental drug overdose deaths in the state. During the first eight months of 2015 there were 201 overall overdose deaths in Rhode Island. Additional data about drug overdose deaths is available on RIDOH’s website and on PreventOverdoseRI.org.

“We are cautiously optimistic about the numbers we are releasing today. There is still an enormous amount of work to do to overcome this epidemic. Every week I am giving a hug to someone else who has lost a son or a daughter, a brother or a sister, or a mom or a dad,” said Governor Gina M. Raimondo. “We need to fight against stigma and let people know that there is zero shame in coming out and saying that you need help. Addiction is a disease; recovery is absolutely possible.”

“This is a glimmer of hope in the uphill battle we face,” said Secretary Eric J. Beane. “The data signal that our Overdose Prevention and Intervention Task Force has a strong plan in place. We remain dedicated to helping Rhode Islanders on their road to recovery.”

“The data being announced today suggest that our work to get people into treatment and on the road to recovery is starting to yield results. However, this issue absolutely remains a public health crisis and we must push even harder now in order to see any improvements sustained,” said Director of Health Nicole Alexander-Scott, MD, MPH. “Now is the time to redouble our efforts-everyone has a role to play in beating back this epidemic. Together, we can prevent overdoses and save lives.”

At a press event to present the data at CODAC Behavioral Healthcare’s Cranston site, Governor Raimondo, Dr. Alexander-Scott, and Director Boss directed Rhode Islanders who are living with substance use-disorder to 401-942-STOP for resources available throughout the state. This recovery hotline allows people to access services through an English and/or Spanish-speaking counselor who is licensed in chemical-dependency. The line is open 24 hours a day, seven days a week. Governor Raimondo, Director Boss, and Dr. Alexander-Scott were joined at the press conference by Karen Kaplan who talked about her daughter’s experience with treatment of opioid-use disorder.

“Rhode Island has been deeply affected by the opioid overdose crisis. We still have a lot of work to do,” said Director Boss. “We need to continue to leverage the expertise of the members of Governor Raimondo’s Overdose Prevention and Intervention Task Force, as well as our community partners as we expand our work in Prevention, Rescue, Treatment and Recovery. Each of these areas are crucial as we chart the right course for our state and for those living with a substance use disorder.”

Dr. Alexander-Scott and Director Boss are the co-chairs of Governor Raimondo’s Overdose Prevention and Intervention Task Force. Although the size and relative recentness of the decrease in overdose deaths prevents state officials from attributing it to any one factor, a series of interventions in the four areas of the Action Plan are believed to be contributing.

Treatment and Recovery
Upon entering the Rhode Island Department of Corrections (RIDOC), individuals are screened for opioid use disorder and medication-assisted treatment is then offered to anyone who has opioid use disorder.
Rhode Island has set up ten Centers of Excellence throughout the state where people can receive medication-assisted treatment and recovery services for opioid-use disorder. Additionally, individuals who go to a Rhode Island emergency department after an opioid overdose are introduced to recovery resources by a certified peer recovery specialist. This program has been recognized as a model for other states.
Rescue
The Governor’s Task Force has worked with community-based organizations, pharmacies, emergency departments, and substance-use disorder treatment programs to provide naloxone to people at risk of experiencing or witnessing an overdose. The state pioneered pharmacy naloxone access regulations and delivery models, and optimized disaster assistance capacity to help first responders get overdose prevention training.
Prevention
To promote safer prescribing and decrease the risk for opioid use disorder and subsequent overdoses, Rhode Island’s regulations for acute pain management were updated in March 2017. Opioid prescriptions are now limited to no more than 30 morphine milligram equivalents per day for 20 doses total, specifically for acute pain management; long-acting or extended-release opioids are prohibited for initial prescriptions for acute pain; and continuing education is required for prescribers on topics such as appropriate prescribing for pain, pharmacology, potential for dependence, and alternatives to opioids for pain management.
Major cross-cutting initiative
Rhode Island has established consistent standards for hospitals and emergency departments statewide to provide quality care for opioid-use disorder and overdoses. An example of a requirement in these first-in-the-nation set of guidelines is for all hospitals and emergency departments to provide comprehensive discharge planning that includes patient education, connection to a peer recovery coach, and dispensing of naloxone. Our Lady of Fatima Hospital, the Miriam Hospital, Rhode Island Hospital, and Newport Hospital, and Roger Williams Hospital have all earned Level 1 distinctions, which is the highest of the distinction in the Levels of Care for Rhode Island Emergency Departments and Hospitals for Treating Overdose and Opioid Use Disorder.