New EMS Data Indicate Continued Need for Community Naloxone Use

Report released as Rhode Island remains on downward overdose trend

New Rhode Island Department of Health (RIDOH) data indicate that more than a third of the opioid overdose calls to which Emergency Medical Services (EMS) responded in Rhode Island in 2018 occurred in public places. Public health leaders are again urging all Rhode Islanders who are comfortable doing so to carry naloxone, the overdose reversal medication.

The data, published on March 1, 2019 in the Rhode Island Medical Journal, indicate that 34.2% of the opioid overdoses that EMS responded to in 2018 occurred in public places. That figure was 29.6% in 2016. Examples of public places include streets, parking lots, restaurants, stores, and beaches.

“Naloxone can be purchased over the counter at pharmacies throughout Rhode Island, and it is as easy to use as nasal spray,” said Director of Health Nicole Alexander-Scott, MD, MPH. “We are starting to make some progress in addressing the drug overdose crisis. However, as this report demonstrates, this is a changing epidemic. With so many overdoses happening in everyday places, and sometimes in plain sight, everyone can play a role in preventing overdoses and saving lives.”

For the first 10 months of 2018, Rhode Island saw a 6.1% decrease in opioid-related overdose deaths, compared to the first 10 months of 2017. A total of 324 Rhode Islanders died due to drug overdose in all of 2017. Rhode Island’s 2018 overdose data should be finalized in the coming weeks, as toxicology results are still pending for many of the deaths that occurred in November and December.

“When someone overdoses on an opioid, they need help immediately. If naloxone is administered quickly, it can reverse the overdose effects, usually within minutes,” said Jason Rhodes, MPA, AEMT-C, Chief of the Center for Emergency Medical Services at RIDOH. “By carrying naloxone and using it when it is needed, everyone has the ability to be a first responder and save a life.”

A Good Samaritan law in Rhode Island protects people from legal liability if they are making a good faith effort to assist a person in a medical emergency, including a suspected overdose.

The lead authors of the study published in the Rhode Island Medical Journal were Leanne Lasher, MPH, the Program Manager of Opioid Overdose Surveillance at RIDOH; Jason Rhodes, MPA, AEMT-C, Chief of the Center for Emergency Medical Services at RIDOH; and Samara Viner-Brown, MS, Chief of the Center for Health Data Health Data and Analysis and Public Health Informatics at RIDOH.

Governor Gina Raimondo’s Overdose Prevention and Intervention Task Force distributed more than 16,000 naloxone kits in 2018, more than double the number in 2017. The steps taken to expand naloxone availability throughout Rhode Island include:

• Partnering with outreach organizations and peer recovery specialists to get naloxone to people at highest risk. Examples of outreach organizations include The Providence Center’s Anchor Recovery Mobile Outreach Recovery Efforts (MORE), Project Weber/RENEW, AIDS Care Ocean State’s ENCORE Needle Exchange Program, and Rhode Island Communities for Addiction Recovery Efforts (RICARES).
• Implementing a new regulation that requires prescribers of controlled substances to co-prescribe naloxone to patients who are at a higher risk of overdose.
• Working with city and town law enforcement to make naloxone available to all officers.
• Funding (through an RIDOH mini-grant) the development of NaloxBoxes, a mountable container that includes naloxone and all the necessary life-saving supplies to reverse a suspected overdose. Rhode Islanders can go online to locate public NaloxBoxes.

Governor Raimondo’s Overdose Prevention and Intervention Task Force is co-chaired by Dr. Alexander-Scott, Director Rebecca Boss of the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH), and Tom Coderre, Senior Advisor to Governor Raimondo.

The data in the article were compiled as a result of updated regulations for EMS agencies that were enacted in January 2019. EMS professionals now must upload patient care reports from EMS incidents within two hours of completing a call. RIDOH is working to create a real-time automated overdose outbreak detection system with web-based dashboards and alerts.

The complete article, titled Identification and Description of Non-Fatal Opioid Overdose Using Rhode Island EMS Data, 2016-2018,is available online.