Spike in Fentanyl-Related Overdose Deaths
The results of initial toxicology screens suggest that Rhode Island is experiencing a significant increase in accidental opioid overdose deaths that involve the synthetic drug fentanyl. Although the results of confirmatory tests are still pending, these initial screenings suggest that fentanyl could have been involved in approximately 60% of overdose deaths in March, April, and early May. This figure is a significant increase over the approximately 47% of fentanyl-related overdose deaths in 2015. Law enforcement, Rhode Island emergency departments, and outreach workers have reported similar increases in recent weeks and months.
The Dangers of Fentanyl, and Increased Need For Naloxone
Fentanyl is an opioid that is more powerful than heroin, and that is often added to heroin to make supplies more profitable. The addition of even slight traces of fentanyl to heroin, which is a lethal narcotic on its own, increases the deadliness of heroin significantly. Recent victims have reported using heroin without being told by their suppliers that it had been altered with fentanyl.
In working to communicate this warning to heroin users and first responders, the Rhode Island Department of Health (RIDOH) and the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH) will also communicate that additional doses of naloxone are often needed when responding to fentanyl-related overdoses. In some instances, two or three doses of naloxone are needed. Naloxone is a medication that reverses an overdose, and is often carried by people with substance use disorders and their family members.
"People are injecting, swallowing, and snorting this drug without realizing that they are often breathing their last breaths. Unfortunately, fentanyl kills, and it kills quickly," said Nicole Alexander-Scott, MD, MPH, Director of the Rhode Island Island Department of Health (RIDOH). "In many instances, people don't know that they are taking fentanyl. If someone around you uses heroin or fentanyl, make sure you have naloxone, and if you think that someone around you is overdosing, call 911 as soon as possible. Every second counts."
Changing Trends in Rhode Island's Drug Overdose Crisis
Since 2012, there has been a 135% increase in illicit drug overdose deaths in Rhode Island, and a 34% decrease in prescription drug overdose deaths. In this time, the total number of drug overdose deaths has continued to rise steadily. In 2012, there were 182 drug overdose deaths in Rhode Island, compared to at least 257 in 2015.
The shifts in prescription and illicit drug overdose deaths may be due to a number of factors. During this time, we have seen growth in the global heroin market, and increases in the accessibility of synthetic and research chemicals, including fentanyl. The number of overdose deaths related to fentanyl has increased 15-fold since 2012.
The shifts in prescription and illicit drug overdose deaths also began roughly when more focused efforts were undertaken nationally to reduce the supply of prescription drugs. In Rhode Island, there was a 35% decrease in the number of Schedule 2 and Schedule 3 drugs prescribed between December 2011 and February 2016.
During tomorrow's monthly meeting of the Overdose Prevention and Intervention Task Force, Governor Gina M. Raimondo will release a detailed action plan developed to address the drug overdose crisis in Rhode Island. The meeting will take place at 11 a.m. at the Rhode Island Department of Administration (One Capitol Hill, Providence, RI 02908) in Conference Room 2A.
Strategies in the plan are all intended to address substance use disorders among people using both illicit and prescription drugs. These strategies include expanding access to medication-assisted treatment, increasing the number of peer recovery coaches in Rhode Island, and pushing naloxone into the community.