New overdose death data from the spring and reports from overdose survivors indicate that Rhode Island remains in the midst of a fentanyl-use crisis that is increasingly claiming victims who are unaware that the cocaine or heroin they have purchased has been altered with the synthetic drug.
"Fentanyl is 30 to 50 times more lethal than heroin. Fentanyl kills and it kills quickly, often only moments after someone has snorted or injected a quantity the size of the head of a match," said Nicole Alexander-Scott, MD, MPH, Director of the Rhode Island Department of Health (RIDOH). "Governor Raimondo's Overdose Prevention and Intervention Task Force has helped make recovery resources available throughout the state. Anyone who is using drugs should come forward and ask for help. Addiction is a disease, but recovery is possible."
There have been 150 overdose deaths thus far in 2016. Last May, RIDOH used preliminary data to report a spike in those overdose deaths related to fentanyl. The confirmed causes of death in those incidents now reveal that in April, May, and June, fentanyl was involved in roughly 70%, 61%, and 67% of overdose deaths respectively. These numbers are significantly higher than in 2015, when roughly 47% of the 258 overdose deaths were related to fentanyl.
Last week, the Centers for Disease Control and Prevention (CDC) released a warning about the influx of fentanyl-laced counterfeit pills and carfentanil, an extremely potent form of fentanyl. Although carfentanil has yet to be identified in Rhode Island, state officials remain vigilant.
An important part of Rhode Island's response to the overdose crisis is expanding access to naloxone. Naloxone is rescue medication that can reverse the effects of an overdose. Additional doses of naloxone are often needed when responding to fentanyl-related overdoses (in some cases, three or four doses are required). Anyone who lives with or spends time with someone who uses drugs should have naloxone on hand. Naloxone is available at CVS, Walgreens, Rite Aid, and many community pharmacies. No prescription is required and many pharmacists offer free training on how to use it.
At the Rhode Island Adult Correctional Institutions (ACI), five inmates survived near fatal overdoses since April after using substances potentially laced with fentanyl without their knowledge. All five individuals were revived because of the availability of naloxone and the excellent response of ACI staff who were well trained on the administration of the rescue medication. The fiscal year 2017 budget passed by the General Assembly includes $2 million in funding advocated for by Governor Gina M. Raimondo to expand the use of medication-assisted treatment in the state prisons, whose population is among the most vulnerable to overdose.
As part of its work to reduce overdose deaths in Rhode Island by one-third within three years, Raimondo's Overdose Prevention and Intervention Task Force has taken many steps to address Rhode Island's overdose and fentanyl-use epidemics. These include: • Launching a statewide multimedia campaign, which includes a new website and recovery support line (942-STOP). • Developing and distributing educational materials warning people who use illicit drugs about the dangers of fentanyl. • Connecting people who have overdosed with a recovery coach and recovery services before being discharged from hospital emergency departments. • Educating and training correctional officers, other staff, and inmates at the ACI on naloxone use, as well as equipping staff and correctional officers with naloxone (as well as inmates, upon discharge). • Offering education sessions to inmates on the dangers of fentanyl use, and the dangers of relapse upon discharge. • Establishing the infrastructure to begin offering medication-assisted treatment at the ACI, which • Conducting visits to physicians' offices to increase usage of the Prescription Drug Monitoring Program, and providing prescribing profiles to high-prescribing physicians. • Working to expand the number of physicians throughout the state who are waivered to offer medication-assisted treatment. Anyone who is using drugs can call 942-STOP to get treatment and recovery support. The phone line is staffed by licensed chemical dependency counselors and is open from 9 a.m. to 9 p.m., seven days a week. Support is available in English and Spanish.