As data from the Rhode Island Department of Health (RIDOH)'s Office of the State Medical Examiners (OSME) indicate a continued increase in overdose deaths involving fentanyl, the State is working to expand community-level access to resources and supports to prevent overdoses and save lives.
During the first 11 months of 2020, 256 Rhode Islanders lost their lives to a fentanyl-involved overdose, accounting for 73% of all overdose deaths during this time. These data compare to 69% in 2019. (It can take up to 90 days for the OSME to confirm a decedent's cause and manner of death. For this reason, Rhode Island's 2020 overdose death data is not yet final.)
This increase in fentanyl-related overdose deaths has contributed to an increase in overall drug overdose deaths. There were 356 accidental drug overdose deaths between January 2020 to November 2020 in Rhode Island, more than any year on record to date. In addition to the increased presence of fentanyl and fentanyl analogs, other contributing factors could include COVID-19-related social isolation and people using drugs alone.
"We know that the COVID-19 pandemic has had a devastating impact on Rhode Island's overdose crisis," said Governor Dan McKee. "It's more important now than ever that we strengthen our efforts to ensure Rhode Islanders who are struggling with substance use and their families receive the support and resources they need. I thank our Overdose Prevention Task Force Co-Chairs for their continued work to address this important public health issue in our communities."
"Illegal drugs have always been dangerous, but right now they are more deadly than ever," said Director of Health Nicole Alexander-Scott, MD, MPH. "If you do use drugs, do not use alone, and make sure that your friends and family have naloxone available. Steps like these can save a life and give someone an opportunity to take the first step on their own personal journey of recovery."
"The drug overdose epidemic has been profoundly impacted by the COVID-19 pandemic which makes it even more important to reach out to members of your community during this unprecedented time," said A. Kathryn Power, Director of the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities & Hospitals. "If you know someone who is struggling, we implore you to call BH Link at 401-414-LINK (5465). Remember that addiction is a disease, treatment is available, and recovery is possible for everyone."
Dr. Alexander-Scott and Director Power are the co-chairs of Governor Dan McKee's Overdose Prevention and Intervention Task Force. The Task Force has four focus areas led by work groups: rescue, treatment, prevention, and recovery. Additional Task Force work groups have since been activated and include efforts related to harm reduction, families, first responders, pregnant and parenting families with substance-exposed newborns, and racial equity. Addressing the drug overdose crisis through the lens of structural racism and equity is front and center to all Task Force-related work.
Fentanyl is a lethal opioid that is usually colorless, tasteless, and odorless. Even a very small amount can cause an overdose. It is often found in counterfeit pills. Pills are pressed to look identical to prescription medications, particularly counterfeit oxycodone pills (sometimes called "Perk 30s," "Perks," "Vikes," or "Oxys"), benzodiazepines (sedating drugs), and Adderall (a stimulant). Fake pills containing fentanyl are even more lethal when crushed and snorted.
Fentanyl is also often found in heroin, methamphetamine, and cocaine. From January 2020 to November 2020, 72% of accidental drug overdose deaths involving cocaine also involved fentanyl.
In addition to fentanyl, methamphetamine is becoming an emerging drug threat in New England. Methamphetamine is a highly-addictive stimulant available as a powdery substance and as a pill. Another version of the drug is called "crystal meth." This type of methamphetamine is often smoked and looks like chunky fragments or shiny blue-white "rocks."
Last week, the Drug Enforcement Agency (DEA)'s New England Branch issued a warning to the public to beware of methamphetamine pills that are being pressed to look like prescription Adderall. Adderall is a medicine usually prescribed to treat attention deficit hyperactivity disorder (ADHD) and narcolepsy. Counterfeit Adderall pills are pressed with lethal methamphetamine and made to look like prescription pills.
Resources for People Who Use Drugs and Their Loved Ones
People who use drugs and their loved ones are strongly encouraged to:
- Learn the signs of an overdose and how to respond with a brief online overdose prevention training developed by The University of Rhode Island's Community First Responder Program. The free training is available at PreventOverdoseRI.org in English and Spanish. - Carry naloxone (overdose reversal medicine) and request a free naloxone kit shipped to your address at no cost. Visit PreventOverdoseRI.org to request a kit today. You can also get naloxone from any Rhode Island pharmacy without a prescription from a healthcare provider. - Call a local community-based organization for free and anonymous delivery of safer drug use supplies (naloxone, sterile needles, fentanyl test strips) to your location, or to arrange a pickup. People can visit preventoverdoseri.org safer-drug-use-practices/ to learn more. - Always call 9-1-1 first if someone might be experiencing an overdose. People are protected by the Rhode Island Good Samaritan Law and cannot be arrested if giving naloxone to someone who is experiencing an overdose. - Call Rhode Island's 24/7 Buprenorphine Hotline, 401-606-5456, for help if you or someone you care about is experiencing opioid withdrawal. Callers can speak with a healthcare provider, learn about Medication Assisted Treatment (MAT) options, and make a plan for treatment and recovery support. - Call BH Link, 401-414-LINK (5465), for immediate assistance with a mental health or substance use crisis. People can also visit BH Link's drop-in center at 975 Waterman Ave. in East Providence. English and Spanish-speaking counselors are available 24 hours a day, seven days a week to offer support and connect callers to local resources.
State-level initiatives
A number of efforts are currently underway to address the drug overdose crisis in Rhode Island.
- Community-based organizations have increased street outreach presence in overdose hotspots across the state. Certified peer recovery support specialists (CPRSs) distribute naloxone, sterile syringes, and fentanyl test strips, and provide wrap-around services and basic needs to people who use drugs. Project Weber/RENEW conducts outreach in Providence's Kennedy Plaza in partnership with the Downtown Providence Community Overdose Engagement (CODE) Collaborative. - Rhode Island's 10,000 Chances Project has distributed more than 10,000 free kits of intranasal naloxone to Rhode Islanders who are at risk of overdose and families and friends of people who are at risk. - Increased housing supports have been made available for people in Woonsocket and Providence through the West Elmwood 02907 and Woonsocket CODE Collaborative projects, key initiatives of the West Elmwood and Woonsocket Health Equity Zones (HEZ). - Strategic placement of Substance Abuse and Misuse Teams (SMART) at Rhode Island and Landmark Hospital Emergency Departments. Trained ED staff are ready to connect patients who have recently experienced an overdose to local treatment and recovery support services.