With several new overdose prevention efforts now being managed or supported by the McKee Administration statewide, data released today by the Rhode Island Department of Health (RIDOH) indicate that drug overdose deaths remained at crisis levels in Rhode Island in 2022. However, after increasing for years, the number of fatal overdoses did not increase from 2021.
In 2022, 434 Rhode Islanders died of accidental overdose deaths, on par with data from 2021 (when 435 accidental overdose deaths occurred). The number of drug overdose deaths in Rhode Island had been increasing since 2019, largely because of a more lethal drug supply locally and nationally. This plateauing in 2022 was the result of a significant reduction in the rate of overdose deaths in the second half of the year. There was an 13% decrease in overdose deaths between the first six months of 2022 and the second six months of 2022.
"My heart breaks for each and every person who has lost a loved one to this epidemic. We owe it to the Rhode Islanders who have passed, and to their families, to do everything possible to prevent any additional overdose deaths," said Governor Dan McKee. "We have many new interventions in place to respond to the dynamic nature of this crisis. We have to keep innovating and collaborating with our partners in the community to do everything we can to prevent overdoses, save lives, and improve the quality of life for Rhode Islanders."
These new overdose data were discussed in more detail at today's hybrid meeting of Governor McKee's Overdose Task Force. Governor Dan McKee's Overdose Task Force is a coalition of professionals and community members who help guide drug overdose prevention and intervention activities in the state.
"The Task Force has a Strategic Plan to end the overdose crisis and ensure racial equity is embedded across all pillars of its work, including prevention, harm reduction and rescue, treatment, and recovery," said Interim Director of Health Utpala Bandy, MD, MPH. "We are working to change lives by uplifting community voices, using data to drive change, and building lasting connections to care."
"What underlies substance use disorder are the factors in our communities that affect people's abilities to be healthy and safe, such as housing, employment, and discrimination," said Cathy Schultz, the Director of the Governor's Overdose Task Force. "Getting prevention and treatment resources into the community to prevent overdoses immediately is crucial. To do this, we must meet people where they are at and continue working to address these larger structural issues. Every single fatal overdose is a family member and member of our community, and these deaths are preventable."
Data overview
Fatal drug overdose data in Rhode Island are generated using results from RIDOH's Office of the State Medical Examiner and RIDOH's State Health Laboratories. Because of the complex toxicology testing required for many cases, it can take several months to finalize the year's fatal overdose data.
- In 2022, fatal overdoses in Rhode Island remained essentially unchanged from 2021. One fewer fatal overdose occurred in 2022 (434 vs. 435).
- The rate of overdose deaths decreased substantially in the second half of 2022. In the first six months of 2022 there was a 13% increase in fatal overdoses compared to the same time period in 2021. Had this trend continued, Rhode Island's total for fatal overdose deaths would have been 492.
- Overdoses were disproportionately seen amongst men, Rhode Islanders from 25 to 54 years of age, and Black non-Hispanic Rhode Islanders. - The rate of fatal overdoses among Hispanic/Latino Rhode Islanders increased by 50% from 2021 to 2022.
- Most overdoses continued to occur in private settings (84%).
- Fentanyl and cocaine continued to be involved in most fatal overdoses. Fentanyl was involved in 75% of fatal overdoses and cocaine was involved in 50% of fatal overdoses.
A more detailed data summary is available online (see link below).
Interventions
Several State-level interventions may have contributed to the decrease in overdose deaths in the second half of 2022. They include:
- Mobile outreach: The State has significantly increased its mobile outreach efforts. The State partners with four local harm reduction organizations (AIDS Care Ocean State, Community Care Alliance, Parent Support Network, and Project Weber/RENEW) to deploy outreach teams to overdose hotspots to connect people with harm reduction tools (safe injection kits, condoms, fentanyl test strips, naloxone, safer smoking kits, wound care kits, etc.), basic needs, and treatment and recovery services.
- Availability of naloxone and other harm reduction tools: RIDOH has established centralized naloxone supply hubs for community-based organizations to access naloxone for local distribution. In 2022, 36,590 naloxone kits were distributed, a 70% increase compared to 2021. In 2022, RIDOH also launched a Harm Reduction Vending Machine Program in collaboration with AIDS Care Ocean State. This Program provides 24/7 access to free harm reduction supplies.
- Mobile medical treatment: CODAC's Mobile Medical Treatment Unit has been going to high-risk statewide locations offering health assessments. Medication options and treatment inductions, along with a variety of other counseling services are also available. Since May of 2022, the unit has averaged 584 contacts per month and has had a total of 7,063 clients.
- Recovery centers: The Department of Behavioral Healthcare, Developmental Disabilities & Hospitals (BHDDH) continued to support six recovery community centers that provide peer-based recovery support services.
- Prevention education: Through partnerships with schools and Regional Prevention Coalitions, BHDDH continued to do education and primary prevention work.
Going forward, the State has several new interventions to prevent overdoses either planned or already in place. They include:
- Opioid settlement funds: The Executive Office of Health and Human Services (EOHHS) and its partner state agencies have allocated approximately $20 million Opioid Settlement and Stewardship funds for FY23 and FY24. This has happened through contracts, grants, or MOUs for interventions focused on prevention, harm reduction/rescue, treatment, recovery, social determinants of health (including basic needs and housing), communications, and other emerging issues.
- Overdose prevention center: EOHHS has contracted with Project Weber/RENEW to support the opening of one of the nation's first overdose prevention centers. The center will be a place for people to use pre-obtained drugs under the supervision of medical professionals and trained staff, as well as to get connected to harm reduction, treatment, and recovery support services.
- Targeted text messaging campaign: In February, RIDOH began sending targeted text message alerts to people in communities with increased overdose activity based on weekly data from RIDOH's Opioid Overdose Integrated Surveillance System.
- Increased outreach within the Hispanic/Latino community: In response to the increase within the Hispanic/Latino community, the State is doing increased messaging in Spanish (educational materials, paid media, social media) warning about the dangers of fentanyl, xylazine, and other substances. Additional educational materials are being created in Spanish on how to access naloxone.
For information on additional State interventions, see preventoverdoseRI.org.
Resources for people who need help
- Learn more about available resources at preventoverdoseri.org.
- BH Link operates Rhode Island's 24/7 behavioral health hotline. Calling or texting the 988 Suicide and Crisis Lifeline connects callers to trained professionals who can provide confidential counseling, referrals, and support services (Spanish-speaking callers are available). People can also stop by the 24/7 BH Link Walk-In Triage Center at 975 Waterman Avenue, East Providence, RI to get connected to support.
- The Buprenorphine 24/7 Hotline, 401-606-5456, provides telehealth services for experiencing opioid withdrawal. Callers can learn about Medication for Opioid Use Disorder (MOUD) options and make a plan for continued treatment and recovery support. Learn more about available resources at Get Help – Prevent Overdose RI.
- Fire stations in East Providence, Pawtucket, Providence, Smithfield, and Woonsocket (and the police stations in Bristol, Tiverton and Warren) are designated "Safe Stations." Staff are available 24/7 to help people in crisis get connected to a peer recovery support specialist and treatment and recovery support services.
How you can save a life
- Learn the signs of an overdose, such as slow, shallow breathing; gurgling noises; or breathing that has stopped; unconsciousness/unresponsiveness, or skin tone that appears grayish or ashen to bluish-purple.
- Call 911 first if someone is overdosing. The Rhode Island Good Samaritan Law provides certain legal protection when you call 911 when someone is overdosing, whether you have drugs on you or not.
- Carry the overdose reversal medicine naloxone (sometimes called Narcan) and know how to use it. Naloxone is available at pharmacies without a prescription (and will be available for purchase over-the-counter this fall). You can also get naloxone from a community-based organization. For more information, see preventoverdoseri.org.