July 1st, 2014

R.I. tries to address overdose deaths

In response to a rise in drug overdose deaths in Rhode Island and nationwide, Rhode Island Governor Lincoln D. Chafee in April outlined a series of ongoing actions and strategies.

As of April, at least 85 overdose deaths occurred in R.I. in 2014. The state and the Anchor Recovery Community Center earlier this year co-hosted several public forums on overdose, addiction and recovery. Also, state officials signed an emergency regulation that puts Naxolone in use more easily and broadly, such as to first responders, providers and family members. Naxolone (also known as Narcan) can reverse the effects of an opioid overdose when administered in a timely manner, according to state officials.

The state also developed a campaign to reduce stigma  and encourage treatment and issued new guidelines for physicians and health care professionals to report overdose deaths and surviving patients.

Garry Bliss, director of government and external relations for The Providence Center, which operates Anchor Recovery Community Center, says Anchor has hosted several forums and also a free showing of the documentary “The Anonymous People,” about the history of the recovery movement in this country.

Bliss says the center was pleased that the state expanded the availability of Narcan and that it will invest funds to make recovery coaches available and on-call to urban area hospital emergency departments on weekends. Bliss says Anchor has identified certified recovery coaches and is putting infrastructure in place.

“Our goal is to connect (persons who have overdosed)  with a recovery coach while they are in the emergency department,” Bliss says. “The person who will be talking to them is not a medical professional, but a peer-to-peer outreach – someone who knows the experience and challenges this person is up against.” The coach will help connect the patient to recovery services. “The coach will be a peer who has been through this before, so they will know the challenges, the hurdles and the obstacles and from their own experience, what they were able to draw on to make a success of it,” Bliss says.

Craig Stenning, director, R.I. Department of Behavioral Healthcare, Developmental Disabilities and Hospitals (BHDDH), says the weekend is when most overdoses occur. “So now, there will be somebody right there in the emergency room to help bridge the gap between the hospital and  the treatment facility,” Stenning says.

Stenning also announced another new initiative that will help quickly link patients to treatment. One of BHDDH’s licensed treatment service providers will offer physicians an immediate opiate-use assessment for patients who have been identified as high risk for opiate abuse. “Any physician who has a patient sitting in their office who needs a behavioral health assessment would be able to make that appointment immediately,” he says. Stenning says the assessment could be done that day or within the next 24 hours. “Or if the physician felt the patient was not ready to leave, the professional from the treatment agency would go right to that office.”

Bliss says that while many people frame what has been happening nationwide as an “overdose” crisis, it is actually an “addiction” crisis, due in part to widespread availability of prescription painkillers. “We also see people who can no longer get these prescription painkillers, who will then turn to street drugs,” Bliss says. A meaningful number of the overdose deaths in R.I. have been from cases where heroin was laced with fentanyl. People who have recently left treatment programs, or have returned to the community from incarceration, are particularly vulnerable. “That first 48-72 hours, if they are in an environment and have the opportunity to use drugs, they may remember what the quantity was that they took prior to treatment or incarceration and taking that amount again can be a death sentence when their tolerance is much lower,” Bliss says.

Stenning hopes the forums have helped bring the conversation about substance abuse out into the open. “Part of my presentation has been around the stigma,” Stenning says. “As long as we continue to place shame and disgrace and discrimination on the user, the less likely they are to come forward to seek treatment.”

By Pamela Berard

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