The Opioid Crisis in Rhode Island

What is the state doing to help stem the tide of overdoses?

Illustration by Andrew J. Nilsen

(page 1 of 2)

Jonathan Goyer cruises to a stop at the Huntington Avenue underpass. The morning is overcast, and the wind sends a shiver through the plastic bags and paper wrappers tangled in the chain link fence beyond the curb. Not 200 feet away, clients stream in and out of the CODAC methadone clinic, but no one stirs in the tents pitched on the concrete pad under Route 10. There are many fronts in Rhode Island’s recently declared war on opioid addiction. Anchor Recovery’s outreach team fights theirs on the street.

Goyer, program coordinator for the peer-based recovery nonprofit, and his outreach team, Donna Price and Michael Fry, regularly scour the homeless shelters, soup kitchens and bus stations for those who are ready for rescue. They approach the small encampment.

“There’s three kinds of people,” explains Goyer. “Those who don’t even know that recovery exists, those who have relapsed and feel too guilty to try and those people who are on the fence — those are the people we hunt every day. Anchor Recovery is a bridge to treatment and a net — to catch people in between treatments.”

This morning, however, the bridge is out. A muffled voice informs Fry and Price that he doesn’t want to be disturbed. They leave a Narcan kit and move on.

In 2013, Rhode Island had the highest rate of illicit drug use in the nation. And not surprisingly, death has followed. Last year, 248 Rhode Islanders lost their lives in accidental drug overdoses, a slight increase from 2014’s toll of 239. According to the Governor’s Overdose Prevention and Intervention Task Force’s November report, Rhode Island topped New England in the rate of drug overdose deaths.

“This is a national epidemic,” says Dr. Nicole Alexander-Scott, director of the Rhode Island Department of Health. “We have to be able to tackle this until numbers are down to zero. The effort we are putting in every single day, the multiple strategies, with all the right people at the table pushing it, gives me great confidence we are going to reach our goal.”

The immediate plan is reduce opioid overdose deaths by one-third within three years. The task force identified four paths to get there: increase the number of opioid addicts receiving medication-assisted treatment; ramp up the number of people administering naloxone, marketed as Narcan; reform opioid prescribing; and expand peer-
recovery services.

What the Centers for Disease Control and Prevention has called the “worst drug overdose epidemic” in United States history has been more than a decade in the making.
“The medical community was under fire for not doing an adequate job treating pain, and at about that same time, opioid-based painkillers began to show up in the marketplace,” says Steven R. DeToy of the Rhode Island Medical Society. “The pendulum began to swing from not doing enough to treat pain to doing too much, and the pharmaceutical industry did not make prescribers aware of the addictive qualities of these new painkillers. Basically the medical community and other prescribers unwittingly introduced a whole lot of people to opioids.”

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