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Hundreds in Rhode Island Expected to Die from Overdose in 2014

Tuesday, February 18, 2014


Drug overdoses in Rhode Island have been labeled an "epidemic" by HEALTH, and academics.

Literally, Rhode Islanders are dying by the hundreds.

If the pace continues in Rhode Island this year, the number of overdose fatalities tied to heroin and other opiates will exceed 320 deaths, nearly double the 180 deaths reported 2012, the last year the Rhode Island Department of Health (HEALTH) has reported data.

"This is an epidemic. It's been an epidemic before it spiked, it's outrageous," said Dr. Jody Rich, an infectious disease specialist at Miriam Hospital. "[HEALTH Director] Dr. Fine's done a great job of understanding the issue, and pushing on it. We need a greater understanding. This is people dying. Colonel O'Donnell a few months back said, if we had this many shooting fatalities, this would be an outrage."

The Rhode Island Department of Health (HEALTH) reported last week that for the first six weeks of the year, there have been 38 overdose deaths in the state so far this year.

Dr. Traci Green, Professor of Epidemiology at Brown University, said, "Why hasn't there been more outrage? I think this is the stigma of addiction rearing its ugly head -- we have a really clear call for help who aren't able to call for help."

Green continued, "I think at this point, we don't have a precedent -- and no one else does either. The sad thing is we're ahead of the game in Rhode Island because we're seeing it first. The acetylfentanyl outbreak we saw last spring, Dr. [Christina] Stanley, RI's Chief Medical Examiner, was able to see those numbers quickly, and we have a coordinated approach. I worry that other states will now be catching up."

"This certainly qualifies as an epidemic," said Dr. Brandon Marshall, Assistant Professor in Epidemiology at Brown. "This is now the leading cause of accidental death in Rhode Island, outpacing car deaths." Marshall echoed Green when he said, "We're starting to see this now across the country."

Rapid Rise in Rhode Island

For 2013, HEALTH reported 118 overdose deaths in the first six months -- it has not reported on the second half of the year -- which was on pace for nearly 240 deaths. The number rose steadily from from 137 in 2009, to 152 in 2010, to 176 in 2011, and 182 in 2012, before it made a more significant leap, in the past two years.

"We saw something similar in 2005, we saw an outbreak in fentanyl based heroin, which killed thousands in Chicago, [Philadelphia]...they were able to trace it back to an underground lab," said Green. "Subsequently, a number of people came people came together nationally, from multiple state agencies, to talk twice a month on what they were seeing. It had been relatively quiet since then, but now we've had a lot to report back."

Green continued, "We're not seeing acetylfentanyl-- but something still synthetic, and it's being created somewhere. Access and availability are a key component. What we're seeing with patterns of deaths, is not only that the numbers are increasing, the composition of people dying are changing. It used to be that two-thirds of opiate overdoses were prescription related, and we're see more illicit substances now, people are taking more chances of combining prescription opiates with illicit drugs."

"Each of those things is incredibly dangerous. It doesn't take too much shifting of the purity to alter the fatality rates. We have a high prevalence of opioid abuse as a starting point to begin with. If you're an enterprising dealer, and you want to try something out, what's a better place to try it out," said Green.  "The fact that it happened here, and now this is happening, there's something about where we are, and we need to keep closer tabs."

Responses Addressed

"The most effective response we've seen are comprehensive, multi-pronged approach, there's a role for a lot of different groups -- law enforcement, healthcare, leadership," said Marshall.

At Friday's HEALTH press conference, Craig Stenning with the Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals highlighted three tools in place to help cut down on opioid related deaths throughout the state, including the Good Samaritan Law, access to expanded treatment, and the use of Naxolone (used to counter the effects of an opiate overdose).

"The Rhode Island police will be now be carrying Naxolone in all of their cruisers, and now Walgreen's signed a collaborative practice agreement to sell Naxolone at their stores," said Marshall. "It is a safe medication, and incredibly effective in reducing the effects of an overdose."

Marshall explained, "An overdose is a surprisingly long process -- it's a slower rate of breathing, it's a lack of oxygen. The opioid slows down a person's breath. There's a significant amount of time to intervene -- and Naxolone is able to address it right away

Brown's Greene addressed the Good Samaritan Law, which was approved in Rhode Island to allow someone who call for help for someone overdosing won’t face charges for drugs found at the scene.

"They did move the "Good Samaritan Law". One thing I'm worried about is there's a sunset clause, and it's incomplete. It will expire at the end 2015. I hope it will be reinstated. The Attorney office is updating the number of cases that have been dismissed because for law."

Green mentioned an aspect of the law she hoped to see changed. "Folks who are out of prison might not call police in the event of as suspected overdose...the law does provide that under probation or parole, you're not protected. We've had at least two people call and end up getting picked up, or people who didn't call and overdose. "

Community Perceptions, Solutions

A community forum Wednesday will attempt to get the pulse -- and a remedy -- for the overdose epidemic in Rhode Island.

"There's a disconnect between the body bags piling bags and the response," Rich. "There is a tremendous stigma around this. This addiction is worse than other addictions. The physiology behind opiates...users develop a tolerance, and they keep having to use a higher and higher dose. The withdrawal to stop is horrendous.  To see someone in that situation, you see someone curled up in the fetal position."

"People should know about the diabolical nature of opiate addiction -- there's strong predisposition. The more people are exposed, the more they'll be hooked. On some levels, it is a choice -- on some levels, it's not. When someone's using, there's no one answer. Strong community, family, and individual support is a start.

"A lot of people say, they get what they deserve -- the answer is "no," said Rich.  "No one knows what they're getting into. I hear from patients who say they don't want to get high anymore, they just want to feel normal. And for them that's not possible."

On Wednesday, A Community Listening Forum on Overdose Prevention will be held from 7 to 9 p.m. in Miriam Hospital, with state, health, community, and law enforcement leaders coming together to address the overdose epidemic.

Rebecca McGoldrick with Protect Families First, who will be at the forum, addressed what saw as their main goal -- saving lives.

"This is a complex battle that we need to combat on several fronts. One, we need to prevent people who aren't already addicted from becoming addicted, which means raising awareness among doctors and patients about the risk of dependence and overdose. It also means decreasing the possibility of non-prescribed users from trying prescription opioids, so people should store and dispose of their medications properly. And for those already addicted, we need more access to affordable, evidence-based treatment programs. Currently, only one in ten people who needs treatment gets it," said McGoldrick."

"Unfortunately, it's taken too many deaths for people to sound the alarms and mobilize, but there is a lot of great work going on across the state to address this crisis. State troopers are going to start carrying naloxone. BHDDH is going to provide naloxone to patients with a history of opioid use. Hopefully we can get the ACI to do the same for inmates upon discharge. Right now I think most people are in damage-control mode, and saving lives is our priority." 


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Hey Brett Smiley, do want to legalize Herion too? Maybe you can create more violence when you legalize weed too! Then all the money can be used to support your buddy Teny Gross's non/violence empire!

Comment #1 by lupe fiasco on 2014 02 18

I'm sorry, but I don't have sytmpathy for these people. If they want to shoot up, then rob and steal from people to support their habits, they're better off dead. They are weak willed individuals who don't give any thoughts to their actions or the consequences. They are a drain on society and if they kill themselves, so be it. Maybe when they're all dead, there will be no market for drugs and that entire industry will dry up and go away. Sounds cruel, but they did it to themselves. Lesson learned. I'm tired of doing the right thing my entire life, then being asked to feel bad for those that did not. Screw them.

Comment #2 by Phil Paulson on 2014 02 18

wow- i can hardly wait for some of the other comments to be made

Comment #3 by Howard Miller on 2014 02 18

this is very sad, tragic to those victims and their families. and all the others that are addicted.

once you are hooked.....

sadly, we have politicians advocating for climate change, same sex marriage, etc these have some importance but drugs in this country are an immediate threat. and you don't hear a peep.

michelle Obama has 3 years left in the white house. I would focus a lot more on drugs than obesity.

Comment #4 by john paycheck on 2014 02 18

One of the challenges with Freedom is that you must allow people choice. Some choose well, others don't--and the really sad thing is the abdication of good parenting by many--with all the usual excuses--to help young people make good choices.

All the feel-good programs in the world won't fix this problem.

Comment #5 by Jimmy LaRouche on 2014 02 18

We've got to get these people into Government sponsored, Government paid for, Government run rehabs and Methadone treatment.

Methadone is okay because it's from the Government. Please note a touch of sarcasm here for those that can't read between the lines.

Comment #6 by Jim D on 2014 02 18

@ Phil Paulson - You're not being asked to just feel bad for them, you're also being asked to pay for treatment for those that live.

@ john paycheck - It is sad and tragic, maybe the family should have intervened, maybe they tried, maybe you just can't help some people.

@ Jimmy LaRouche - You're statement was dead on target.

@ Jim D - Unfortunately your remark, though meant and taken as sarcasm, was way too true. That is exactly what progressives want more Government intervention, less personal responsibility.

Comment #7 by Wuggly Ump on 2014 02 19

Wuggly we are on the same page.

Comment #8 by Jim D on 2014 02 19

I'm not going to feel bad for them and I'd prefer not to have to pay to get them straightened out. Maybe I have a gambling addiction... will someone pay my mortgage for me because I blew all my money at Twin Rivers?

Comment #9 by Phil Paulson on 2014 02 19

Everyone quoted in this story gets their paychecks through the Government one way or the other. Brown may be a private university but they take in more tax payer dollars than anything excluding the State.

It's in their best interest to keep the drugs flowing and keep nonsense treatments alive and well.

Methadone was created by the Nazis so their soldiers could continue to fight without sleep or pain or food just more methadone.

2 of Rob Horowitz's clients own methadone clinics so GoLocalProv will never say anything bad about them - never.

Lets see 6-12 months using heroin then 6-12 months in jail then 6-12 month on Methadone then 6-12 months on heroin then jail again.

Vermont got the article in Time so Rhode Island libs are now lobbying for more money so as not to be left out.

Comment #10 by Jim D on 2014 02 19

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