As the opioid epidemic continues, an analysis of state data shows the dramatic extent of just how severe it is in some Rhode Island communities.
Nearly a third of the state’s communities are seeing fatalities at rates that exceed the national average of two deaths per 10,000 people. (See here for more.)
“The impact that overdose is having on Rhode Island is profound, and devastating. Overdose deaths are premature, making them unexpected and tragic. Harder yet, most overdoses are preventable,” said Traci Green, a researcher and epidemiologist affiliated with Brown University and Boston University.
The crisis has been most severe, at least in terms of fatalities, in Woonsocket, where 72 residents have lost their lives to drugs between January 2014, and June 2017. In 2016 alone there were 29 fatal overdoses. For Woonsocket, with a population of 41,406, that translates into a rate of 7 deaths per 10,000 residents.
That makes Woonsocket an outlier.
The next highest community is Providence, where the rate is 5.1 deaths per 10,000. Next is Johnston, with 4.8, which is nearly tied with Scituate, at 4.7.
Thomas Oates, the police chief of Woonsocket, is on the front lines of the epidemic. “It’s a tremendous drain. They’re truly victims. They’re in a cycle they can’t control,” Oates said.
Viewed in the span of a few years, the problem seems to be getting worse, according to one person who is on forefront of the fight in Providence.
“I would say in the last five years, even more particularly in the last two to three years, we’ve seen a major increase in the number of people in our community who have overdosed and died,” said Eileen Hayes, the president of Amos House.
“A Major Increase”
Amos House runs a 90-day recovery program for homeless persons that aims to help them deal with a range of issues they are facing. A third of them have a problem with opioids, according to Hayes. After the program, members can move into longer-term housing, ensuring they stay in recovery while also helping to keep families together. (One of the houses, known as the Mother Child Reunification House, allows mothers to stay with their children.)
But the problem is not just an urban one. The top 15 communities most affected—those with about two or more deaths per 10,000 residents—are spread out across the state. They include northern Rhode Island and South Coast communities, cities and farm towns, rich and poor. Central Falls makes the list, but so does Westerly, where the rate was slightly worse in 2016. (See below slides for more data on the top 15 communities.)
And these numbers are just the tip of the statistical iceberg. That’s because not everyone who overdoses, necessarily dies—thanks, in part, to new measures, such as equipping police officers with overdose antidotes like Narcan. In 2016, there were 1,562 total overdoses. Out of those, 336 were fatal.
More Than An Urban Problem
In any given month, there are more than two overdoses a day in Rhode Island. In December 2017, there were nearly five a day. And that’s just counting those that made it to emergency rooms, which have to report the incidents to the Department of Health.
In Woonsocket, police officers responded to 82 overdose incidents in 2017. In 12 to 14.6 percent of those cases, the officers administered Narcan.
Prior to his arrival as police chief, 18 months ago, Oates said his officers did not have the life-saving medication—something he made a point of changing when he took the reins of the department. Oates said he could not say whether the absence of Narcan was a factor in Woonsocket’s higher overdose rate in 2016.
Many of those who overdose and survive do so repeatedly, tying up emergency responders and hospital resources, Oates said. Department of Health data shows that among those who were treated for overdoses in hospitals in 2017, 65 percent were discharged—free to use again. Only 2.5 percent went into a detox program and another 3.7 percent went to an inpatient program at the hospital.
In Woonsocket, Oates said he tried to stop what he describes as a ‘vicious cycle’ by partnering with a few other communities and the state Department of Health to launch a program that would send clinicians—accompanied by officers—to follow up on individual who had overdosed and survived, to encourage them to get into a treatment program. But the federal funding for the program never materialized, according to Oates.
Narcan Is A Lifesaver
But the state has taken a number of other proactive steps. In Providence, for example, Mayor Jorge Elorza recently announced a new program allowing addicts to walk in any day, any time to a fire station to be enrolled in a treatment program.
“There are excellent resources in RI, more so than many other places, to help address overdoses in the community. We know that availability of medications for addiction treatment, ready access to the overdose antidote naloxone, and communicating with friends and family about checking in and how to respond in an overdose are all life-saving approaches,” Green said.
A Bad Situation, Getting Worse
One factor fueling the ongoing epidemic is the availability of fentanyl, which was responsible for more than half of Rhode Island’s deaths in 2016.
While it may be frustrating that the epidemic persists and evolves, despite many efforts locally and statewide to combat, Green issued a plea for patience.
“Because the key driver of overdose right now is fentanyl and the uncertainty that fentanyl brings to the drug supply, we need to learn how to help keep people alive and to support them in staying alive, and not lose our humanity or give into impatience or frustration along the way. It took almost two decades for the opioid problem to reach epidemic levels; it may take a while to address it effectively,” Green said.