Gov. Gina Raimondo flagged $4 million of the 2017 budget to combat the “opioid crisis” plaguing Rhode Island and enlisted a task force to confront the complicated issues surrounding the problem. This comes days before President Donald Trump denied calling the rise in overdose fatalities a national emergency, but rather an epidemic.
In an executive order last month Gov. Raimondo declared the “alarming rate of deaths by opioid overdoses constitutes a public crisis.” The order demanded the Governor’s Overdose Prevention and Intervention Task Force, established in August 2015, the RI Department of Health and the Department of Behavioral Healthcare Developmental Disabilities and Hospitals to enact a four-part plan including prevention, rescue, treatment and recovery. The Governor’s Overdose Prevention Action Plan aims for a one-third reduction of overdose deaths in three years.
Since the start of the year, RIDOH reports approximately 61 non-fentanyl and 81 fentanyl related overdoses, although those numbers may go up as toxicology reports come in.
The $4 million budget would enable the Department of Corrections to increase peer-recovery specialists, medication assisted treatment and model discharge and recovery plans for patients with substance abuse disorder. In addition, the Task Force will coordinate a public outreach campaign for families and high-risk youths, focusing on education and prevention.
According to the Centers for Disease Control, in 2015 Rhode Island was the fifth state, behind West Virginia, New Hampshire, Kentucky and Ohio, with the highest rate of overdoses per capita with over 290 deaths. In 2016 there were 336 death-resulting overdoses. Although the crisis began with prescription drugs, according to Prevent Overdose RI, the overdose deaths from prescriptions has leveled out from its high point of 92 deaths in 2011 to 56 deaths in both 2015 and 2016. The problem now lies more with illicit substances such as heroin, cocaine and fentanyl. Fentanyl is a synthetic opioid, around 50 to 100 times more potent than morphine, prescribed by doctors in the form of a patch for chronic pain but is bought and sold on the streets, often mixed with heroin.
The Task Force has open monthly meetings form 11 a.m. to 12:30 p.m. on the second Wednesday each month at the Department of Administration in conference room 2A. More information is at www.PreventOverdoseRI.org, where the task force has resources and strategic plans open to the public.
While there’s no indication that the task force is considering it, drug deactivation pouches may be an option for private medication disposal.
Deterra’s Drug Deactivation System is a disposable and environmentally-friendly pouch that will allow people to dispose of old or unwanted prescriptions in a “just add water” method that can be purchased and used at home.
“Instead of take-backs, it’s a way to inactivate the drugs and reduce the supply of drugs,” said Jeffrey Bratberg, URI Clinical Professor of Pharmacy said. He said standard methods of flushing can be harmful to water supplies, but mixing pills with coffee grounds is another effective way to inactivate pills.
The pouches, available on Amazon, come in sizes for 15, 45 and 90 pills. Inside the pouch is a detergent-style pod containing activated charcoal-based absorbent that permanently bonds to and neutralizes the chemicals in prescriptions when added with water. The drug in the pills is no longer useful and are safe for water and landfills. The smaller 15 pill pouches can be purchased at Wal-Mart pharmacy for $3.98.
In an interview, prevention begins at home, said Rob Reynolds, retired police chief of Edin Prairie, Minnesota and Deterra’s advocacy director. Youths and teenagers are most vulnerable to abusing older or unfinished medications found in cabinets of friends and family members. He said people, especially seniors who struggle to make it to give-back programs, often forget the pills are in the cabinets and don’t even notice if any went missing.
“Statistics are that 70 percent of prescriptions go whole or in part unfinished. And 80 percent of people who abuse opioids go through medicine cabinets of friends and family,” Reynolds said. “Limiting access is key. A significant effort will have an impact on the opioid-heroin crisis.”
“I guess every little bit helps,” said Colonel Stephen McCartney, Warwick Chief of Police about the product. “It’s [opioid abuse] still a multifaceted problem that needs to be attacked on different fronts.”
This includes exactly how much is being prescribed.
“An important part of overdose protection is judicious and responsible prescribing,” said Joseph Wendelken, public information officer at the Rhode Island Department of Health.
He said just as important is giving patients all the information and warnings that go along with taking an addictive substance. Included in prevention, coordinated public outreach effort and public health information to educate patients of the risk of addiction associated with pain medications is a priority for the Task Force.
In Pennsylvania, the Board of Pharmacy distributed to pharmacies in the 12 hardest hit areas pouches to go along with all opioid prescriptions. Studies said 96 percent of people who received the pouch would use it, Reynolds said.
Although the process to getting the word out in Rhode Island is slow, Reynolds said Deterra works on pricing with advocacy agencies to get the product in homes where it is most effective.
There are over 25 no-questions-asked drop-off locations throughout the state, including one in the lobby of the Warwick Police station that can be used free of cost. For locations go to www.PreventOverdoseRI.org/get-rid-of-medicines.