Mind and Body

The task ahead in fighting overdoses in Rhode Island

New task force seeks to shift the epidemic curve by a series of strategic interventions, with Nov. 1 deadline for plan

Courtesy of the R.I. Department of Health

This graph was presented at the first public meeting of the Overdose Prevention and Intervention Task Force, detailing the incidences of accidental drug overdoses in the last 20 months in Rhode Island.

By Richard Asinof
Posted 8/24/15
The first public meeting of the newly formed Overdose Prevention and Intervention Task Force defined the mission – shift the epidemic curve – and the timetable to hand the plan to the Governor – by Nov. 1.
How will access to data around accidental overdose deaths be handled in the future? Will the R.I. Department of Labor and Training be invited to join the task force, as suggested at the meeting? Will a specific plan be developed around how to pay for peer recovery coaches as a reimbursable program through health insurance? Will recovery housing become part of the recommended strategy? Will the Good Samaritan Law emerge as part of the ongoing discussions?
Rhode Island's efforts are part of a larger national wave of activities around drug overdose deaths and addiction. The epidemic of accidental drug overdoses and heroin addiction has emerged as a key issue in New Hampshire among candidates running for President in 2016. Hillary Clinton has promised to share her plan for a national intervention in the next few weeks. Other candidates, such as Jeb Bush, have begun to share their own personal stories regarding addiction of family members. The voters in New Hampshire are demanding answers from the candidates.
On Oct. 4, on the National Mall in Washington, D.C., an event called Unite To Face Addiction will feature numerous rock stars, including Joe Walsh, Steven Tyler, and Sheryl Crow, among others.

PROVIDENCE – The first public meeting of the newly formed Overdose Prevention and Intervention Task Force was held on Wednesday, Aug. 19, in the basement of the R.I. Department of Health, a room that Dr. Josiah ‘Jody’ Rich, one of the public health experts that will be leading the effort, compared to a “bunker.”

The metaphor of a bunker was apt, he said, because: “This is really a war; 1,000 people have died in the last five years.”

Further, unlike the similar task force in Massachusetts, which came up with a list of 65 recommended action steps, this task force would be developing “a small number of really critical steps” to fashion “the best strategic plan,” Rich said.

Traci Green, Ph.D., Rich’s public health expert co-leader, explained the difference in focus by saying that this was not a “kitchen sink” approach. While there were many things that needed to be done to improve the overall health of Rhode Island and people living with addiction, she continued, “Our efforts are targeted at identifying the components for prevention, treatment, reversal, and recovery that will shift the epidemic curve."

Both Green and Rich stressed the plan would be data-driven, evidence-based, with strategic, measurable initiatives.

The task force’s mission was also defined: to develop the most “impactful” initiatives to address the prevention of opioid addiction, the reversal of opioid overdose, treatment of opioid addiction, and recovery, in order to reduce addiction and stop overdose death in Rhode Island.

New details emerge
The group of public health experts now includes: Green; Rich; Brandon Marshall, assistant professor and graduate program director of the Department of Epidemiology at the Brown University School of Public Health; Jeffrey Bratberg, clinical professor in the URI College of Pharmacy; and Jonathan Goyer, a person in recovery.

Although he was not listed as a member of the expert team, Dr. Joshua Sharfstein, the associate dean for Public Health Practice and Training at the Johns Hopkins Bloomberg School of Public Health, will be involved in coordinating assistance to the expert Rhode Island team, according to a spokeswoman at the R. I. Department of Health.

The total amount of money contributed by private sources to fund the work of the task force is $70,000, with. $60,000 coming from CVS Health and another $10,000 from Blue Cross & Blue Shield of Rhode Island, according to a R.I. Department of Health spokeswoman. Both companies have representatives serving on the task force.

A firm deadline has been set to have a plan delivered to Gov. Gina Raimondo by Nov. 1, which, as Dr. Nicole Alexander Scott, director of the R.I. Department of Health, and co-chair of the task force, reminded the task force members, was “just 74 days away.”

Maria Montanaro, the director of the R.I. department of Behavioral Healthcare, Developmental Disabilities and Hospitals, the other co-chair of the task force, clarified the role of the task force, saying that they would inform the plan that was developed, but their responsibility was not to write the plan.

Data-driven
In a graph shared with the task force members, Rich and Green provided a detailed look at the incidences of accidental overdose deaths in Rhode Island from July 2013 through February 2015, identifying the total number of deaths, the use of opioids of any type, as well as the use of fentanyl from a probable illicit source.

The graph indicated a seasonal pattern to the deaths, according to Green. She said that task force members would be receiving data updates on a regular basis.

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