PROVIDENCE – The debate on the Senate floor on Tuesday, May 29, on Kristen’s Law apparently caught Providence Journal reporter Kathy Gregg off guard.

“Wow. What [is] playing out on Capital TV is unusual,” she tweeted. “One Senator after another – and primarily the Senate’s progressives – are rising to oppose proposed ‘Kristen’s law.’”

Unusual? Only, perhaps, if you had not been following the story, or had been dependent on The Providence Journal for news coverage.

Later that evening, the Senate passed the proposed legislation, 22-to-11, after a heated debate on the Senate floor. The bill now moves to the House for a vote.

The proposed law, described as a “a drug-induced homicide bill,” seeks to criminalize accidental drug overdoses, making the person who shares or delivers “a controlled substance” for something of value that results in death “because of ingestion orally, injection or inhalation of the controlled substance,” liable to be imprisoned up to life. [The original language of the bill called for a mandatory life sentence, but that was later tweaked to say “up to life.”]

The proposed legislation, first introduced by R.I. Attorney General Peter Kilmartin, was named after Kristen Coutu, who died from an overdose in 2014 after she took illicit drugs containing fentanyl, a synthetic opioid that is at least 50 times more powerful than heroin. She was 29 years old at the time of her death.

In 2017, Aaron Andrade, who had sold Coutu the drugs on which she had overdosed, pleaded guilty to second-degree murder and received a 40-year prison sentence, with 20 years to serve.

Why strong vocal opposition by numerous Senators would have been a surprise to The Providence Journal State House reporter is perhaps surprising in itself, given the testimony at a R.I. Senate Judiciary hearing on April 26. [See link below to ConvergenceRI story, “Is a drug overdose murder?”]

As ConvergenceRI had reported a month ago on April 30: In its testimony in favor of the law, the R.I. Attorney General’s office spoke about the high prevalence of fentanyl in the illicit drug supply in Rhode Island, arguing that the proposed legislation was necessary to serve as a deterrence to the use of fentanyl in the state, especially given the high profitability of the sale of this drug.

Also speaking in favor of the bill was Suzanne Coutu, Kristen’s mom, who provided the devastating story of her loss, saying that no one would ever call her mom again.

However, most of the testimony was in opposition to this proposed legislation, which people said would be ineffective, unnecessary, unfair, and costly.

Opponents speaking against the legislation included: the ACLU, RICARES, Direct Action for Rights and Equality, the National Lawyers Guild, Open Doors, Preventing Overdose and Naloxone Intervention (PONI), Protect Families First, the Rhode Island Users Union, and several individuals – including a father who had lost two children to overdoses in the past year, and a journalist who studies this issue.

The R.I. Medical Society and the Mental Health Association of Rhode Island submitted a letter in opposition, and the Center for Prisoner Health and Human Rights submitted a letter signed by 22 doctors and public health professionals.

Among the questions raised by opponents were: Why did Rhode Island need a new law? Do such laws serve as effective deterrents? Where was the evidence to support such a claim? How much would the new law increase the state costs of operating the correction facilities?

At $50,000 a year to care for an inmate, someone such as Andrade, sentenced to 20 years, would result in a bill for $1 million. Add 10 inmates convicted under Kristen’s Law, and that’s a cost of $10 million; add 100 inmates, and that’s a cost of $100 million over the next 20 years. Where will the money come from in future state budgets to support such expenses?

The irony is that providing a fentanyl test strip, which costs $1, to illicit drug users, might have prevented Kristen’s death in the first place, identifying the presence of fentanyl. There is legislation pending before the R.I. General Assembly to make the distribution of fentanyl test strips legal under the Good Samaritan Act. [See link below to ConvergenceRI story, “If a $1 fentanyl test strip can save lives, why not deploy it?”]

Junkies?
Fast forward to the news story that appeared in The Providence Journal on May 30, co-authored by Gregg and Providence Journal reporter Patrick Anderson.

In the story, they wrote: “A letter sent last week to lawmakers, signed by 15 organizations and 60 individuals, including the founder of the Brown University Center for Alcohol and Addiction Studies and a former state director of public health, Dr. Michael Fine, said that the bill “and its focus on harsh criminal penalties, will have a deleterious effect” on work to combat the opioid crisis.

Specifically, opponents of the bill say it would target low-level drug dealers and junkies [emphasis added] who share drugs, creating a potential barrier to potentially life-saving treatment.”

Junkies? Such a term was not included in the letter sent to lawmakers, according to Annajane Yolken, executive director of Protect Families First, one of the signatories of the letter.

In the manner in which the story had been constructed in The ProJo, it appeared that the writers of the letter – the opponents the bill – had been the ones to use the term “junkies,” which ConvergenceRI found surprising.

ConvergenceRI wrote to Gregg and Anderson in an email on May 30, asking for clarification: In reading your story this morning, I was struck by the use of the word “junkies”: was that a word that the opponents used, specifically, or was it a word that you chose to use?

My question: Did the letter signed by 15 organizations and 60 individuals use the word “junkies?” Thanks for the clarification.

Reporter Patrick Anderson replied promptly: “It was not in the letter, but has been used by opponents of the bill in State House debate. We are changing the word.”

Outcomes
The word got changed in the story, post publication, which is a good outcome. Asking about the use of “junkies” may seem like nitpicking to some, but, in many ways, it gets at the heart of the difficulties around efforts to combat the opioid epidemic: dealing with the stigma attached.

Of course, perhaps it would have been better, journalistically, if Anderson and Gregg had specifically identified which opponents had used the term “junkies,” rather than appearing to attribute it to the letter from opponents.

[Note to Providence Journal Editor Alan Rosenberg: The larger question, unaddressed, is: why would the editors at The Providence Journal permit the use of the word “junkies” in its news coverage, except as a direct quote? For example, no one referred to Kristen Coutu as a junkie.]

Unintended consequences
At a time when everyone appears to be in a political tizzy about proposed plans by the state to support building a new stadium for the Pawtucket Red Sox at the site of the former Apex building and what it will cost, there has been little if any discussion or economic analysis of what the potential hidden cost burden of implementing Kristen’s Law would be on the state’s future budgets.

If it costs $50,000 a year to house an inmate in state correctional facilities, with a likely sentence of 20 years or longer in jail imposed on someone convicted of Kristen’s Law, the overall projected cost to the state taxpayers is $1 million.

The math is quite simple: for everyone arrested, convicted and sentenced under Kristen’s Law, it adds a total of $1 million in costs to the state’s future budgets. If the number of people charged, convicted and sentenced were to be 10, that would become $10 million; if it were to be 100, that price tag would become $100 million. Is that a steep enough price to pay for a pound of flesh?

Nothing, of course, can bring Kristen Coutu back to life, or diminish the pain and tragedy endured by her mother or, for that matter, the thousands of families in Rhode Island that have lost a loved one to an accidental drug overdose in recent years.

But one cannot help but wonder if Coutu or Andrade had had access to a $1 fentanyl test strip, and they had identified that the illicit drugs contained fentanyl, might that have changed the tragic outcomes?

By the numbers
In 2016, there were 336 accidental overdose deaths; in 2017, there were 323 accidental overdose deaths; in 2018, the numbers once again may top 300 deaths, a perverse metric. [See link below to ConvergenceRI story, “What is the best way to measure success in efforts to measure drug ODs?”]

Despite all the efforts and good work by members of the governor’s Task Force on preventing and intervening in drug overdoses, the problem still remains Rhode Island’s number-one public health emergency.

On May 30, the same day that the story by Gregg and Anderson appeared, a news release about a public health alert was sent out by the R.I. Department of Health, talking about a recent increase in drug overdoses.

“The alert below was sent [out on May 30] because we exceeded the threshold we have set for the state as a whole,” explained Joseph Wendelken, communications spokesman at the R.I. Department of Health.

Through the reporting system the agency has developed with hospitals, Wendelken continued, “We have been seeing roughly 29 overdoses a week in 2018 [that number includes reports about fatal and non-fatal overdoses from hospitals].”

For the week of May 21 through May 27, Wendelken said, “There were 44 overdoses in Rhode Island, adding that all of these ODs were non-fatal.

“We do not yet know the exact cause of this spike,” Wendelken said. “However, we do know that fentanyl is driving Rhode Island’s drug overdose crisis at this point.”

To speak out, or not to speak out
On Monday, June 4, at 11 a.m. Dr. Michael Fine and Dr. Jody Rich will join with members of the recovery community to take a stand against Kristen’s Law and the further criminalization of substance use. The news conference will take place at the Parent Support Network headquarters in Warwick; it will be hosted by Protect Families First, in an effort to influence the outcome of the pending vote in the R.I. House of Representatives.

Gov. Gina Raimondo’s office did not respond to requests from ConvergenceRI about whether or not the Governor had taken a position on Kristen’s Law. Spokesman Josh Block did not return phone calls from ConvergenceRI.

In turn, the R.I. Department of Health, in response a question from ConvergenceRI, said that the agency “does not have a position on this bill.”

On Friday morning, June 8, the Rhode Island Business Group on Health will hold its 2018 well being summit, entitled: “Opioids are impacting your business results, whether you know it or not.”

Among the participants are: Tom Coderre, co-chair of the Governor’s Overdose Prevention and Intervention Task Force; Linda Mahoney, administrator at the R.I. Department of Behavioral Healthcare, Developmental Disabilities, and Hospital; Erin McDonough, director of Naloxone & Overdose Prevention Education Program; and Dr. Robert Neal Mills, medical director for Health and Benefits Practice at Aon.

Will there be any discussion of Kristen’s Law at the event? Good question.