Accidental drug overdoses kill more Rhode Islanders than car accidents, or any other kind of accident. And that’s been the trend for a while now. But there’s new energy – and new resources – to help combat this public health problem. This week on The Pulse, Rhode Island Public Radio’s Kristin Gourlay chats with news director Elisabeth Harrison about the state’s new overdose prevention work and the federal dollars that could help sustain it.
Here's a transcript of their conversation.
ELIS: Kristin, Rhode Island has won a grant from the Centers for Disease Control and Prevention to help prevent drug overdose deaths. It’s about three-point-seven million dollars over four years, how will that money be put to work?
KRIS: This came up at the most recent meeting of the governor’s overdose prevention task force. In a nutshell, the money will pay for – as one member of the task force put it – salaries and strategies. One strategy involves boosting the number of prescribers – doctors and nurses – who use the state’s online prescription drug monitoring program.
ELIS: That’s the system that lets doctors track a patient’s prescriptions, the addictive ones, to make sure the patient isn’t re-filling that script with multiple doctors and pharmacies.
KRIS: Right. It’s supposed to help doctors identify patients who might have a problem. The CDC money will help the state update that technology and connect it with other systems so it’s easier to use. Most doctors are not using it right now because they say it’s not updated frequently enough, it doesn’t send them any alerts, it’s time consuming, etc….
ELIS: OK, that’s one piece of this puzzle – doctors are over-prescribing these addictive painkillers like OxyContin. What about training doctors and pharmacies to use a little more caution when prescribing?
KRIS: That’s definitely part of the plan. Rhode Island is one of 16 states to win these federal grants, and there’s money to educate more doctors and pharmacists. The funds will also be used to collect better data on overdoses and on how and where we’re using naloxone. That’s the overdose reversal drug, sometimes called Narcan.
And Elisabeth, here is something I found curious. The CDC grant specifically cannot be used to pay for that drug. That’s a big deal because the price of this drug has nearly doubled over the past few years, and some cities and emergency medical response teams are finding it difficult to afford.
ELIS: This drug naloxone can reverse an overdose – so in some cases, that means it can save a life. But what happens to the people who do survive? Is there any broader effort to get them treatment for drug addiction?
KRIS: Yes. Every weekend, at a bunch of emergency departments around the state, there are a handful of people called recovery coaches on call. They’re people who’ve been there, who understand what it’s like to battle addiction and they’re trained to help people get connected with treatment. Doctors have told me it’s really helpful to have them on call because emergency departments are busy and doctors don’t always have time or don’t always feel equipped to talk to overdose survivors about their options. But as I mentioned the program is limited: these recovery coaches are only around on weekends in some emergency departments. The CDC grant could help put more of them to work throughout the week.
ELIS: So those are just a few of the programs the CDC grant will help pay for. Kristin Gourlay, what about the governor’s overdose prevention task force. What progress are they making?
KRIS: Right, well this grant is just part of the overall effort underway in Rhode Island to fight this epidemic of addiction and accidental drug overdose. The task force is reviewing coming up with a big picture strategic plan, which they will present to the governor in November. The Health Department has just announced they will go back to releasing weekly statistics on overdose deaths, to keep the focus on this problem. There are also a lot of researchers and doctors and advocacy organizations trying to figure out how to make a dent. We’ve got researchers from Brown and the University of Rhode Island looking into ways pharmacies could play a stronger role in preventing overdose deaths. There are lots of addiction treatment programs, and nonprofits promoting recovery from addiction. Law enforcement and emergency medical services are increasingly equipped to respond to an accidental overdose. There’s lots of energy pouring into solving this problem right now. But with hundreds of Rhode Islanders dying each year, it still feels pretty intractable.
ELIS: Kristin Gourlay, there are a lot of reasons this problem has gotten so bad. For one, there’s a seemingly endless supply of prescription painkillers and cheap heroin. Maybe we could shrink the supply. But what about the demand?
KRIS: That’s the major hurdle here. Addiction is a chronic disease of the brain. People who have become dependent on prescription painkillers or heroin need higher and higher doses just to feel normal. Without it, they go into withdrawal. And opioid withdrawal has been described to me as the flu times one thousand. The disease of addiction will drive people to avoid that at all costs. But opioids like oxycontin or heroin suppress the central nervous system. They slow and eventually stop your breathing. Taking too much, or taking your normal dose after you’ve been abstinent for a while can be fatal. It’s usually unintentional. But it’s preventable. And treatment works.