The National Institute of Drug Abuse explains opioids are a class composed of both legal and illegal drugs. Common legal prescription pain relief opioids include oxycodone (OxyContin), hydrocodone (Vicodin), morphine and others. In the last 30 years, a synthetic opioid named fentanyl, used in anesthesia and for severe pain, has also become widely abused. The most common illegal opioid is heroin, a street drug with a long-standing U.S. history. Opioids cause a reaction with the nerves in the brain and throughout the body to diminish the feelings of pain and may put the user in a euphoric state. They are generally safe for short-term use with close physician supervision; however, when taken for longer periods, they become very addictive.
The federal government's Department of Health & Human Services called the opioid epidemic a “public health emergency”. Rhode Island Senator Jack Reed feels that simply declaring this an emergency is very insufficient. He feels the problem should be declared a national state of emergency, which then allows for a release of federal funds to the states. Governor Gina Raimondo agrees that efforts to curtail the wave of problems from the opioid epidemic are in need of funding.
Fatal overdoses in Rhode Island continue to rise each year with 336 during 2016. The Governor established an Overdose Prevention & Intervention Task Force, which is part of a broad Strategic Plan. The focus for the next three years is to reduce the number of fatal overdoses by one-third. Nicole Alexander-Scott, the Director of the Rhode Island Department of Health, explained that new regulations have been put in place so that physicians are more cautious about prescribing these dangerous and addictive medications.
Rhode Island did reduce the volume of opioid prescriptions between 2013 and 2015 by 16%, the biggest such reduction among U.S. states for that period. Officials did emphasize that their efforts are not directed toward limiting access for those with long-term conditions such as cancer patients. Some of their key actions include the following:
- That those being treated with opioids are slowly transitioned off the medication, rather than abruptly stopping and potentially thrusting patients into severe withdrawal
- Reducing overall daily doses of the medications
- Stopping the practice of prescribing extended-release opioids for initial treatment of acute pain
- Requiring prescribers to participate in education regarding dosages, drug dependence and potential alternatives in managing severe pain
Brandon Marshall, an Associate Professor of Epidemiology, says more financial resources should be allocated toward the usage of Naloxone, which is an antidote for those overdosing. He explains overdoses may occur over a period of one to two hours, sufficient time for the user to be administered Naloxone and likely prevent death. At the Providence City Hall, a “NaloxBox” was installed as an example of a means of making the antidote available to potential responders who encounter an individual who is overdosing. During the first half of 2017, there was an estimated 12% reduction in fatal overdoses, which is an encouraging sign.