Drug Overdoses Continue at an Epidemic Rate in RI

At East Bay Center, our outpatient facility helps people manage their addiction(s) as an alternative to inpatient admission to a psychiatric hospital or drug rehabilitation center. This allows individuals to safely withdraw from an addictive substance while living with family members and continuing to function in school or a career – all while under medical supervision.

Unfortunately RI continues to experience a rapid rise in opiate drug overdoses this year, as referenced in the recent Providence Journal article (11/19/14, Gregory Smith). “Out of the 188 deaths since January1st, 163, or 90%, involved at least one opioid or medication (such as OxyContin and Vicodin). At least 64, or 36%, involved the painkiller, Fentanyl.” Of those who died, “136 were men and 52 were women”, and resided in 31 out of Rhode Island’s 39 cities and towns. The crisis is not only affecting young people, but many in their 40’s and 50’s as well, with 7 victims in their 60’s.

Two notably positive steps have been taken so far this year in helping to reduce the numbers where possible. The first involves the widespread availability and training in the use of Naloxone (Narcan), which can be very effective in reversing an overdose in progress when administered by injection or nasal spray. The medication works within three (3) to five (5) minutes to reverse respiratory depression, sedation, and hypotension. Walgreens Pharmacy has entered into an agreement with the State to make the medication available without prescription, and local and state police cruisers have been issued doses of Naloxone to have on hand when responding to calls. The RI Department of Health reports that “for the year, emergency medical personnel have administered 1,413 doses of Narcan, with an additional 95 administrations in hospital emergency rooms between April and October”. Without the use of Naloxone/Narcan, another 1,508 victims could have been added to the statistics.

The second initiative involves the strengthening of the Prescription Monitoring Program (PMP), which has been in effect since 1997 under RI law, and collects prescriptions written by all RI physicians, physician assistants, advanced practice nurses, podiatrists, dentists, veterinarians, midwives, and optometrists for Schedules II, III, and IV medications. Prescribers can access the PMP to see all of the prescriptions that have been written and filled for their patients, and to see if other prescribers have already given the patient a similar medicine or a medication that might cause a serious adverse drug reaction. If a similar or the same medication has already been prescribed by another, the practitioner can consider whether the patient may be over-utilizing a medication because his/her pain is not well managed, if the patient may be diverting the medication (to a family member/friend, or selling on the street), or whether the patient has become dependent, pseudo-addicted, or addicted. The PMP will also report if the patient is utilizing more than one pharmacy to fill prescriptions, using more than one home address, and the frequency prescriptions are filled (too early, on time, sporadic, etc.), which can all factor into the practitioner’s decision.

In 2013, data from the PMP showed that 1,394 patients utilized five (5) or more pharmacies to fill prescriptions from five (5) or more prescribers. By providing prescribers data such as this, practitioners can better manage their caseloads, be more informed before writing prescriptions for potentially addictive medications, or those that have a high street value. It can help to open the dialog with the patient regarding possible addiction treatment that may be necessary, and, most importantly, save lives.

When a prescriber next renews his/her professional license, if he/she isn’t already a registered member of the PMP, he/she will be required to register to access the PMP before the license application will be approved. Legislation passed this year also allows a prescriber to authorize an office staff member to access the database on his/her behalf, which frees up the prescriber to spend more time directly with the patient to review the results, and strategize intervention and/or treatment as necessary.

Saving lives should always be a priority and EBC will continue to do its part to educate consumers and the community as this epidemic unfolds.

Access to Care When You Need It:

East Bay Center clinicians are always available by scheduled appointment or through the Center’s “Walk-in” model of care to assist adults, children, and their families through any number of complicated issues. Conveniently located in East Providence on the Wampanoag Trail – help is just around the corner. We encourage you to visit our website at www.eastbay.org for information regarding services, employment, locations, etc. To speak to someone regarding services or to schedule an appointment, please call 401-246-1195 and ask for “Intake”.