In the midst of one of the deadliest public health crises in U.S. history, President Trump has directed the Department of Health and Human Services to declare the opioid epidemic a “public health emergency,” a move he hopes will “liberate our communities from this scourge of drug addiction.” But Senator Jack Reed, D-RI, has criticized the declaration as an empty gesture.
Many speculated prior to Trump’s announcement that the president might declare a national state of emergency, a move that would have automatically allocated funds to affected states. The public health emergency stops short of this, releasing no funds.
“The opioid crisis is a national emergency that requires urgent care, attention and resources. The president’s response has been underwhelming,” Reed said in a press release.
In Rhode Island, Gov. Gina Raimondo counts herself among those who believe the Trump Administration’s declaration is not enough. In an October press release, Raimondo condemned the president’s response, saying that she has “attended the funerals of too many constituents and too many of my friends’ kids who have lost their lives because of this crisis.”
“If we’re going to end it and save lives, states like Rhode Island need resources from the President and his administration, not rhetoric,” the release continued.
In 2016, the Ocean State saw 336 overdose deaths — a number that has risen each year since the data was first reported in 2009, according to PreventOverdoseRI.org, a website run by the State of Rhode Island and Brown’s School of Public Health.
“The Governor believes that the opioid crisis is the most urgent public health challenge facing our state today,” said Catherine Rolfe, Raimondo’s deputy press secretary in an email to The Herald. While Rhode Island has taken significant actions to address the epidemic, Raimondo believes the state needs todo more to combat the crisis, Rolfe said.
As part of an ongoing effort to reduce the number of overdose deaths in the state, the governor signed an executive order in 2015 creating the Overdose Prevention and Intervention Task Force. The task force names guidelines for the treatment of opioid addiction in hospitals and emergency departments and offers medication to state inmates to combat addiction while incarcerated. It is the first program of its kind, said Joseph Wendelken, public information officer for the Rhode Island Department of Health.
The state’s task force and associated Overdose Action Plan prioritize reducing the number of overdose deaths first, then attempt to address the wider problem of opiate addiction, said Brandon Marshall, associate professor of epidemiology at the School of Public Health. Part of this effort involves increased funding for the distribution of Naloxone — an antidote to opioid overdose.
“What a lot of people don’t realize is that overdose is a relatively slow condition,” Marshall said, noting that it can often take one to two hours for a person overdosed on heroin to succumb, during which they could be resuscitated by Naloxone. Fentanyl, a relatively new illicit opiate, gives the rescuer less time, part of the reason why it poses such a danger.
For its part, Providence has installed a “NaloxBox” in City Hall. Designed by Geoff Capraro, professor of emergency medicine, along with a group from the Rhode Island School of Design, the box aims to distribute Naloxone to those who could intervene during an overdose.
“The President is certainly right to call the scourge of opioid addiction a public health emergency,” said Senator Sheldon Whitehouse (D-RI) in a press release. “But to fight this emergency in earnest, we need more than declarations; we need full funding behind the Comprenhensive Additiction and Recovery Act Congress passed last year.”
Whitehouse co-authored the act last year with Senator Rob Portman (R-OH), seeking to “educate people about the consequences of drug abuse and to boost prevention efforts,” wrote a spokesperson on behalf of Whitehouse in a follow-up email to the Herald. “The legislation is helping family, friends and health care and law enforcement professionals in confronting an overdose. And it lends support to those following the long, noble path to recovery.”
While former President Obama signed the bill into law in 2016, it still needs more funding to be effective, Whitehouse said.
“The number of people who die from opioid addiction is rising extremely fast,” said Marshall, who contributes to the state website.
According to Marshall, the opioid crisis rose from wide overprescription of opiate painkillers in the 1990s. That resulted in a “huge amount of opioids circulating in the community.” Many young people’s initial exposure to opioids is through prescription pills, but, as their dependency increases or their access to prescription drugs dries up, many transition into illicit drugs such as heroin or fentanyl, Marshall said.
In 2016, illicit drugs caused 214 overdose deaths in Rhode Island, compared with just 31 deaths in 2009. Meanwhile, overdoses due to prescription drugs have decreased.
While the crisis appears bleak, Marshall said that recent data suggest the trend of increasing death counts may be shifting. According to Marshall, the first six months of 2017 showed a 12 percent decrease in reported overdose deaths, a figure he calls “encouraging.”
Correction: A previous version of this article stated that Raimondo believes the state needs to commit more funding to combat the opioid crisis. In fact, Raimondo believes the state needs to do more to combat the opioid crisis, not limited to funding. The Herald regrets the error.