Rhode Island is a leader in overdose research in the United States.
On this page, you will find published research studies involving overdose prevention and treatment in Rhode Island. For many of these studies, you will also find a link to the full article for free. These research studies help guide our state’s overdose response efforts.
What is Rhode Island's response to the overdose crisis?
Association between initial opioid prescription diagnosis type and subsequent chronic prescription opioid use in Rhode Island: a population-based cohort study
Benjamin D Hallowell, Laura C Chambers, Luke Barre, Nancy Diao, Collette Onyejekwe, Alexandra Banks, Jeffery Bratberg, Heidi Weidele, Samara Viner-Brown, James McDonald
BMJ Open, December 2021.
This cohort study followed a population of Rhode Island patients initially prescribed opioids and analyzed risk factors that made people more likely to have long-term, chronic prescription opioid use. They found that people who became chronic users were typically prescribed for longer periods of time and a greater net amount, but had lower morphine milli-equivalents prescribed per day. Moreover, patients with musculoskeletal disease, nervous system diseases, or cancers were more likely to have chronic prescription opioid use.
Using Timely Overdose Data to Address a Spike in Nonfatal Overdoses and Inform a Coordinated Community-Level Response in Rhode Island, 2019
Leanne Lasher, Benjamin D. Hallowell, Laura C. Chambers, Jennifer Koziol, James McDonald, Rachael Elmaleh, Sarah Karim, Samara Viner-Brown
Public Health Reports, November 2021.
This case study provides an example of how timely opioid overdose data can be effectively used to detect a spike in nonfatal opioid overdoses and inform a strategic, community-level response.
Using Emergency Medical Services Data to Monitor Nonfatal Opioid Overdoses in Real Time: Development, Validation, and Use of a Case Definition, Rhode Island, 2018
Benjamin D. Hallowell, Laura C. Chambers, Jason Rhodes, Melissa Basta, Samara Viner-Brown, Leanne Lasher
Public Health Reports, November 2021.
No case definition exists that allows public health authorities to accurately identify opioid overdoses using emergency medical services (EMS) data. We developed and evaluated a case definition for suspected nonfatal opioid overdoses in EMS data.
Racial and Ethnic Disparities in Accidental Drug Overdose Deaths – Rhode Island, 2016–2020
Jaejoon Shin, MPH; Benjamin D. Hallowell, PhD; Rachel P. Scagos, MPH
Rhode Island Medical Journal, October 2021.
Nationally, provisional demographics data shows that drug overdose deaths in 2020 increased across all age and race/ethnicity groups when compared to 2019. The largest percent increases, however, were seen among the younger population, American Indian or Alaska Native, Asian, Black, and Hispanic/Latino communities. To help guide prevention efforts and address the increase in fatal drug overdoses in Rhode Island, we examined accidental drug overdose deaths in Rhode Island from 2016 to 2020 to identify if racial and ethnic disparities were present, and if they contributed to the rapid increase in fatal overdoses observed in 2020. We also studied how the rate of accidental drug overdose deaths varied by substances contributing to the cause of death for different race and ethnicity groups.
The provision of counseling to patients receiving medications for opioid use disorder: Telehealth innovations and challenges in the age of COVID-19
Jaclyn M W Hughto, Lisa Peterson, Nicholas S Perry, Alex Donoyan, Matthew J Mimiaga, Kimberly M Nelson, David W Pantalone
Journal of Substance Abuse Treatment, January 2021.
This paper aimed to investigate the use of telehealth counseling for people on medication for opioid use disorder (MOUD). In the past, mandatory counseling in order to access these medications has been a barrier to care due to the inflexibility of standard in-person care models. Many individuals noted not having time to travel to clinics, no form of transportation, or fear of being seen at the clinic. According to the authors, telehealth counseling helps mediate gaps in care and can be a positive asset to care even after COVID-19 protocols have been lifted.
Medication for Opioid Use Disorder (MOUD) in Rhode Island: Who Gets Treatment, and Does Treatment Improve Health Outcomes?
Mary A Burke, Riley Sullivan
New England Public Policy Center Research Reports, 2020.
This study by the Federal Reserve Bank of Boston found that medication for opioid use disorder (MOUD) in Rhode Island reduced the risk of opioid overdose. They found that patients who have overdosed before were “less likely to experience a second overdose”. They also find that while federal policies have increased uptake of buprenorphine for Medication for Opioid Use Disorder (MOUD) there are still disparities in the accessibility of Medication for Opioid Use Disorder (MOUD).
The Impact of COVID-19 on Service Provision for Emergency Department Patients Post-Opioid Overdose: A Field Report
Alexandra B Collins, Francesca L Beaudoin, Elizabeth A Samuels, Rachel Wightman, Janette Baird
Journal of Addiction Medicine, November 2020. doi: 10.1097/ADM.0000000000000779.
This study looks at how COVID-19 has affected treatment of people who use drugs through interviews with emergency department practitioners in Rhode Island. The authors found that COVID-19 has increased barriers to connecting people with MOUD to services, and increased the difficulty of treating people who use drugs in the emergency department.
Concurrent Utilization of Prescription Opioids and Non-opioid Controlled Substances: Rhode Island Prescription Drug Monitoring Program, 2018
Eric P Borrelli, Blake Morphis, Rouba Youssef, Laura C Chambers, Benjamin D Hallowell, Jeffrey Bratberg, Stephen J Kogut
Rhode Island Journal of Medicine, October 2020.
This paper conducted a cross-sectional observational study of substance use in Rhode Island, and estimated concurrent use of other substances alongside opioids as well. The authors found that prescription opioids are commonly used alongside other controlled substances, indicating the need for interventions targeting controlled substance polypharmacy.
Accidental Drug Overdose Deaths in Rhode Island: January 1, 2016–July 31, 2020
Benjamin D Hallowell, Heidi R Weidele, Rachel P Scagos
Rhode Island Journal of Medicine, December 2020.
This paper provides a summary of accidental drug overdose deaths in Rhode Island for the first seven months of 2020. Trends discovered included increased overdose deaths compared to 2019, and similar demographic trends to that of the nation as a whole.
Mapping the Opioid Epidemic in Rhode Island: Where Are We Missing Resources?
Rachel Schneider, Lynn Carlson, Samantha Rosenthal
Rhode Island Journal of Medicine, February 2020.
This paper conducted a spatial survey of Rhode Island to determine regions where further opioid interventions and resources could be allocated. Using geographic information systems, the authors identified specific towns that necessitated more emergency response or rehabilitation resources.
Defining a recovery-oriented cascade of care for opioid use disorder: A community-driven, statewide cross-sectional assessment
Jesse L Yedinak, William C Goedel, Kimberly Paull, Rebecca Lebeau, Maxwell S Krieger, Cheyenne Thompson, Ashley L Buchanan, Tom Coderre, Rebecca Boss, Josiah D Rich, Brandon D L Marshall
PLOS Medicine, November 2019. doi: 10.1371/journal.pmed.1002963.
As one of the states hardest hit by the opioid crisis, Rhode Island sought to analyze stages of risk for opioid use disorder (OUD). This paper identified five stages in the cascade of care for OUD, and provided estimates for the at-risk population for MOUD in Rhode Island. The authors suggest that these five stages may help structure a response to MOUD to identify gaps in care and improve health policy.
Multidisciplinary Team Reviews of Drug Overdose Deaths and the Use of Minigrants to Advance Recommendations: A Statewide Pilot in Rhode Island
H Holly Hackman, Jennifer A Koziol, Meghan McCormick, James V McDonald, Traci C Green
Journal of Public Health Management & Practice, May/June 2020. doi: 10.1097/PHH.0000000000001081.
The RI Department of Health’s efforts to increase drug overdose surveillance included a strong focus on minigrants to advance specific policy recommendations from multiple community and government stakeholders; this paper analyzes the effectiveness of this process, and concludes that minigrants are an effective financial investment in combating the opioid epidemic.
Impact of State Regulations on Initial Opioid Prescribing Behavior in Rhode Island
Luke Barre, Brant Oliver, Nicole Alexander-Scott, Meghan McCormick, Rachael Elmaleh, James V McDonald
Rhode Island Journal of Medicine, August 2019.
This paper analyzed the RI Prescription Drug Monitoring Program to determine the effects of state regulations on affecting prescribing behavior throughout the state. It found that the rate of administering unsafe opioid doses decreased significantly upon publishing updated pain management regulations by the state of Rhode Island.
Emergency Department and Hospital Care for Opioid Use Disorder: Implementation of Statewide Standards in Rhode Island, 2017–2018
Elizabeth Samuels, James McDonald, Meghan McCormick, Jennifer Koziol, Catherine Friedman, Nicole Alexander-Scott
American Journal of Public Health, December 2018. doi: https://doi.org/10.2105/AJPH.2018.304847
In March 2017, Rhode Island released treatment standards for care of adult patients with opioid use disorder. This paper describes the standardized care policies for opioid use disorder, enhanced opioid overdose surveillance and response, and expanded linkage to peer recovery support, naloxone, and medication for opioid use disorder.
Action-focused, plain language communication for overdose prevention: A qualitative analysis of Rhode Island’s overdose surveillance and information dashboard
Katherine M. Waye, Jesse L.Yedinak, Jennifer Koziol, Brandon D.L.Marshall
International Journal of Drug Policy, October 2018. doi: 10.1016/j.drugpo.2018.08.010.
This paper discussed the website you’re on now, www.PreventOverdoseRI.org (PORI), and sought to determine how people who use drugs (PWUD) perceive and utilize overdose prevention material hosted on this website, and to evaluate PORI’s action-based, plain language content.
Rx for addiction and medication safety: An evaluation of teen education for opioid misuse prevention
Emily Patry, Jeffrey Bratberg, Ashley Buchanan, Andrea Paiva, Sara Balestrieri, Kelly Matson
Research in Social and Administrative Pharmacy, July 2018. doi: 10.1016/j.sapharm.2018.07.00
This paper measures how much 9th grade students learned about opioid overdose prevention, naloxone, and treatment and for an opioid use disorder from a substance use disorder curriculum. The authors found that the curriculum was effective at teaching the students about non-medical prescription opioid use, overdose response, and recovery resources.
Estimating the Direct Costs of Outpatient Opioid Prescriptions: A Retrospective Analysis of Data from the Rhode Island Prescription Drug Monitoring Program.
Hilary Aroke, Ashley Buchanan, Xuerong Wen, Peter Ragosta, Jennifer Koziol, Stephen Kogut
Journal of Managed Care and Specialty Pharmacy, March 2018. doi: 10.18553/jmcp.2018.24.3.214
This paper estimated the statewide direct cost burden of prescription opioid use using data from the Prescription Drug Monitoring Program (PDMP). The study suggests that cost savings could result from using generic forms of commonly prescribed opioid products. Reducing opioid use, especially among middle-aged people, could also save money and lead to better health outcomes.
Rhode Island unintentional drug overdose death trends and ranking- office of the state medical examiners database
Yongwen Jiang, James McDonald, Maria Lena Wilson, Jennifer Koziol, Ariel Goldschmidt, Ewa King, Samara Viner-Brown, Sandra Powell, Nicole Alexander-Scott
Rhode Island Medical Journal, February 2018.
This paper described patterns of accidental overdoses in Rhode Island from 2009-2016. It also compared overdoses in Rhode Island to other states in New England. The study discussed how overdose numbers may increase if interventions to prevent overdose are not implemented.
Using data to guide and evaluate responses to the opioid crisis: Rhode Island’s drug overdose dashboard
Brandon Marshall
National Network of Libraries of Medicine New England Region, March 2018. Repository 54.
This is the script from a webinar about the data dashboard, www.PreventOverdoseRI.org (PORI), the website you are on now. The webinar discussed the process for analyzing overdose surveillance data and metrics of the Former Governor’s Task Force Strategic Plan. Methods for improving data sharing and transparency were also discussed.
Development of a statewide, publicly accessible drug overdose surveillance and information system
Brandon Marshall, Jesse Yedinak, Jonathan Goyer, Traci Green, Jennifer Koziol, Nicole Alexander-Scott
The American Journal of Public Health, November 2017. doi: 10.2105/AJPH.2017.304007.
This paper discussed the website you’re on now, www.PreventOverdoseRI.org (PORI), and its role in the response to Rhode Island’s overdose crisis. The website PORI was created as a data dashboard to increase sharing of overdose surveillance data,
Can Emergency department, hospital discharge, and death data be used to monitor burden of drug overdose in Rhode Island
Yongwen Jiang, James McDonald, Jennifer Koziol, Meghan McCormick, Samara Viner-Brown, Nicole Alexander-Scott
Journal of Public Health Management and Practice, September 2017. DOI: 10.1097/PHH.0000000000000514.
This paper used multiple overdose surveillance data sets to examine trends in overdose, including emergency department and medical examiner records. The study found that people who died from overdose were more likely to be young, male, white and live in suburban areas of Rhode Island.
Practical considerations for prescribing benzodiazepines and opioids
James McDonald, Victoria Ayers, Jackie Pacquin
Rhode Island Medical Journal, July 2017.
This paper discussed the serious risks of prescribing prescription opioids and benzodiazepines together. Strategic guidance was offered to minimize risks for patients: a) stop starting, b) taper, titrate and do not escalate, and c) monitor closely. This paper suggests these efforts will contribute to decreased risk of overdose among patients.
Development and use of a new opioid overdose surveillance system, 2016
Meghan McCormick, Jennifer Koziol, Kelly Sanchez
Rhode Island Medical Journal, April 2017.
This paper described the surveillance system that was developed after Rhode Island passed emergency regulations to require all hospitals and emergency departments to report cases of opioid overdose within forty-eight hours. In October 2015, The Rhode Island Department of Health started an online Opioid Overdose Reporting System. The reporting system allowed the Department of Health to follow the overdose crisis in near real-time.
The Rhode Island community responds to opioid overdose deaths
Sarah Bowman, Ariel Engelman, Jennifer Koziol, Linda Mahoney, Christopher Maxwell, Michelle McKenzie
Rhode Island Medical Journal, October 2014.
This article discussed the 2014 response to the overdose crisis in Rhode Island. It covers the multiple strategies and projects that came out of the early crisis, and how organizations came together to respond. Many of the approaches focused on increasing access to naloxone and improving treatment and recovery care for people with substance use disorders.
Using the Rhode Island Prescription Monitoring Program (PMP)
James McDonald
Rhode Island Medical Journal, June 2014.
This paper offered an outline for prescribers to utilize the Prescription Drug Monitoring Program (PMP) as a means to combat the opioid crisis at the patient level. The paper outlines key guidelines for monitoring opioid prescribing, doses, and patient issues.
Appropriate prescribing of opiates as professional conduct
James McDonald
Rhode Island Medical Journal, November 2013.
This paper covered 2013 standards for opioid prescribing from The Rhode Island Board of Medical Licensure and Discipline. These practices and standards were designed to increase responsible opioid prescribing among clinicians.
Comparing Projected Fatal Overdose Outcomes and Costs of Strategies to Expand Community-Based Distribution of Naloxone in Rhode Island.
Xiao Zang, Sam E Bessey, Maxwell S Krieger, Benjamin D Hallowell, Jennifer A Koziol, Shayla Nole, Czarina N Behrends, Sean M Murphy, Alexander Y Walley, Benjamin P Linas, Bruce R Schackman, Brandon D L Marshall
JAMA Network Open, November 2022. doi: 10.1001/jamanetworkopen.2022.41174.
This analytical model study compared the community-based naloxone distribution programs in Rhode Island with an aim to identify the effects it has on preventing overdose deaths. They found that naloxone distribution programs would be most effective when kits are distributed to the areas with the greatest need focusing on those who inject drugs or those who use illicit drugs as they are “highest risk for overdose.”
Naloxone Recipients in Rhode Island, January 2019-March 2022.
Kristen St John, Christina Hom, Heidi Weidele
RI Medical Journal, September 2022. doi:1;105(7):67-70.
This paper provides a description of those who received naloxone in Rhode Island from January 2019 to March 2022. They found a shift in naloxone recipients coming from pharmacies to both pharmacies and community agencies, yet they often did not target those who were at highest risk of fatal overdose.
Snapshot of Harm Reduction in Rhode Island (February 2021-January 2022).
Erin Brown, Sarah Biester, Cathy Schultz, Sarah Edwards, Annajane Yolken, Dennis Bailer, Raynald Joseph, Katharine Howe
RI Medical Journal, April 2022. doi:1;105(3):61-63.
In Rhode Island, the leading harm reduction organizations that provide HCV, HIV and overdose related harm reduction services include: AIDS Care Ocean State (ACOS) and Project Weber/RENEW (PWR). This paper describes the individuals who accessed these organizations and their services. They found that racial disparities continue to be an issue, with the rate of fatal overdoses among non-Hispanic Black and Hispanics continuing to rise.
Statewide Policy to Increase Provision of Take-Home Naloxone at Emergency Department Visits for Opioid Overdose, Rhode Island, 2018‒2019.
Jennifer Griffith, Rachel R Yorlets, Laura C Chambers, Corey S Davis, Anna Wentz, Francesca L Beaudoin, Janette Baird, Elizabeth A Samuels
American Journal of Public Health, February 2023. doi:10.2105/AJPH.2022.307213\
In an attempt to address opioid overdose, Rhode Island created new standards for emergency department treatments for those presenting with opioid use disorder. This paper discussed the number of recipients of take-home naloxone when going to the ED for opioid overdose. They found that about half of patients received naloxone under these new standards.
Using Emergency Medical Services Data to Monitor Nonfatal Opioid Overdoses in Real Time : Development, Validation, and Use of a Case Definition, Rhode Island, 2018
Benjamin D Hallowell, Laura C Chambers, Jason Rhodes, Melissa Basta, Samara Viner-Brown, Leanne Lasher
Public Health Reports, December 2021. doi: 10.1177/00333549211018989.
This paper explained how a case definition was created and evaluated by the Rhode Island Department of Health for identifying suspected non fatal overdoses in EMS data. This case definition was shown to be an effective tool for monitoring overdoses in real time.
Using Timely Overdose Data to Address a Spike in Nonfatal Overdoses and Inform a Coordinated Community-Level Response in Rhode Island, 2019
Leanne Lasher, Benjamin D Hallowell, Laura C Chambers, Jennifer Koziol, James McDonald, Rachael Elmaleh, Sarah Karim, Samara Viner-Brown
Public Health Reports, December 2021. doi: 10.1177/00333549211012407.
This case study provides an example on the importance and effectiveness of using real time Emergency Medical Service (EMS) opioid overdose data to detect and respond to spikes in overdoses. EMS data found a 463% increase in nonfatal overdoses in Woonsocket between April and June of 2019, and it was identified that many of the patients with cocaine-related overdoses had fentanyl in their system that they were not aware of. This timely data allowed for a quick response and action was taken to reduce overdoses in the community.
Rhode Island’s Opioid Overdose Hospital Standards and Emergency Department Naloxone Distribution, Behavioral Counseling, and Referral to Treatment
Elizabeth A Samuels, Anna Wentz, Meghan McCormick, James V McDonald, Brandon D L Marshall, Catherine Friedman, Jennifer Koziol, Nicole E Alexander-Scott
Annals of Emergency Medicine, July 2022. doi: 10.1016/j.annemergmed.2021.02.004.
This retrospective analysis discussed the impact that the new policies created by Levels of Care for Rhode Island Emergency Departments had on a hospital’s response to patients coming into the Emergency Department for opioid overdose. They found that with these policies in place, there was improvement in hospitals’ levels of distributing naloxone, completing behavioral counseling, and referring patients to treatment.
Controlled Substance Prescription History among Individuals Who Died of an Accidental Opioid-Involved Drug Overdose in Rhode Island
Thomas F Siegert, Laura C Chambers, Heidi Weidele, Rachel Scagos, James McDonald, Collette Onyejekwe, Benjamin D Hallowell
Substance Use and Misuse, October 2022. DOI: 10.1080/10826084.2022.2137814
This paper compares the opioid-related drug overdoses deaths in Rhode Island in 2020 and prior years. The results show there was an increase in overdose deaths in the state over the years. Demographic characteristics and controlled substance prescription history did not change.
Preventing Overdose Using Information and Data from the Environment (PROVIDENT): protocol for a randomized, population-based, community intervention trial.
Brandon D L Marshall, Nicole Alexander-Scott, Jesse L Yedinak, Benjamin D Hallowell, William C Goedel, Bennett Allen, Robert C Schell, Yu Li, Maxwell S Krieger, Claire Pratty, Jennifer Ahern, Daniel B Neill, Magdalena Cerdá
Addiction, April 2022. PMID: 34729851.
This article describes how a randomized, population-based, community intervention trial will be used to evaluate PROVIDENT (Preventing Overdose using Information and Data from the Environment), a machine learning-based forecasting tool to predict future overdose deaths at the neighborhood level. The findings will inform the utility of predictive modeling as a tool to improve public health decision-making and inform resource allocation to communities that should be prioritized for prevention, treatment, recovery and overdose rescue services.
Translating Predictive Analytics for Public Health Practice: A Case Study of Overdose Prevention in Rhode Island.
Bennett Allen, Daniel B Neill, Robert C Schell, Jennifer Ahern, Benjamin D Hallowell, Maxwell Krieger, Victoria A Jent, William C Goedel, Abigail R Cartus, Jesse L Yedinak, Claire Pratty, Brandon D L Marshall, Magdalena Cerdá
American Journal of Epidemiology, October 10 2023. DOI: 10.1093/aje/kwad119.
Case studies on overdose deaths from different neighborhoods in Rhode Island were used to predict overdose deaths using machine learning. The aim was to understand how using criteria including urbanicity, racial/ethnic composition, and poverty can influence public health practices and health equity promotion. The results of using such metrics to predict overdose deaths offered a wide variety of information that can be used to inform intervention and prevention decision-making.
Examination of the Accuracy of Existing Overdose Surveillance Systems
Jennifer Griffith, Laura C Chambers, Benjamin D Hallowell, Ashley Gaipo, Craig Mailloux, Janette Baird, Francesca L Beaudoin, Elizabeth A Samuels
JAMA Network Open, June 2023. Doi: 10.1001/jamanetworkopen.2023.20789.
In this cross-sectional study, the aim was to compare the CDC opioid overdose case definition and Rhode Island’s opioid overdose surveillance systems. This evaluation used Emergency Health Records from Emergency Department visits in Rhode Island. The visits used met the CDC’s definition of opioid overdose. The results found that the CDC’s definition was more accurate than the current Rhode Island definition.
Thirty-day Treatment Continuation After Audio-only Buprenorphine Telehealth Initiation
Caroline Wunsch, Rachel Wightman, Claire Pratty, Brendan Jacka, Benjamin D Hallowell, Seth Clark, Corey S Davis, Elizabeth A Samuels
Journal of Addiction Medicine, March 2023. doi: 10.1097/ADM.0000000000001077.
This retrospective study reviews data of participants who received buprenorphine treatment by audio-only encounters between April 2020 and February 2021. Rhode Island Prescription Drug Monitoring Program data is used to track if buprenorphine prescriptions were filled within 30 days of first encounter. Results display high rates of treatment initiation and continuation.
Preliminary findings from the Rhode Island Harm Reduction Surveillance System: January 2021-December 2022.
Emily M Ledingham, Michelle McKenzie, Haley McKee, Kristen St John, McClaren Rodriguez, Nya Reichley, Benjamin D Hallowell
Rhode Island Medical Journal, April 2023. PMID: 36989103.
This article summarizes findings from the Rhode Island Harm Reduction Surveillance System (HRSS). There is a continued need for naloxone distribution to individuals at high risk of observing an overdose, given the high proportion of overdoses that are not attended by a medical professional and the high utilization of naloxone by peers to reverse an overdose. Despite the high percentage of individuals who experienced or witnessed an overdose, harm reduction practices in this population remained underutilized. The findings from this descriptive analysis can help inform prevention, program, and policy efforts to promote harm reduction practices and prevent fatal overdoses in Rhode Island.
“I Don’t Go Overboard”: Perceptions of Overdose Risk and Risk Reduction Strategies among People Who Use Drugs in Rhode Island
Alexandra B Collins, Eliana Kaplowitz, Parsa Bastani, Haley McKee, Delaney Whitaker, Benjamin D Hallowell, Michelle McKenzie
Substance Use and Misuse, 2024. doi: 10.1080/10826084.2023.2294968.
In this qualitative study, individuals accessing harm reduction services in Rhode Island are interviewed. The goal of this study is to understand if harm reduction services are meeting community needs. It found that individuals were concerned about overdosing, and want to manage overdose risk on their own. Increased community level interventions are needed to support those who use drugs to address overdose rates.
Prescription Drug Exposure Among Pregnant Individuals in Rhode Island, 2019-2022
Taylor J Paiva, Margo Katz, William Arias, Kristen ST. John
Rhode Island Medical Journal, February 2024.
This paper describes the prescribing practices among pregnant people in Rhode Island. The prescriptions of interest include opioid analgesics, benzodiazepines, and buprenorphine MOUD. Data found a decrease in the proportion of births involving these prescriptions since 2019.
Bystander Presence and Response During Accidental and Undetermined Drug Overdose Deaths: Rhode Island, January 1, 2016-December 31, 2021
Justina Omari, Heidi R Weidele, Benjamin D Hallowell
Rhode Island Medical Journal, April 2024.
This paper analyzed overdose data in Rhode Island, and found that about half of these deaths had a bystander present. It was found that the top reasons for non-response was being spatially separated (64.8%), failing to recognize signs of overdose (54.1%), or unaware that the individual was using drugs (40.2%). The aim of this paper is to address the barriers to bystander response to overdose.
↑ Back to Top
How does fentanyl affect the overdose crisis in Rhode Island?
One year of methadone maintenance treatment in a fentanyl endemic area: Safety, repeated exposure, retention, and remission
Andrew C Stone, Jennifer J Carroll, Josiah D Rich, Traci C Green
Journal of Substance Abuse Treatment, August 2020. doi: 10.1016/j.jsat.2020.108031.
This paper assesses the effectiveness of methadone maintenance treatment (MMT), one form of treatment for OUD. The authors found that the majority of patients on MMT were able to achieve remission, and that MMT is effective at protecting fentanyl-exposed patients during their treatment period.
An assessment of the limits of detection, sensitivity and specificity of three devices for public health-based drug checking of fentanyl in street-acquired samples
Traci C Green, Ju Nyeong Park, Michael Gilbert, Michelle McKenzie, Eric Struth, Rachel Lucas, William Clarke, Susan G Sherman
The International Journal On Drug Policy, January 2020.
The paper focuses on the testing of 3 portable devices that are marketed for use in identifying fentanyl: fentanyl test strips, hand-held Raman Spectrometer, and the desktop Fourier-transform Infrared Spectrometer (FTIR). Machines were tested on samples retrieved from law-enforcement agencies in Baltimore and Providence. Fentanyl test strips provided the lowest limit of detection, the lowest false-negative rate, and the lowest false-positive rate. The test strips were also able to detect two fentanyl analogs (acetyl and furanyl). The FTIR is able to detect amount of a substance in addition to its presence.
Perspectives on rapid fentanyl test strips as a harm reduction practice among young adults who use drugs: a qualitative study
Jacqueline E Goldman, Katherine M Waye, Kobe A Periera, Maxwell S Krieger, Jesse L Yedinak, Brandon D L Marshall
Harm Reduction Journal, January 2019. doi: 10.1186/s12954-018-0276-0.
In the wake of surges in fentanyl-induced deaths, rapid fentanyl test strips are one possible intervention to prevent overdose deaths. The authors interviewed self-reported drug users regarding their perspectives on the effectiveness of fentanyl test strips for take-home use. This paper found that fentanyl test strips had high uptake by users, and positive results led participants to behaviors such as keeping naloxone nearby and using with others.
Acceptability of implementing community-based drug checking services for people who use drugs in three United States cities: Baltimore, Boston and Providence
Susan G Sherman, Kenneth B Morales, Ju Nyeong Park, Michelle McKenzie, Brandon D L Marshall, Traci Craig Green
International Journal of Drug Policy, August 2017. doi: 10.1016/j.drugpo.2017.05.023.
Fentanyl test strips are one method by which drug users can check the safety of their supply; this paper sought to determine perspectives on drug checking services by people who use drugs in Baltimore, Boston, and Providence. The authors found that drug users were more likely to endorse drug checking after having viewed a fatal overdose, underscoring the importance of improved drug checking programs.
Exposure to fentanyl-contaminated heroin and overdose risk among illicit opioid users in Rhode Island: A mixed methods study
Jennifer J. Carroll, Brandon David Lewis Marshall, Josiah D. Rich, Traci C. Green
International Journal of Drug Policy, August 2018. doi:10.1016/j.drugpo.2017.05.023.
This paper described trends in fentanyl exposure through interviews with opioid users in Rhode Island, and found that while fentanyl exposure is common, people who use drugs are growing more interested in mitigation and treatment efforts. The authors concluded that overdose reduction strategies should focus heavily on the perspectives of local drug users and existing strategies.
Methadone maintenance treatment among patients exposed to illicit fentanyl in Rhode Island: Safety, dose, retention, and relapse at 6 months
Andrew Stone, Jennifer Caroll, Josiah Rich, Traci Green
Drug and Alcohol Dependence, November 2018. doi:10.1016.j.drugalcdep.2018.07.019
This was the first study to look at methadone treatment for people who have been exposed to fentanyl. The researchers found that of the people who had been admitted for methadone treatment, 80% had tested positive for fentanyl. While most of the participants remained on methadone for 6 months, relapse was common, as was continued fentanyl exposure.
Use of rapid fentanyl test strips among young adults who use drugs
Maxwell Krieger, William Goedel, Jane Buxton, Mark Lysyshyn, Edward Bernstein, Susan Sherman, Josiah Rich, Scott Hadland, Traci Green, Brandon Marshall
International Journal of Drug Policy, October 2018. doi:10.1016/j.drugpo.2018.09.009
This study found that young adults who use drugs used fentanyl test strips to test their drugs. They found the test strips to be easy to use. Positive test strip results were more likely for people who use heroin, people who inject drugs, and ever witnessed an overdose. People were more likely to use a harm reduction strategy to help prevent overdose after having a positive test strip result.
Risk of fentanyl-involved overdose among those with past year incarceration: Findings from a recent outbreak in 2014 and 2015
Lauren Brinkley-Rubinstein, Alexandria Macmadu, Brandon Marshall, Andrew Heise, Shabbar Ranapurwala, Josiah Rich, Traci Green
Drug and Alcohol Dependence, April 2018. doi: 10.1016/j.drugalcdep.2017.12.014
This study found that Rhode Islanders who have been in jail in the previous year had an almost double the chance of a fentanyl overdose. This means that people who left jail may have benefited from more help to prevent overdose when they were released, like getting Medication for Opioid Use Disorder (MOUD), overdose education, and naloxone in case of an overdose.
Increase in drug overdose deaths involving fentanyl—Rhode Island, January 2012–March 2014
Melissa Mercardo, Steven Sumner, M Bridget Spelke, Michele Bohm, David Sugarman, Christina Stanley
Pain Medicine, March 2018. doi: 10.1093/pm/pnx015.
This study described the characteristics of people who died from a drug overdose in Rhode Island from January 2012 to March 2014. People who died from fentanyl were more likely to be young and have used heroin recently. About 35%, that means 188 people of the 536 in the study, had an opioid prescription filled 90 days before their overdose death. The authors suggest that doctors and pharmacists should look up people’s substance use history on their medical records before prescribing opioids.
High willingness to use rapid fentanyl test strips among young adults who use drugs
Maxwell Krieger, Jesse Yedinak, Jane Buxton, Mark Lysyshyn, Ed Bernstein, Josiah Rich, Traci Green, Scott Hadland, Brandon Marshall
Harm Reduction Journal, February 2018. doi: 10.1186/s12954-018-0213-2.
This study tested willingness to use fentanyl drug test strips among young people who used drugs in Rhode Island. The strips helped detect fentanyl in drugs like heroin. The results suggested that nearly all people in the study thought the test strips would be easy to use to help prevent an overdose.
Epidemiology of fentanyl-involved drug overdose deaths: A geospatial retrospective study in Rhode Island, USA
Brandon Marshall, Maxwell Krieger, Jesse Yedinak, Patricia Ogera, Priya Banerjee, Nicole Alexander-Scott, Josiah Rich, Traci Green
International Journal of Drug Policy, August 2017. doi: 10.1016/j.drugpo.2017.05.029.
This study assessed accidental drug overdose deaths across Rhode Island from January 2014 to September 2016. Almost half of the overdose deaths, that means 358 of the 788 total, were from fentanyl. The study reported that people who overdosed due to fentanyl tended to be younger, inject drugs, and used more than one drug at once. Overdoses from fentanyl were highest in cities like Providence and Woonsocket.
Prevalence and correlates of fentanyl-contaminated heroin exposure among young adults who use prescription opioids non-medically
Alexandria Macmadu, Jennifer Carroll, Scott Hadland, Traci Green, and Brandon Marshall
Journal of Addiction Behavior, May 2017.
This study showed that fentanyl in heroin was a growing issue for young adults in Rhode Island from 2015 to 2016. Young adults who used cocaine and heroin, who had injected drugs, or who had overdosed before were most likely to think fentanyl was in their drugs.
Fentanyl and Fentanyl Analogs Detected Among Unintentional Opioid Involved Overdose Deaths in Rhode Island: January 2019-December 2021.
Heidi R Weidele, Rachel Wightman, Kristen St John, Louis Marchetti, Jeffrey Bratberg, Benjamin D Hallowell
RI Medical Journal, December 2022. doi:10.1001/jamanetworkopen.2022.41174.
This paper discusses the fentanyl analogs found in the unintentional opioid overdose deaths in Rhode Island. Using RI’s State Unintentional Drug Overdose Reporting system, they confirmed that the fentanyl was detected in and was determined the cause of the majority of overdose deaths in 2021(89%).
Insights from biosurveillance: non-fatal opioid overdoses in Rhode Island 2019-21.
Ewa King, Louis Marchetti, Heidi Weidele, Jenna Wolanski, Noyo Shrestha, Kristen St John, Rachel Scagos
Addiction, September 2022. doi:10.1111/add.15902
This paper described the lab results of urine sample tests associated with non-fatal overdoses in Rhode Island. The results show that a majority of the suspected overdoses in RI from 2019 to 2021 had fentanyl or a fentanyl analog in it.
Analysis of Intentional and Unintentional Drug Overdose Deaths Occurring in Rhode Island, 2016-2019
Jonathan Barkley, Jaejoon Shin
RI Medical Journal, February 2022. doi:1;105(1):46-48.
Since 2016, the State Unintentional Drug Overdose Reporting System (SUDORS) was established in RI to report unintentional overdoses and intentional overdoses are reported to the National Violent Death Reporting System (RIVDRS). This paper compares the overdose deaths reported to both of these systems to understand the differences by intent. The results found that previous analysis of accidental overdoses to correct which included “males, younger individuals, and those working in natural resources, construction, and maintenance occupations to be at highest risk of accidental fatal overdoses.”
Analysis of Buprenorphine Dose and Time to Discontinuation Among Patients With Opioid Use Disorder in the Era of Fentanyl
Laura C. Chambers, Benjamin D. Hallowell, Andrew R. Zullo, PharmD, Taylor J. Paiva, Justin Berk, Rachel Gaither, Aidan J. Hampson, Francesca L. Beaudoin, Rachel S. Wightman
JAMA Network Open, September 2023. doi: 10.1001/jamanetworkopen.2023.34540
In this retrospective study, they examined data from the Rhode Island Prescription Drug Monitoring Program data . They aimed to find a relationship between dose of buprenorphine and the time to stop treatment. Patients with the higher dose were likely to remain in treatment for a longer period.
The impact of polysubstance use patterns on engagement of substance use disorder treatment among emergency department patients at high risk of opioid overdose.
Fiona Bhondoekhan, Yu Li, Rachel Gaither, Mackenzie Daly, Benjamin Hallowell, Laura Chambers, Francesca Beaudoin, Brandon Marshall
Addictive Behaviors Reports, August 2023. doi: 10.1016/j.abrep.2023.100512
This study compares the results of two behavioral interventions at the time of an emergency department (ED) visit. When visiting the two Rhode Island ED’s, substance use history was self-reported. The aim to find associations between substance use patterns and treatment engagement. Results determined that there is a significant link between using multiple substances and treatment engagement.
↑ Back to Top
What role does naloxone play in community response to overdose?
Community-based naloxone coverage equity for the prevention of opioid overdose fatalities in racial/ethnic minority communities in Massachusetts and Rhode Island
Shayla Nolen, Xiao Zang, Avik Chatterjee, Czarina N Behrends, Traci C Green, Aranshi Kumar, Benjamin P Linas, Jake R Morgan, Sean M Murphy, Alexander Y Walley, Shapei Yan, Bruce R Schackman, Brandon D L Marshall
Addiction, May 2022. doi:10.1111/add.15759
This paper aimed to investigate if areas with high percentages of non-white residents have equitable access to naloxone. The paper did not find a significant difference in the distribution of naloxone by community organizations in areas with higher percentages of non-white residents compared to those with lower. There was a positive relationship between higher naloxone coverage and municipalities with higher percentage of African American/Black residents specifically and residents living below the poverty level.
Pharmacy leaders’ beliefs about how pharmacies can support a sustainable approach to providing naloxone to the community
Elizabeth Donovan, Jeffrey Bratberg, Janette Baird, Dina Burstein, Patricia Case, Alexander Y Walley, Traci C Green
Research in Social and Administrative Pharmacy, October 2020. doi: 10.1016/j.sapharm.2020.01.006.
This study looks at how leaders in pharmacy organizations view efforts to optimize dispensing of naloxone, a key drug that can prevent opioid overdose. They found that most leaders still believe increased training and collaboration between pharmacies statewide is necessary to support naloxone distribution.
Rurality and differences in pharmacy characteristics and community factors associated with provision of naloxone in the pharmacy
Traci C Green, Jeffrey Bratberg, Janette Baird, Dina Burstein, Kimberly Lenz, Patricia Case, Alexander Y Walley, Ziming Xuan
International Journal of Drug Policy, November 2019. doi: 10.1016/j.drugpo.2019.11.010.
Naloxone dispensing is a critical prong of responding to the opioid crisis; this paper aimed to determine characteristics of pharmacies and communities associated with naloxone prevision. The authors found that various characteristics, including being in more rural areas, younger areas, higher volumes of prescriptions, and longer hours were associated with increased likelihood of naloxone dispensing.
Pharmacy on-site overdose protocols and prevention of overdose
Traci C Green, Ayorinde Soipe, Brianna Baloy, Dina Burstein, Ziming Xuan, Abigail Tapper, Alexander Y Walley, Patricia Case, Jeffrey Bratberg, Janette Baird
Substance Abuse, March 2020. doi: 10.1080/08897077.2020.1736236.
This paper looked at protocols for responding to opioid overdoses at community pharmacies through an online survey to pharmacists in Rhode Island and Massachusetts; the authors found that pharmacists who had better understandings of their protocols were more likely to offer naloxone and less likely to work at a chain pharmacy.
Pharmacist attitudes toward pharmacy-based naloxone: A cross-sectional survey study
Dina Burstein, Janette Baird, Jeffrey Bratberg, Elizabeth Donovan, Ayorinde Soipe, Abigail Tapper, Patricia Case, Alexander Y Walley, Traci C Green
Journal of the American Pharmacists Association, March/April 2020. doi: 10.1016/j.japh.2019.11.004.
This paper looked at the attitudes of pharmacists in RI and MA towards opioid overdose prevention and formalized an Opioid Overdose Prevention Attitude (OOPA) scale. They found that pharmacies that were able to dispense naloxone without a physician’s prescription had pharmacists with more positive attitudes on the OOPA scale.
Retention of student pharmacists’ knowledge and skills regarding overdose management with naloxone
Anita N Jacobson, Jeffrey P Bratberg, Miranda Monk, John Ferrentino
Substance Abuse, April 2018. doi: 10.1080/08897077.2018.1439797
After the implementation of overdose prevention and naloxone training at the College of Pharmacy at the University of Rhode Island, this paper sought to determine the effectiveness of adding skills-based clinical examination on top of traditional didactic lectures. However, the analysis found no significant difference in information retention on naloxone and opioid use disorder.
The NaloxBox Program in Rhode Island: A Model for Community-Access Naloxone.
Geoffrey Capraro, Claudia Rebola
The American Journal of Public Health, December 2018. doi: 10.2105/AJPH.2018.304735.
This article describes the NaloxBox initiative, an innovative program to make naloxone more accessible, especially in communities with high overdose risk. NaloxBoxes are publicly-available units containing all the tools and instructions needed for a layperson to intervene in an overdose before emergency medical services arrive. To see where to get naloxone click here.
An interprofessional education workshop to develop health professional student opioid misuse knowledge, attitudes, and skills
Kristina Monteiro, Luba Dumenco, Sally Collins, Jeffrey Bratberg, Celia MacDonnell, Anita Jacobson, Richard Dollase, Paul George
The Journal of the American Pharmacists Association, March 2017. doi: 10.1016/j.japh.2016.12.069.
This article describes the evaluation of educational workshops for health professional students at Brown University’s Warren Alpert Medical School. The workshops taught the students how to administer naloxone and how to treat people with substance use disorders. The workshops were found to be successful in increasing the student’s knowledge and showed that training health professional students may be useful in improving substance use care.
Factors associated with knowledge of a Good Samaritan Law among young adults who use prescription opioids non-medically
Tristan Evans, Scott Hadland, Melissa Clark, Traci Green, Brandon Marshall
Harm Reduction Journal, July 2016. doi:10.1186/s12954-016-0113-2.
This study found that less than half of young adults in Rhode Island who were surveyed knew about the Good Samaritan Law (Good Sam), a type of law that offers legal protection if a bystander calls 911 during an overdose. While less than half knew about Good Sam, almost all of the young adults said they would call 911 if someone was overdosing. This study suggests that expanded education about Good Sam would help young adults who use opioids non-medically respond to overdose.
Orienting patients to greater opioid safety: models of community pharmacy-based naloxone
Traci Green, Emily Dauria, Jeffrey Bratberg, Corey Davis, Alexander Walley
Harm Reduction Journal, August 2015.
This study examined Rhode Island’s pharmacy-based naloxone program, where the pharmacies in Rhode Island partnered with naloxone prescribers to expand naloxone distribution across the state. The results of this study suggested that offering naloxone in pharmacies may be an important part of a state-wide overdose response.
Community-based naloxone coverage equity for the prevention of opioid overdose fatalities in racial/ethnic minority communities in Massachusetts and Rhode Island
Shayla Nolen, Xiao Zang, Avik Chatterjee, Czarina N Behrends, Traci C Green , Aranshi Kumar, Benjamin P Linas, Jake R Morgan, Sean M Murphy, Alexander Y Walley, Shapei Yan, Bruce R Schackman, Brandon D L Marshall
Addiction, November 2021. doi: 10.1111/add.15759
This paper reviews community-based data from Massachusetts and Rhode Island to establish if the communities with a high percent of non-white residents had fair access to naloxone. In one analysis, the access to naloxone was not noticeably different among municipalities based on the percentage of non-white residents with no difference based on the percentage of Hispanic residents. A secondary analysis shows that municipalities of a higher African American population had more access to naloxone.
The role of increasing pharmacy and community distributed naloxone in the opioid overdose epidemic in Massachusetts, Rhode Island, and New York City
Jake R Morgan, Christina E Freibott, Ali Jalali, Philip J Jeng, Alexander Y Walley, Avik Chatterjee, Traci C Green, Michelle L Nolan, Benjamin P Linas, Brandon D L Marshall, Sean M Murphy
Drug and Alcohol Dependency Reports, September 2022. doi:10.1016/j.dadr.2022.100083
This study evaluated the effect retail pharmacy and community naloxone distribution rates had on the level of opioid related deaths in three states, including Rhode Island. The results show that communities that were in most need of naloxone, were adequately receiving the medication. However, with the overdose rates increasing due to fentanyl, naloxone distribution will need to increase.
Implementation and maintenance of an emergency department naloxone distribution and peer recovery specialist program
Brendan P Jacka, Hannah N Ziobrowski, Alexis Lawrence, Janette Baird, Anna E Wentz, Brandon D L Marshall, Rachel S Wightman, Michael J Mello, Francesca L Beaudoin, Elizabeth A Samuels
JMIR Formative Research, September 2022. doi: 10.2196/37483.
This retrospective cohort study examined the feasibility of two Rhode Island hospital’s emergency department overdose prevention programs. The study found that naloxone distribution, behavioral counseling and referral to trThe impact of polysubstance use patterns on engagement of substance use disorder treatment among emergency department patients at high risk of opioid overdose
eatment in the ED can be achieved, but more work is needed to improve services within the clinical setting.
Evaluation of Racial and Ethnic Disparities of Naloxone Uptake among Harm Reduction Clients in Rhode Island
Erin Brown , Sarah Ogundare, Katharine Howe, Sarah Edwards, Nya Reichley, Stacey Levin, Dennis Bailer, Raynald Joseph
Rhode Island Medical Journal, October 2023. PMID: 37768164.
This paper aimed to analyze the race and ethnicity makeup of Rhode Island residents who received Naloxone in 2022. Local harm reduction organizations record a person’s demographic information. This is done when giving out harm reduction supplies. The results show that Black, Hispanic and other race groups are less likely to receive naloxone than White individuals.
Statewide Policy to Increase Provision of Take-Home Naloxone at Emergency Department Visits for Opioid Overdose, Rhode Island, 2018‒2019
Jennifer Griffith, Rachel R Yorlets, Laura C Chambers, Corey S Davis, Anna Wentz, Francesca L Beaudoin, Janette Baird, Elizabeth A Samuels
American Journal of Public Health, April 2023. DOI: 10.2105/AJPH.2022.307213.
This study evaluated the emergency department (ED) distribution of take-home naloxone from nine Rhode Island hospital EDs, following implementation of new ED treatment standards for opioid overdose and opioid use disorder. The evaluation aimed to identify factors associated with provision of take-home naloxone for ED patients treated after an opioid overdose. Among the visits where naloxone was distributed from the ED, most patients were White, male, and aged 25 to 34 years. Establishing and maintaining a high level of ED naloxone distribution may help to close the naloxone access gaps when community supply is limited.
↑ Back to Top
How are Emergency Medical Services involved in preventing overdose?
Coordinating clinical and public health responses to opioid overdoses treated in emergency departments: Joint Webinar: Vital Signs Town Hall and COCA Call
Alana Kantor, Elizabeth Samuels, Meghan McCormick
Center for Disease Control and Prevention, March 2018.
This online lecture discussed data from opioid-related deaths at emergency departments. The lecture talked about ways public health workers and emergency departments can work together to prevent overdoses and increase treatment options. Additionally, important steps that emergency departments may take to prevent future overdoses were described.
An initial evaluation of law enforcement overdose training in Rhode Island
Corey Saucier, Nickolas Zaller, Alexandria Macmadu, Traci Green
Drug and Alcohol Dependence, May 2016. doi: 10.1016/j.drugalcdep.2016.03.011.
This study evaluated a Rhode Island training for law enforcement officers in recognizing and responding to an overdose. The results showed that after having the overdose training, the officers were more prepared to recognize signs of an overdose, administer naloxone, and knew about the Good Samaritan Law.
Use of Naloxone by emergency medical services during opioid drug overdose resuscitation efforts
Steven Allen Summer, Melissa Mercado-Crespo, M. Bridget Spelke, Leonard Paulozzi, David Sugerman, Susan Hills, Christina Stanley
Prehospital Emergency Care, March 2016. doi: 10.3109/10903127.2015.1076096.
This study wanted to determine how Emergency Medical Services (EMS) responders used naloxone when an overdose was thought to be happening. From 2014 to 2016, it was found that men were given naloxone nearly three times as often as women. Also, people younger than 30 were more likely to be given naloxone. The authors suggest that EMS does not always recognize that a person is having an overdose and that there should be more training about recognizing and responding to overdoses.
Calls of Despair: An EMS Perspective on Suicide and Overdose in Rhode Island during COVID-19
James L Thorndike, Carolina Roberts-Santana, Jason Rhodes, Kenneth A Williams
RI Medical Journal, February 2023. doi: 1;106(1):42-47.
This study looks to identify changes to suicide and overdose 911 calls from before COVID-19 to the first year of the pandemic. The data shows that there was a decrease in the number of these 911 calls throughout the first year of the COVID-19 pandemic, despite suicide and overdose rates being increased within that time period.
Characteristics of events in which police responded to overdoses: an examination of incident reports in Rhode Island
Alexandria Macmadu, Annajane Yolken, Lisa Frueh, Jai’el R Toussaint, Roxxanne Newman, Brendan P Jacka, Alexandra B Collins, Brandon D L Marshall
Harm Reduction Journal, October 2022. doi:10.1186/s12954-022-00698-2
This study used police incident reports in Rhode Island to examine naloxone administration by police and arrests made in overdose events. The data found that in overdose events where police were called, naloxone was administered by others 65% of the time, and were likely to be the last responders on the scene. It would be beneficial to have first responders that can respond quickly to an overdose, without police being on the scene.
An evaluation of the association between specific post‐overdose care services in emergency departments and subsequent treatment engagement
Laura C Chambers, Benjamin D Hallowell, Elizabeth A Samuels, Mackenzie Daly, Janette Baird, Francesca L Beaudoin
Journal of American College of Emergency Physicians Open, January 2023. doi:10.1002/emp2.12877
This retrospective cohort study evaluated emergency department visits in which patients received post-overdose services to see if they would go to opioid use disorder treatment after. The analysis shows that patients who received treatment in the ED were likely to engage in treatment. However, those who only received take-home naloxone or a naloxone prescription with referral to treatment, were not likely to engage in treatment after.
Prior Emergency Medical Services Utilization Among People Who Had an Accidental Opioid-Involved Fatal Drug Overdose-Rhode Island, 2018-2020.
Kailai Duan, Laura C. Chambers, Melissa Basta, Rachel P. Scagos, Carolina Roberts-Santana, and Benjamin D. Hallowell
Public Health Reports, March 2023. DOI: 10.1177/00333549231154582.
To help understand whether decreased emergency medical services (EMS) utilization due to the COVID-19 pandemic contributed to increased accidental fatal drug overdoses, this study characterized recent EMS utilization history among people who had an accidental opioid-involved fatal drug overdose in Rhode Island. In Rhode Island, decreased EMS utilization because of the COVID-19 pandemic was not a driving force behind the increase in overdose fatalities observed in 2020. However, with half of people who had an accidental opioid-involved fatal drug overdose having an EMS run in the 2 years before death, emergency care is a potential opportunity to link people to health care and social services.
Evaluation of a Statewide Policy to Improve Post-Overdose Care in Emergency Departments and Subsequent Treatment Engagement
Laura C Chambers, Benjamin D Hallowell, Elizabeth A Samuels, Mackenzie Daly, Janette Baird, Francesca L Beaudoin
Rhode Island Medical Journal, March 2023. PMID: 36848541.
The objective of this study was to evaluate the impact of a statewide treatment standards policy for post-overdose emergency department (ED) care on services provided and subsequent treatment engagement. Outcomes were compared for patients attending EDs for opioid overdose before and after policy release. Visits post-policy more often included initiation of buprenorphine in or from the ED, provision of a take-home naloxone kit or prescription, and referral to treatment. Statewide post-overdose treatment standards may improve provision of some ED services and additional strategies are needed to improve subsequent treatment engagement.
↑ Back to Top
What groups are affected by barriers to treatment?
Who Gets Medication for Opioid Use Disorder (MOUD), and Does It Reduce Overdose Risk? Evidence from the Rhode Island All-payer Claims Database
Mary A. Burke, Riley Sullivan, Katherine G. Carman, Hefei Wen, J. Frank Wharam, Hao Yu
Federal Reserve Bank of Boston Research Department Working Papers, April 2021.
This paper aimed to investigate the distribution of medication for opioid use disorder (MOUD) in Rhode Island since the 2016 federal policy changes that aimed to expand access. Barriers to MOUD include health insurance coverage restrictions, regulation on availability of the medication itself, and social stigma. The authors found that women and older patients are less likely to receive MOUD. Additionally, economic level associated with zip code and comorbidity with alcohol use disorder (AUD) have mixed results in methadone and buprenorphine access. Individuals sticking to MOUD had a reduction in risk of future opioid overdose.
“Health Is on the Back Burner:” Multilevel Barriers and Facilitators to Primary Care Among People Who Inject Drugs
Delia Motavalli, Jessica L Taylor, Ellen Childs, Pablo K Valente, Peter Salhaney, Jennifer Olson, Dea L Biancarelli, Alberto Edeza, Joel J Earlywine, Brandon D L Marshall, Mari-Lynn Drainoni, Matthew J Mimiaga, Katie B Biello, Angela R Bazzi
Journal of General Internal Medicine, September 2020. doi: 10.1007/s11606-020-06201-6.
This paper analyzes potential barriers to health care utilization by people who inject drugs (PWID) in Massachusetts and Rhode Island. Through interviews with various PWID, the authors identified barriers to primary care utilization on individual, interpersonal and systemic levels, which include stigma, inadequate transportation, and other competing priorities (e.g. housing).
Willingness to use a supervised injection facility among young adults who use prescription opioids non-medically: a cross-sectional study
Benjamin A Bouvier, Beth Elston, Scott E Hadland, Traci C Green, Brandon D L Marshall
Harm Reduction Journal, February 2017. doi: 10.1186/s12954-017-0139-0.
While supervised injection facilities (SIFs) have been used in ten countries, the United States has yet to open a SIF. This paper, an initiative of the Rhode Island Young Adult Prescription Drug Study (RAPiDS), looked at the willingness of participants in RAPiDS who had previously injected drugs or were at risk of initiating injection drug use. The authors found that the majority of participants would be willing to use SIFs, and found that those in support of SIF use were more likely to have been homeless, accidentally overdosed, have used fentanyl non medically, use heroin, or use prescription opioids alone; this indicates that risk factors for overdose might also lend to higher acceptance of SIFs.
Post-release treatment uptake among participants of the Rhode Island Department of Corrections comprehensive Medication for Opioid Use Disorder (MOUD) program
Rosemarie A Martin, Shelley A Gresko, Lauren Brinkley-Rubinstein, L A R Stein, Jennifer G Clarke
Preventive Medicine, November 2019. doi: 10.1016/j.ypmed.2019.105766
This paper looked at potential barriers for medication for opioid use disorder (MOUD) in the Rhode Island Department of Corrections. Through surveying 214 individuals who were formerly incarcerated, most participants were able to obtain MOUD post-release, but identified novel factors that could both help or harm continuation of MOUD.
Access to substance use treatment among young adults who use prescription opioids non-medically
Elliott Liebling, Jesse Yedinak, Traci Green, Scott Hadland, Melissa Clark, Brandon Marshall
Substance Abuse Treatment Prevention and Policy, November 2016.
This study examined how young adults in Rhode Island who use prescription opioids non-medically find and get into treatment for drug use. Study results suggested it was harder to get treatment for young adults who have overdosed before or who had been in jail.
The More Things Change: Buprenorphine/Naloxone Diversion Continues While Treatment Remains Inaccessible
Jennifer Carroll, Josiah D. Rich, Traci C. Green
Journal of Addiction Medicine, August 2018.
This study considered data from 2 Rhode Island based studies (conducted in 2009 and 2016, respectively) of people who use illicit or diverted prescription opioids and their patterns of buprenorphine/naloxone diversion. Using targeted sampling, individuals who use opioids completed a brief questionnaire about their drug use. The use of diverted/buprenorphine remains common among people who use opioids non-medically and indicates a severe shortage in treatment capacity and inaccessibility of existing services.
Towards an Improved Substance Use Disorder Treatment Landscape in Rhode Island – Barriers, Current Progress, and Next Steps
Hannan M Braun, Juliette A Holtzman, Caroline Wunsch, Seth A Clark
RI Medical Journal, April 2022. doi: 1;105(3):24-27.
This paper discusses the barriers associated with receiving addiction treatment, the progress so far and the next steps to be made to reduce these barriers to treatment in Rhode Island.
Drug use behaviors, trauma, and emotional affect following the overdose of a social network member: A qualitative investigation
Alexandria Macmadu, Lisa Frueh, Alexandra B Collins, Roxxanne Newman, Nancy P Barnett, Josiah D Rich, Melissa A Clark, Brandon D L Marshall
The International Journal on Drug Policy, September 2022. doi: 10.1016/j.drugpo.2022.103792
This study seeks to identify the influence of knowing someone who has overdosed on an individual’s own drug use behavior. The results found that more effort is needed to provide support to those who use drugs, including bereavement support and mental health services.
Identifying Predictors of Opioid Overdose Death at a Neighborhood Level With Machine Learning
Robert C Schell, Bennett Allen, William C Goedel, Benjamin D Hallowell, Rachel Scagos, Yu Li, Maxwell S Krieger, Daniel B Neill, Brandon D L Marshall, Magdalena Cerda, Jennifer Ahern
American Journal of Epidemiology, February 2022. doi: 10.1093/aje/kwab279.
This paper aimed to close the gap in the existing research analysis surrounding community-level predictors of opioid overdose mortality risk. This paper found that predictive modeling with machine learning can identify additional predictors of overdose risk compared to previous analysis models.
Accidental Drug Overdose Deaths in Rhode Island: January 1, 2016-December 31, 2022.
Weidele HR, Omari J, Rodriguez M, Hallowell BD.
RI Medical Journal, September 2023. DOI: 1;106(8):42-44. PMID: 37643342.
This report displays the data on accidental drug overdose deaths in Rhode Island for 2016 through 2022. The aim is to understand how the numbers have changed over time. In Rhode Island, opioids and fentanyl continued to be the biggest contributors to the overdose deaths. Data shows that non-Hispanic Black individuals had the highest rate of burden, and that Hispanic/Latino overdose rates doubled from 2021 to 2022.
Prevalence and correlates of experiencing drug-related discrimination among people who use drugs presenting at emergency department at high risk of opioid overdose.
Shayla Nolen, Taneisha Wilson, Brendan P Jacka, Yu Li, Francesca L Beaudoin, Brandon D L Marshall.
Addiction Behaviors Reports, May 2023. doi: 10.1016/j.abrep.2023.100496.
The data in this study is from the Navigator Trial. This trial examined behavioral interventions of individuals with a high risk of opioid overdose. The visits took place at Rhode Island emergency departments. The study results found that individuals who received the highest drug-related discrimination were White participants, as well as female and LGBQIA+ patients.
Sociodemographic and prescribing characteristics that impact long-term retention in buprenorphine treatment for opioid use disorder among a statewide population
Benjamin Hallowell, Laura Chambers, Elizabeth Samuels, Jeffrey Bratberg, James McDonald, Adam Nitenson, Collette Onyejekwe, Francesca Beaudoin
Drug Alcohol Dependence, December 2022. DOI: 10.1016/j.drugalcdep.2022.109680
This study analyzed data from Rhode Island’s prescription drug monitoring program. The aim was to understand if there are associations that influence length of treatment. The characteristics of both the individual and the prescription were analyzed. Results determined that there demographic and prescription factors that play a role. Those who are more likely to stay on treatment include those who are older, female, and have Medicaid.
Comparison of Characteristics of Deaths From Drug Overdose Before vs During the COVID-19 Pandemic in Rhode Island.
Alexandria Macmadu, Sivakumar Batthala, Annice M. Correia Gabel, Marti Rosenberg, Rik Ganguly, Jesse L. Yedinak,Benjamin D. Hallowell, Rachel P. Scagos,Elizabeth A. Samuels, Magdalena Cerdá, Kimberly Paull, Brandon D. L. Marshall
JAMA Network Open, September 2021. doi:10.1001/jamanetworkopen.2021.25538
This retrospective study compares deaths due to overdose in Rhode Island between 2019 and 2020. The aim is to understand the rates and characteristics of these deaths from before and during the COVID-19 pandemic. This shows increased deaths from overdose in 2020 compared to in 2019 with a change in death characteristics.
↑ Back to Top
What are Peer Recovery Coaches and how are they being used in overdose response?
Randomised clinical trial of an emergency department-based peer recovery support intervention to increase treatment uptake and reduce recurrent overdose among individuals at high risk for opioid overdose: study protocol for the navigator trial
William C Goedel, Brandon D L Marshall, Elizabeth A Samuels, Mark G Brinkman, Debra Dettor, Kirsten J Langdon, Linda A Mahoney, Roland C Merchant, Tarek Nizami, George A O’Toole, Susan E Ramsey, Jesse L Yedinak, Francesca L Beaudoin
BMJ Open, November 2019. doi: 10.1136/bmjopen-2019-032052.
This paper proposed a methodology for comparing engagement in opioid use disorder treatment and visits to the ER for opioid overdose in patients with peer recovery support specialists, vs. patients with licensed clinical social workers.
Implementing peer recovery services for overdose prevention in Rhode Island: An examination of two outreach-based approaches
Katherine Waye, Jonathan Goyer, Debra Dettor, Linda Mahoney, Elizabeth Samuels, Jesse Yedinak, Brandon Marshall
Journal of Addictive Behaviors, February 2019. doi:10.1016/j.addbeh.2018.09.27
This paper describes how the emergency department-based peer recovery specialists, AnchorED and AnchoreMORE were created and implemented to prevent future overdoses for people who came to the emergency department because of an overdose. The authors found that these peer recovery services can help people who are at a high risk of experiencing an overdose get access to harm reduction services.
Peer navigation and take-home naloxone for opioid overdose emergency department patients: Preliminary patient outcomes
Elizabeth Samuels, Steven Bernstein, Brandon Marshall, Maxwell Krieger, Janette Baird, Michael Mello
Journal of Substance Abuse Treatment, November 2018. doi:10.1016/j.jsat.2018.07.013
This study evaluated a program that provided naloxone, peer recovery coaching, and treatment for people who came to the emergency department because of an overdose. The authors found that patients who had peer recovery coaching started treatment quicker than those who did not get peer recovery coaching. Also, they found that women and older patients were less likely to get naloxone or consultations for peer recovery coaching.
Emergency department naloxone distribution: a Rhode Island department of health, recovery community, and emergency department partnership to reduce opioid overdose deaths
Elizabeth Samuels
Rhode Island Medical Journal, October 2014.
The Rhode Island Department of Health, Rhode Island emergency department (ED) doctors and the Anchor Community Recovery Center (Anchor) created a program to give out naloxone and offer peer-recovery coaching to people who come into an ED for an overdose. This paper describes the intervention that was created, where ED patients were given a take-home naloxone kit, trained on how to use the naloxone, and had the option to meet an Anchor peer recovery coach. This program started in August of 2014 at several Rhode Island EDs.
Effect of a Peer-Led Behavioral Intervention for Emergency Department Patients at High Risk of Fatal Opioid Overdose: A Randomized Clinical Trial
Francesca L Beaudoin, Brendan P Jacka, Yu Li, Elizabeth A Samuels, Benjamin D Hallowell, Alyssa M Peachey, Roxxanne A Newman, Mackenzie M Daly, Kirsten J Langdon , Brandon D L Marshall
JAMA Network Open, August 2022. doi: 10.1001/jamanetworkopen.2022.25582.
A randomized controlled clinical trial compared peer-led behavioral interventions to the standard behavioral interventions conducted in the emergency department to see their effectiveness in substance use treatment follow-up. The results found that both interventions led to a significant number of patients receiving treatment within 30 days of ED visit.
↑ Back to Top
Why are incarcerated people, young adults, and other groups most affected by the overdose crisis?
Comparison of Characteristics of Deaths From Drug Overdose Before vs During the COVID-19 Pandemic in Rhode Island
Alexandria Macmadu, Sivakumar Batthala, Annice M Correia Gabel, Marti Rosenberg, Rik Ganguly, Jesse L Yedinak, Benjamin D Hallowell, Rachel P Scagos, Elizabeth A Samuels, Magdalena Cerdá, Kimberly Paull, Brandon D L Marshall
JAMA Network Open, September 2021.
This paper is a retrospective cohort study of unintentional deaths from drug overdose in Rhode Island. The authors compared two timeframes during 2019 and 2020. The paper found that the rate of deaths from overdose increased by 28.1% in the 2020 timeframe. The paper found significant increases in the the proportion of deaths from overdose among individuals experiencing job loss, overdoses in personal residences, and overdoses involving synthetic opioids. There were no increases in the proportion of deaths from overdose along Medicaid beneficiaries with psychiatric diagnoses, substance use-related disorders, or prior treatment with opioid agonist therapy, although these individuals had high rates to begin with.
Optimizing the impact of medications for opioid use disorder at release from prison and jail settings: A microsimulation modeling study
Alexandria Macmadu, Joëlla W Adams, S E Bessey, Lauren Brinkley-Rubinstein, Rosemarie A Martin, Jennifer G Clarke, Traci C Green, Josiah D Rich, Brandon D L Marshall
International Journal of Drug Policy, July 2020. doi: 10.1016/j.drugpo.2020.102841
This paper examined the effects of increasing access to medications for opioid use disorder (MOUD) in a unified jail/prison system in Rhode Island through a microsimulation model. The authors found that under their model, increasing access to MOUD in jail or prison settings could reduce overdose mortality, and indicated that MOUD should be further researched for its ability to save lives.
Patterns, contexts, and motivations for polysubstance use among people who inject drugs in non-urban settings in the U.S. Northeast
Pablo K Valente, Angela R Bazzi, Ellen Childs, Peter Salhaney, Joel Earlywine, Jennifer Olson, Dea L Biancarelli, Brandon D L Marshall, Katie B Biello
International Journal of Drug Policy, September 2020. doi: 10.1016/j.drugpo.2020.102934.
This study looks at polysubstance use (when people use 2 or more psychoactive drugs at the same time) and any trends in two states, Rhode Island and Massachusetts, by interviewing people who engaged in polysubstance use. The authors found that polysubstance use often followed long histories of personal drug abuse, and often began as an attempt to self-medicate certain physical or mental health conditions. They propose that healthcare workers must account for polysubstance use, and that the other needs of people who use drugs should be met to disincentivize polysubstance use as a substitute for medical treatment.
Opioid Overdose Deaths with Buprenorphine Detected in Postmortem Toxicology: a Retrospective Analysis
Rachel S Wightman, Jeanmarie Perrone, Rachel Scagos, Maxwell Krieger, Lewis S Nelson, Brandon D L Marshall
Journal of Medical Toxicology, July 2020. doi: 10.1007/s13181-020-00795-3.
While used as a treatment to opioid use disorder, buprenorphine has been involved in some drug overdose fatalities. This paper looked at opioid-involved drug overdose fatalities in Rhode Island, and found that those with buprenorphine detected after death were likely to suffer polysubstance use, though the data is limited. This indicates further research must be done on the potential role of buprenorphine in opioid overdoses.
The protective effect of trusted dealers against opioid overdose in the U.S
Jennifer J Carroll, Josiah D Rich, Traci C Green
International Journal of Drug Policy, April 2020. doi: 10.1016/j.drugpo.2020.102695.
This paper sought to explore factors relating to drug suppliers that affect opioid overdoses; after conducting interviews with users, the authors found that relationships with trusted dealers were on strategy to reduce potential harm, and that trusted dealers used several strategies to ensure users’ health, like testing batches of drugs. This indicates that interventions ought to take into account already existing relationships between users and trusted dealers.
Factors associated with knowledge of a Good Samaritan Law among young adults who use prescription opioids non-medically
Tristan I Evans, Scott E Hadland, Melissa A Clark, Traci C Green, Brandon D L Marshall
Harm Reduction Journal, July 2016. doi: 10.1186/s12954-016-0113-2.
This paper focused on the current levels of awareness, as well as factors associated with awareness, regarding the Good Samaritan Laws in Rhode Island among young adult non-medical prescription opioid (NMPO) users. The authors found that fewer than half of NMPO users were aware of Good Samaritan Laws, indicating that targeted educational interventions for NMPO users regarding GSLs should be researched.
Trends in opioid initiation among people who use opioids in three US cities
Saba Rouhani, Ju Nyeong Park, Kenneth B Morales, Traci C Green, Susan G Sherman
Drug and Alcohol Review, May 2020. doi: 10.1111/dar.13060.
This paper analyzes potential risk factors and trends in opioid initiation in users from Baltimore, MD, Boston, MA, and Providence, RI. The authors found that women are a specific at-risk group for intiaiting with non-medical prescription opioids, a possible demographic for targeted intervention.
“One guy goes to jail, two people are ready to take his spot”: Perspectives on drug-induced homicide laws among incarcerated individuals
Meghan Peterson, Josiah Rich, Alexandria Macmadu, Ashley Q Truong, Traci C Green, Leo Beletsky, Kimberly Pognon, Lauren Brinkley-Rubinstein
International Journal of Drug Policy, August 2019. doi: 10.1016/j.drugpo.2019.05.001.
One common justification for the passing of drug-induced homicide laws is the safety of those who use drugs. This paper analyzes the perception of drug-induced homicide laws by people in a Medication for Opioid Use Disorder (MOUD) program in a jail/prison system in Rhode Island. The study found that most participants thought drug-induced homicide laws were ineffective, which highlights the importance of centering interventions on the experiences of people affected by MOUD.
A randomized, open label trial of methadone continuation versus forced withdrawal in a combined US prison and jail: Findings at 12 months post-release
Lauren Brinkley-Rubinstein, Michelle McKenzie, Alexandria Macmadu, Sarah Larney, Nickolas Zaller, Emily Dauria, Josiah Rich
Drug and Alcohol Dependence, March 2018. doi: 10.1016/j.drugalcdep.2017.11.023.
This paper analyzed the effectiveness of methadone maintenance treatment (MMT) in persons who have been recently incarcerated through a randomized controlled trial. The authors found that those on MMT before release were less likely after release to report engaging in injection drug use, had fewer overdoses, and were more likely to be receiving continuous treatment.
Prevalence and correlates of benzodiazepine use and misuse among young adults who use prescription opioids non-medically
Benjamin A Bouvier, Katherine M Waye, Beth Elston, Scott E Hadland, Traci C Green, Brandon D L Marshall
Drug and Alcohol Dependence, February 2018. doi: 10.1016/j.drugalcdep.2017.10.023.
Benzodiazepine use increases the risk of unintentional opioid overdose; the authors of this paper sought to study co-occurring benzodiazepine and opioid use among young adults in the United States. Part of the Rhode Island Young Adult Prescription Study (RAPiDS), the study found that young adult non-medical prescription opioid users commonly misuse benzodiazepines as well.
The benefits and implementation challenges of the first state-wide comprehensive medication for addictions program in a unified jail and prison setting
Lauren Brinkley-Rubinstein, Meghan Peterson, Jennifer Clarke, Alexandra Macmadu, Ashley Truong, Kimberly Pognon, Morgan Parker, Brandon D L Marshall, Traci Green, Rosemarie Martin, Lynda Stein, Josiah D Rich
Drug and Alcohol Dependence, December 2019. doi: 10.1016/j.drugalcdep.2019.06.016.
This study addresses the implementation of medication for opioid use disorder (MOUD) in the Rhode Island Department of Corrections. The authors conducted 40 interviews with individuals that were both incarcerated and part of the MOUD program, and found the MOUD program caused a reduction in withdrawal symptoms, prevalence of drug use in the jail/prison setting, and increased intentions of using MOUD after leaving.
Increased Risk of Opioid Overdose Death Following Cold Weather: A Case-Crossover Study
William C Goedel, Brandon D L Marshall, Keith R Spangler, Nicole Alexander-Scott, Traci C Green, Gregory A Wellenius, Kate R Weinberger
Epidemiology, September 2019. doi: 10.1097/EDE.0000000000001041.
This paper sought to analyze the association between environmental factors, specifically temperature, on rates of opioid overdoses in Rhode Island and Connecticut. The authors found that low average temperature over a 3-7 period before death was associated with higher odds of fatal opioid overdoses.
Accidental or Undetermined Opioid-Involved Drug Overdose Deaths in Rhode Island and Usual Occupation – Higher Rates Observed in Natural Resources, Construction, and Maintenance Occupations
Rachel P Scagos, Leanne Lasher, Samara Viner-Brown
Rhode Island Medical Journal, October 2019.
This paper analyzed the distribution of fatal overdoses in Rhode Island by occupation, and found that those working in occupations relating to natural resources, construction, and maintenance occupations had the highest rates of opioid overdose fatalities.
Postincarceration Fatal Overdoses After Implementing Medications for Addiction Treatment in a Statewide Correctional System
Traci C Green, Jennifer Clarke,Lauren Brinkley-Rubinstein, Brandon D L Marshall, Nicole Alexander-Scott, Rebecca Boss, Josiah D Rich
JAMA Psychiatry, April 2018. doi: 10.1001/jamapsychiatry.2017.4614.
This paper conducts a preliminary analysis of overdose death rates of individuals released from the Rhode Island correctional system after the implementation of a Medication for Opioid Use Disorder (MOUD) program was implemented at the Rhode Island Department of Corrections. The authors found that there was a large reduction in overdose deaths after the implementation of MOUD at the Rhode Island Department of Corrections, though further individual-level analyses are necessary.
Rx for addiction and medication safety: An evaluation of teen education for opioid misuse prevention
Emily Patra, Jeffrey Bratberga, Ashley Buchanana, Andrea Paivab, Sara Balestrieri, Kelly Matsona
Research in Social and Administrative Pharmacy, July 2018. https://doi.org/10.1016/j.sapharm.2018.07.006
This study assessed changes in Rhode Island 9th grade students’ knowledge, confidence, perceptions of opioid use disorder prevention, overdose response with naloxone, treatment, and recovery, following the delivery of an interactive substance use disorder curriculum. Students report significant NMUPO prevalence.
Post-incarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system
Traci Green, Jennifer Clarke, Lauren Brinkley-Rubinstein
JAMA Psychiatry, April 2018. doi:10.1001/jamapsychiatry.2017.4614.
This study assessed whether a program offering Medication for Opioid Use Disorder (MOUD) to people leaving the Rhode Island Department of Corrections would be useful in lowering overdose rates after release from prison. From 2016 to 2017, the number of overdoses from released inmates dropped by more than half. This study suggests that offering MOUD upon release from jail or prison may be a useful strategy in lowering risk for overdose post-release.
A randomized, open label trial of methadone continuation versus forced withdrawal in a combined US prison and jail; Findings at 12 months post-release
Lauren Brinkley-Rubinstein, Michelle McKenzie, Alexandria Macmadu, Sarah Larney, Nickolas Zaller, Emily Dauria, Josiah Rich
Drug and Alcohol Dependence, March 2018. doi: 10.1016/j.drugalcdep.2017.11.023.
In this study, the authors found that people incarcerated at the Rhode Island Department of Corrections who were treated with methadone maintenance therapy were less likely to use heroin and injection drugs after being released. They were also less likely to have had an overdose and more likely to be in treatment in the year after being released.
Addressing excess risk of overdose among recently incarcerated people in the USA: Harm reduction interventions in correctional settings
Lauren Brinkley-Rubinstein, David Cloud, Nickolas Zaller, Ayesha Delaney-Brumsey, Leah Pope, Sarah Martino, Benjamin Bouvier, Josiah Rich
International Journal of Prison Health, March 2017. doi: 10.1108/IJPH-08-2016-0039.
This paper discussed programs to lower the chance of overdose among people who have been recently incarcerated. The authors suggested improvements to overdose and naloxone education, Medication for Opioid Use Disorder (MOUD) programs, and tools to assess risk for overdose.
Methadone continuation versus forced withdrawal on incarceration in a combined US prison and jail: a randomized, open-label trial
Josiah Rich, Michelle McKenzie, Sarah Larney, John Wong, Liem Tran, Jennifer CLarke, Amanda Noska, Manasa Reddy, Nickolas Zaller
The Lancet, July 2015. doi: 10.1016/S0140-6736(14)62338-2.
This study wanted to determine if methadone treatment in prison was helpful for continuing treatment outside of prison and possibly help lower the chance of overdose. The results found that people who were able to continue methadone treatment when they entered jail or prison doubled their chance of maintaining their treatment when released, as compared to those who were forced to stop their methadone treatment.
Feasibility of prison-based overdose prevention education and prescribed naloxone at release
Traci Green, Sarah Bowman, Madeline Ray, Michelle McKenzie, Josiah Rich
Drug and Alcohol Dependence, July 2014. doi:10.1016/j.drugalcdep.2014.02.221.
This study assessed the effectiveness of an overdose recognition and response training video in a Rhode Island prison. The released inmates, one month later, had to show their new skills by acting out an overdose simulation. The study participants were successful in the one-month testing, suggesting that the prison setting may be a useful location for naloxone training.
Development of an incarceration-specific overdose prevention video: Staying Alive on the Outside
Traci Green, Sarah Bowman, Madeline Ray, Michelle McKenzie, Josiah Rich
Health Education Journal, September 2014.
This study was a systematic review of the content and theory behind overdose education videos. The results led to the creation of an educational video for prisoners in Rhode Island about overdose risk post-release, led by peer educators, entitled “Staying Alive on the Outside”. The intervention was tested for effectiveness at multiple locations.
Injection drug use and overdose among young adults who use prescription opioids non-medically
Elliott Liebling, Traci Green, Scott Hadland, Brandon Marshall
Addictive Behaviors, January 2018. doi: 10.1016/j.addbeh.2017.07.017.
In this study, the authors found that 59 of the 199 young adults surveyed, who used prescription opioids not prescribed by their doctor, had injected drugs at some point in their lifetime. The authors discussed the importance of teaching overdose education and naloxone administration to people who injected prescription opioids.
Social context and perspectives of non-medical prescription opioid use among young adults in Rhode Island: A qualitative study
Jesse Yedinak, Elizabeth Kinnard, Scott Hadland, Traci Green, Melissa Clark, Brandon Marshall
The American Journal of Addictions, December 2016. doi: 10.1111/ajad.12466.
The authors of this study interviewed young adults in Rhode Island who used prescription opioids non-medically. This study discussed drug use norms such as using multiple drugs in social settings, and risk factors for overdose among young adults.
Post-incarceration fatal overdoses after implementing medications for addiction treatment in a statewide correctional system
Traci Green, Jennifer Clarke, Lauren Brinkley-Rubinstein
JAMA Psychiatry, April 2018. doi:10.1001/jamapsychiatry.2017.4614.
This study assessed whether a program offering Medication for Opioid Use Disorder (MOUD) to people leaving the Rhode Island Department of Corrections would be useful in lowering overdose rates after release from prison. From 2016 to 2017, the number of overdoses from released inmates dropped by more than half. This study suggests that offering MOUD upon release from jail or prison may be a useful strategy in lowering risk for overdose post-release.
Increased overdose mortality during the first week of the month: Revisiting the “check effect” through a spatial lens
William Goedel, Traci Green, Samara Viner-Brown, Josiah Rich, Brandon Marshall
Drug and Alcohol Dependence, April 2019. doi: https://doi.org/10.1016/j.drugalcdep.2018.12.024
In Rhode Island, overdose deaths were more common in the first week of a month, clustered in distinct geographic areas in the state. This study examined if benefit receipt at the neighborhood level was associated with spatiotemporal patterns of overdose fatalities. The study found that neighborhood-level public assistance receipt was not associated with cluster location.
“It’s probably going to save my life;” attitudes towards treatment among people incarcerated in the era of fentanyl
Eliana Kaplowitz, Alexandria Macmadu, Traci C Green, Justin Berk, Josiah D Rich, Lauren Brinkley-Rubinstein
Drug and Alcohol Dependence, March 2022. doi: 10.1016/j.drugalcdep.2022.109325.
This study conducted qualitative interviews with people who are incarcerated in Rhode Island, to understand their knowledge of and experience with fentanyl. They found that incarcerated individuals are aware of and have had experience with fentanyl. These individuals understand the dangers of fentanyl, took harm reduction steps when using drugs, and stated the MOUD would reduce the risk of opioid overdose.
Anticipated Barriers to Sustained Engagement in Treatment With Medications for Opioid Use Disorder After Release From Incarceration
Eliana Kaplowitz , Ashley Truong, Alexandria Macmadu, Justin Berk, Harrison Martin, Caroline Burke, Josiah D Rich, Lauren Brinkley-Rubinstein
Journal of Addiction Medicine, February 2023.
This qualitative study examined the barriers to opioid use disorder treatment engagement that individuals experience after release from incarceration. The results found that there are still structural barriers to treatment after release, and suggest that peer recovery specialists could help limit these barriers.
Divergence Between Individual- and Neighborhood-Level Fatal Overdose Burden: A Population-Based Statewide Study
Abigail R Cartus, William C Goedel, Benjamin D Hallowell, Bennett Allen, Claire Pratty, Arrianna M Planey, Jennifer Ahern, Magdalena Cerdá, Brandon D L Marshall
RI Medical Journal, August 2022. doi: 1;105(6):46-51.
This retrospective analysis looked at the cases of overdose deaths between neighborhoods in Rhode Island. They found that “rates of fatal overdose were higher in less White, more Hispanic, and poorer neighborhoods.”
Treatment preference for opioid use disorder among people who are incarcerated
Eliana Kaplowitz, Ashley Q Truong, Justin Berk, Rosemarie A Martin, Jennifer G Clarke, Morgan Wieck, Josiah Rich, Lauren Brinkley-Rubinstein
Journal of Substance Abuse Treatment, June 2022. doi: 10.1016/j.jsat.2021.108690.
Qualitative interviews were conducted to determine incarcerated individuals’ opinions on the current medications for opioid use disorder offered in Rhode Island facilities, and the treatments they prefer. These interviews found that incarcerated individuals have treatment preferences. With that, it can be concluded that treatments in the correctional settings should have a patient-centered treatment approach, and offer more treatment options.
Multi-level influences on increased overdose risk behaviors during the COVID-19 pandemic among people who use drugs in Rhode Island: a qualitative investigation
Lisa Frueh, Alexandra B Collins, Roxxanne Newman, Nancy P Barnett, Josiah D Rich, Melissa A Clark, Brandon D L Marshall, Alexandria Macmadu
Harm Reduction Journal, February 2023. doi: 10.1186/s12954-023-00741-w.
This paper evaluates the drug use behaviors in Rhode Island throughout the COVID-19 pandemic to understand. The results found that pandemic-related responses, such as “anxiety and depression, isolation and loneliness, and boredom” had an impact on drug use behaviors, suggesting more harm reduction is needed during times of crisis.
A rapid ethnographic study of risk negotiation during the COVID-19 pandemic among unstably housed people who use drugs in Rhode Island
Alexandra B Collins, Sarah Edwards, Ryan McNeil, Jacqueline Goldman, Benjamin D Hallowell, Rachel P Scagos, Brandon D L Marshall
International Journal on Drug Policy, May 2022. doi: 10.1016/j.drugpo.2022.103626
Throughout COVID-19, people who use drugs (PWUD) who were unhoused were impacted, and this paper assessed the risk level of these individuals with an aim to address their needs in the future. Results found that public health measures during the pandemic increased the risk levels of PWUD and the unhoused. Future programs such as “permanent housing, social supports, and overdose prevention interventions” could reduce these risk levels.
Use of long-acting injectable buprenorphine in the correctional setting
Rosemarie A Martin, Justin Berk, Josiah D Rich, Augustine Kang, John Fritsche, Jennifer G Clarke
Journal of Substance Abuse Treatment, November 2022. doi: 10.1016/j.jsat.2022.108851.
This paper discusses the use of Extended-release buprenorphine as a medication for opioid use disorder within Rhode Island correctional settings. The results found that it is both feasible and acceptable to use this MOUD, adding a safe option for treatments for those who are incarcerated.
Deaths Involving Fully Alcohol-Attributable Chronic Conditions in Rhode Island: 2018–202
Emily Ledgingham, Kristen ST. John, Benjamin Hallowell
Rhode Island Medical Journal, November 2023
This report displays the deaths in Rhode Island that were associated with alcohol use in 2018 to 2020. Of the deaths in this period, 3.5 percent were associated with alcohol use. The death difference between demographics was very similar, with older males having a bit of a higher burden.
Increased Stimulant Prescribing Following the COVID-19 Pandemic –Rhode Island, 2017–2021
Taylor J Paiva, Kristen St John, Rachel S Wightman, Adam Z Nitenson, Collette Onyejekwe, Benjamin D Hallowell
Rhode Island Medical Journal, July 2023. PMID: 37368836
To better understand the prescribing trends in Rhode Island throughout COVID-19, this study was conducted. They analyzed the stimulant prescription data from the RI Prescription Drug Monitoring Program (PDMP). Data showed an increase in stimulant prescriptions. Yet, there was no change in the proportion of individuals under 65 receiving stimulants stayed the same.
Neighborhood-level association between release from incarceration and fatal overdose, Rhode Island, 2016-2020.
Abigail R. Cartus, William C. Goedel, Victoria A. Jent, Alexandria Macmadu, Claire Pratty, Benjamin D. Hallowell, Bennett Allen, Yu Li, Magdalena Cerda, Brandon D.L. Marshall
Drug and Alcohol Dependence, June 1 2023. DOI: 10.1016/j.drugalcdep.2023.109867.
This study analyzed data from 2016–2020 in Rhode Island, and found a modest association at the census tract level between rates of release and fatal overdose. The association is more pronounced in suburban tracts. The results suggest that neighborhood-level release rates are moderately informative as to tract-level rates of fatal overdose and underscore the importance of expanding pre-release MOUD access in correctional settings.
Receipt of Prescription Psychostimulants and Stimulant-Involved Fatal Overdose: A Population Based Case-Control Study
Alexandria Macmadu, Alexandra J. Banks, Benjamin D. Hallowell, Rachel P. Scagos, Scott E. Hadland, Laura C. Chambers & Brandon D. L. Marshall
Substance Use & Misuse, May 2023. DOI: 10.1080/10826084.2023.2212037.
The objective of this study was to estimate the association between receipt of a psychostimulant prescription in the past year and fatal, unintentional psychostimulant-involved overdose. This was a population-based case-control study using linked, state-level databases from the Rhode Island Department of Health. The findings suggest that there is a strong, positive association between prescription psychostimulant receipt and psychostimulant-involved fatal overdose. Current harm reduction measures should be expanded to include patients who receive psychostimulant prescriptions.
Receipt of Prescription Psychostimulants and Stimulant-Involved Fatal Overdose: A Population Based Case-Control Study
Thomas F Siegert, Laura C Chambers, Heidi Weidele, Rachel Scagos, James McDonald, Collette Onyejekwe, Benjamin D Hallowell
Substance Use & Misuse, October 2022. DOI: 10.1080/10826084.2022.2137814.
This was a cross-sectional study that identified accidental opioid-involved overdose deaths using Rhode Island State Medical Examiner’s Office data, which were then linked to the Rhode Island Prescription Drug Monitoring Program database. The study compared demographic characteristics and prescription history by year of death. The study found that opioid-involved overdose deaths in Rhode Island are increasing overall, but without significant changes in demographics. Prior exposure to some controlled substances did decline over time, but it is not clear if these changes reflect more responsible prescribing practices, or another pattern such as patient abandonment or decreased healthcare access.
History of Methadone and Buprenorphine Opioid Agonist Therapy Among People Who Died of an Accidental Opioid-Involved Overdose: Rhode Island.
Benjamin D Hallowell, Heidi R Weidele, Mackenzie Daly, Laura C Chambers, Rachel P Scagos, Lisa Gargano, James McDonald
American Journal of Public Health, September 2021. PMID: 34410818.
This analysis was used to identify the proportion of individuals previously engaged in methadone or buprenorphine treatment for opioid use disorder by year of death. Most individuals (60.9%) had never received any prior buprenorphine or methadone treatment. Individuals who died of an overdose in 2020 had a similar demographic profile and treatment history compared with prior years. These results helped the Rhode Island Department of Health (RIDOH) identify whether prevention efforts should be directed toward providing additional support to individuals in long-term recovery, currently engaged with treatment, or never engaged in treatment.
Toxicological and pharmacologic sex differences in unintentional or undetermined opioid overdose death.
Rachel S Wightman, Jeanmarie Perrone, Rachel Scagos, Benjamin D Hallowell, Maxwell Krieger, Yu Li, Alyson J McGregor, Lewis S Nelson, Brandon D L Marshall
Drug and Alcohol Dependence, October 2021. DOI: 10.1016/j.drugalcdep.2021.108994.
This was a retrospective review of accidental or undetermined opioid-involved overdose deaths in Rhode Island 2016-2019 using the Rhode Island Department of Health State Unintentional Drug Overdose Reporting System (SUDORS) database. Compared to men, women were more likely to have exposure to benzodiazepine, antipsychotic, and antidepressant drug classes and less likely to have fentanyl and alcohol co-exposure. Higher rates of controlled substance prescription prior to death and prescription drug co-exposures suggest that female opioid-involved drug overdose decedents are often in contact with the health care system immediately preceding their death, presenting the opportunity to create patient-centric approaches for prevention, harm reduction, and substance use treatment.
Benzodiazepine Dose Intensity among Patients Concurrently Prescribed Buprenorphine in Rhode Island.
Eric P. Borrelli, Jeffrey Bratberg, Benjamin D. Hallowell & Stephen J. Kogut
Substance Use & Misuse, May 2023. DOI: 10.1080/10826084.2023.2205492.
The use of buprenorphine and benzodiazepines has been linked to patient fatalities, with greater risk occurring with higher doses of benzodiazepines. This study was a cross-sectional analysis used to assess benzodiazepine dose intensity among patients who were concurrently prescribed buprenorphine, as compared with patients prescribed benzodiazepines who were not receiving buprenorphine. Compared to patients prescribed benzodiazepines who were not receiving buprenorphine, patients concurrently utilizing benzodiazepines and buprenorphine had more than twice the odds of higher dose benzodiazepine utilization. Future studies are needed to assess the relationship between benzodiazepine dose intensity, overdose outcomes, and treatment retention among patients receiving buprenorphine.
Trends and Risk Factors for Overlapping Stimulant and Opioid Prescriptions – Rhode Island.
Adam Z Nitenson, Benjamin D Hallowell, James McDonald
Rhode Island Medical Journal, April 2022. PMID: 35349621.
This was a retrospective cohort study utilizing data from the Rhode Island Prescription Drug Monitoring Program (PDMP). While stimulant prescribing remained relatively constant, the percent of individuals with an overlapping opioid prescription declined. Individuals prescribed overlapping stimulant/opioid prescriptions differed significantly depending on age, sex, payment method, type of stimulant prescribed, and prescriber type. Among residents who were dispensed at least one stimulant prescription, individuals who were older, female, and on Medicare insurance were more likely to have an overlapping stimulant/opioid prescription. The PDMP can be used to identify trends and risk factors regarding prescribing patterns, which can inform future health policy and practice.
Application of a diazepam milligram equivalency algorithm to assess benzodiazepine dose intensity in Rhode Island in 2018.
Eric P Borrelli, Jeffrey Bratberg, Benjamin D Hallowell, Mary L Greaney, Stephen J Kogut
Journal of Managed Care & Specialty Pharmacy, January 2022. PMID: 34949119.
This study conducted a systematic literature review and a cross-sectional analysis to develop and apply a standardized benzodiazepine milligram equivalency conversion algorithm and assess the dose intensity of benzodiazepine use in Rhode Island (RI) in 2018. Individuals aged 35-64 years with Medicaid insurance and those aged under 65 years with Medicare were more likely to be prescribed a benzodiazepine of at least 15 diazepam milligram equivalency (DME) per day. Higher benzodiazepine DMEs were also dispensed to patients who concurrently used prescription opioids or stimulants who may be at increased risk of medication-related harm. The study advocates for routine measurement of benzodiazepine dose intensity as a risk reduction strategy.
Adapting to changing risk environments: examining overdose risk and socio-spatial patterns of unstably housed people who use drugs during converging public health crises.
Alexandra B Collins, Jacqueline Goldman, Sarah Edwards, Benjamin D. Hallowell, Megan C Smith
Drugs: Education, Prevention, and Policy. August 2023. DOI: 10.1080/09687637.2024.2324977.
In this paper, interviews were completed with individuals who are unstably and use drugs. The aim of this study is to understand how this population adapted to changes in the environment during a public health crisis. Results found that public health measure changes can affect risk factors in this population and increase overdose risk.
Association between comorbid chronic pain or prior hospitalization for mental illness and substance use treatment among a cohort at high risk of opioid overdose.
Maayan N Rosenfield, Francesca L Beaudoin, Rachel Gaither, Benjamin D Hallowell, Mackenzie M Daly, Brandon D L Marshall, Laura C Chambers
Journal of Substance Use and Addiction Treatment, December 2023. DOI: 10.1016/j.josat.2023.209273
In this paper, an analysis is done on fatal and non-fatal overdoses in Rhode Island from 2016 to 2020. The goal is to identify if there are neighborhood characteristics associated with higher rates of overdose. Results found that neighborhoods with less stable housing and higher poverty levels had a higher risk of overdose.
Characterizing opioid overdose hotspots for place-based overdose prevention and treatment interventions: a geo-spatial analysis of Rhode Island, USA.
Elizabeth A Samuels, William C Goedel, Victoria Jent, Lauren Conkey, Benjamin D Hallowell, Sarah Karim, Jennifer Koziol, Sara Becker, Rachel R Yorlets, Roland Merchant, Lee Ann Jordison Keeler, Neha Reddy, James McDonald, Nicole Alexander-Scott, Magdalena Cerda, Brandon D L Marshall
The International Journal on Drug Policy, March 2024. DOI: 10.1016/j.drugpo.2024.104322
This randomized controlled trial in Rhode Island aimed to understand the association between having chronic illness, hospitalization for mental illness and SUD treatment engagement. An analysis was conducted on Rhode Island emergency department patients who are at high risk of opioid overdose. Those with prior ED visits for mental illness, but not chronic pain, are more likely to engage in treatment following their ED visits.
Differences in Substance Use and Harm Reduction Practices by Race and Ethnicity: Rhode Island Harm Reduction Surveillance System, 2021-2022
McClaren Rodriguez, Michelle McKenzie, Haley McKee, Emily M Ledingham, Kristen John, Jennifer Koziol, Benjamin D Hallowell
Journal of Public Health Management and Practice, March/April 2024. DOI: 10.1097/PHH.0000000000001863
In this analysis, data is used from the Harm Reduction Surveillance System from January 2021 to December 2022. The goal is to understand how minority populations within Rhode Island are using harm reduction tools and their substance use patterns. Results found that harm reduction and treatment services need to be minority-led and incorporate the culture of the minority groups.
↑ Back to Top
How are local stakeholders doing in their overdose education and prevention efforts?
Rx for Addiction and Medication Safety (RAMS-PEER): Evaluation of an Education and Peer Program on Opioid Misuse
Tianyu Sun, Ashley L Buchanan, Jeffrey P Bratberg, Emily Patry, Kelly L Matson
Preventing Chronic Diseases, May 2020. doi: 10.5888/pcd17.190380.
This paper looks at the Rx for Addiction and Medication Safety (RAMS-PEER) program, an educational program for high schools in Rhode Island about opioid misuse, overdose, and recovery, and its effectiveness in opioid overdose education. The authors found some improvement in knowledge of opioid misuse, but note that these results can only be maintained through continued education.
Early Evidence of an Opioid Education Campaign: A Case Study of Rhode Island
Jessica M Rath, Elizabeth C Hair, Alexis A Barton, Jennifer M Kreslake, John Geraci, Maureen Palmerini, Tom Coderre, Donna M Vallone
Journal of Public Health Management & Practice, May/June 2020. doi: 10.1097/PHH.0000000000001154.
This paper looks at the effectiveness of an opioid education campaign in Rhode Island through surveys of young adults. The authors found that both empathy for opioid users and perceived risk of opioid overdose increased significantly after the implementation of the education campaign, indicating its potential for reshaping public opinion on the issue.
Stakeholder perspectives on implementing fentanyl drug checking: Results from a multi-site study
Jennifer L Glick, Tricia Christensen, Ju Nyeong Park, Michelle McKenzie, Traci C Green, Susan G Sherman
Drug and Alcohol Dependence, January 2019.
This paper aimed to explore stakeholder opinions on drug checking technology and possible implementation challenges. According to the authors, stakeholders responded positively to the concept of drug checking, especially the use of test strips. Test accuracy, costs, liability, interactions with law enforcement, and building community trust/rapport were also topics of interest.
An interprofessional education workshop to develop health professional student opioid misuse knowledge, attitudes, and skills
Kristina Monteiro, Luba Dumenco, Sally Collins, Jeffrey Bratberg, Celia MacDonnell, Anita Jacobson, Richard Dollase, Paul George
Journal of the American Pharmacists Association, March/April 2017. doi: 10.1016/j.japh.2016.12.069.
This paper looks at the effectiveness of a workshop held at the Warren Alpert Medical School of Brown University in April 2016; students who went to the workshop had higher scores on the Opioid Overdose Knowledge Scale, measured through testing pre and post-workshop. Moreover, student satisfaction with the workshop was high.
Prescriber and pharmacist understanding of revised Rhode Island pain management regulations
Britny G Rogala, Alexandria Jarvais, Taylor Ng, Jeffrey Bratberg
Journal of Oncology Pharmacy Practice, June 2020. doi: 10.1177/1078155220929057.
This paper surveyed knowledge of pain management regulations in Rhode Island by prescribers and pharmacists. Both groups were found to have some level of misunderstanding of Rhode Island’s pain management regulations updated in 2018; the authors support educational initiatives for prescribers and pharmacists to fix these gaps in knowledge.
The Effectiveness of Internet- and Field-Based Methods to Recruit Young Adults Who Use Prescription Opioids Nonmedically
Brandon D L Marshall, Traci C Green, Beth Elston, Jesse L Yedinak, Scott E Hadland, Melissa A Clark
Substance Use and Misuse. August 2018. doi: 10.1080/10826084.2018.1425725.
This paper analyzes recruitment efforts for young adults who use opioids non medically via the Rhode Island Young Adult Prescription Drug Study (RAPiDS), and found that demographics via internet recruitment skewed younger and in more rural areas, while those from the field were more likely homeless/formerly incarcerated/use opioids daily.
Proceedings from Bridging Health Disparities to Address the Opioid Epidemic: A Symposium at the Warren Alpert Medical School of Brown University
Luba Dumenco, Kristina Monteiro, Michael Mello, Sally Collins, Don Operario, Karen Scanlan, Richard Dollase, Paul George
Rhode Island Journal of Medicine, April 2017.
This paper discussed a symposium held by the Warren Alpert Medical School of Brown University, “Bridging Health Disparities to Address the Opioid Epidemic”. The authors analyzed feedback from participants at the symposium to identify gaps in healthcare provider knowledge and assist in further interventions to combat the opioid epidemic.
The estimated costs and benefits of a hypothetical supervised consumption site in Providence, Rhode Island
Providence, Rhode Island
Laura C Chambers, Benjamin D Hallowell, Xiao Zang, David M Rind, Greg F Guzauskas, Ryan N Hansen, Nathaniel Fuchs, Rachel P Scagos, Brandon D L Marshall
The International Journal on Drug Policy, October 2022. doi: 10.1016/j.drugpo.2022.103820.
This paper analyzes the cost and benefits that a supervised consumption site would bring to Providence, Rhode Island. This analysis could “2 overdose deaths, 261 ambulance runs, 244 ED visits, and 117 inpatient hospitalizations for emergency overdose care annually,” and “save $1,104,454 annually” compared to the current harm reduction programs in place in the state.
Comparison of a national commercial pharmacy naloxone data source to state and city pharmacy naloxone data sources-Rhode Island, Massachusetts, and New York City, 2013-2019.
Avik Chatterjee, Shapei Yan, Audrey Lambert, Jake R Morgan, Traci C Green, Philip J Jeng, Ali Jalali, Ziming Xuan, Maxwell Krieger, Brandon D L Marshall, Alexander Y Walley, Sean M Murphy
Health Services Research, October 2023. doi: 10.1111/1475-6773.14200
In this retrospective, secondary analysis, naloxone dispensing data from pharmacies in NYC, Rhode Island and Massachusetts is compared to determine differences by location. In the states, NYC and Massachusetts, where naloxone distribution is not required to be reported to local sources, pharmacy claim data displayed more naloxone being dispensed compared to the local source data. In states where it is not required to report naloxone being dispensed by the pharmacy, pharmacy claim data will be most useful to understand how much naloxone is being distributed.
Dispensed Opioid, Buprenorphine, Benzodiazepine, and Stimulant Prescriptions among Rhode Island Residents, 2017-2021
Taylor J Paiva, Adam Z Nitenson, Dana Antinozzi, Collette Onyejekwe, James V McDonald, Benjamin D Hallowell
Rhode Island Medical Journal, August 2023.
This report examines the Prescription Drug Monitoring Program (PDMP). The aim is understand the prescribing trends in Rhode Island during a five year period. The results did not show a change in the demographics of those being prescribed these medications. There was a decline in the prescription rates examined in the PDMP.
Trends in Initiate Pediatric Opioid Prescriptions in Rhode Island: 2017–2021
Adam Z Nitenson, Taylor J Paiva, Collette Onyejekwe, Benjamin D Hallowell
Rhode Island Medical Journal, March 2023.
This paper analyzes trends in the dispensing of pediatric opioid in Rhode Island. The data for this paper came from the states Prescription Drug Monitoring Program. During this time, we observed a decrease in the number of pediatric opioids being initiated and dispensed. Yet, there further need to decrease prescriptions in this area.
PROVIDENT: Development and Validation of a Machine Learning Model to Predict Neighborhood-level Overdose Risk in Rhode Island
Bennett Allen, Robert C Schell, Victoria A Jent, Maxwell Krieger, Claire Pratty, Benjamin D Hallowell, William C Goedel, Melissa Basta, Jesse L Yedinak, Yu Li, Abigail R Cartus, Brandon D L Marshall, Magdalena Cerdá, Jennifer Ahern, Daniel B Neill
Epidemiology, March 2024. DOI: 10.1097/EDE.0000000000001695
This viewpoint paper discusses approaches to making public health dashboards for the general public. Three overdose dashboards for Rhode Island projects are reviewed including PreventOverdoseRI, the VILLAGE project, and PROVIDENT. Lessons were taken from the assessment of these dashboards that can be used to develop future public health dashboards.
Public Health Dashboards in Overdose Prevention: The Rhode Island Approach to Public Health Data Literacy, Partnerships, and Action
Jesse Yedinak, Maxwell S Krieger, Raynald Joseph, Stacey Levin, Sarah Edwards, Dennis A Bailer, Jonathan Goyer, Colleen Daley Ndoye, Cathy Schultz, Jennifer Koziol, Rachael Elmaleh, Benjamin D Hallowell, Todd Hampson, Ellen Duong, Abdullah Shihipar, William C Goede, Brandon DL Marshall
Journal of Medical Internet Research, February 2024. doi: 10.2196/51671
PROVIDENT is “a machine learning-based forecasting tool to predict future overdose deaths at the neighborhood level.” This paper discusses how this model was used to measure how effective proactive resource allocation could be in Rhode Island to address overdose rates. This study shows that machine learning models are capable of predicting overdose risk.
↑ Back to Top
Are we missing anything?
To qualify for this page, we used the following criteria:
- The studies were included in the online database PubMed or were published by a branch of the state government
- The studies occurred in Rhode Island, or the study had a site located in Rhode Island
- The studies were relevant to drug-related overdose
- The studies were published anytime after 2014
Please use the comment box at the bottom of the website to send us a message if you feel we have missed any research studies.