CCRI forum highlights progress in addressing opioid crisis – News – The Newport Daily News

Safe Station designations and NaloxBoxes, among community-based prevention activities designed to combat “the most important public health crisis of our time,” could be in place by summer in Newport.

NEWPORT —  The Newport Fire Department may soon become a “Safe Station,” a designation that signals its fire stations are places where people struggling with opiate addiction can get an immediate evaluation and referred to medical services.

Fire Chief Brian Dugan confirmed in a telephone interview that the Newport Fire Department hopes to launch the initiative and another to place NaloxBoxes in some locations in the city sometime this summer. Inside the boxes are doses of naloxone, a medication that can reverse the effects of an overdose. Fire Capt. Jared Minick is leading these efforts for the department, Dugan said.

“One of the reasons we are working on this is that there is a stigma attached to opioid use, whether it is illegal drug use or prescriptions,” Dugan said. “We are not only helping that person, but their families that are deeply affected.”

The department now can do the evaluations and transfer people to a clinic or other medical facility. But it is important to line up peer recovery coaches who can respond immediately, Dugan said.

“If people in need have to wait too long, they just leave,” he added. “They need to have someone who can guide them through the process.”

Initiatives like these to address the opioid crisis in Rhode Island received support at a forum last week at the Community College of Rhode Island to address questions like “How did we get here?” and “Where are we headed?”

Keynote speaker Bertha Madras, Ph.D., a member of the President’s Commission on Combating Drug Addiction and the Opioid Crisis, told more than 50 people in the CCRI auditorium Thursday, April 4, that 90 percent of heroin users began their addiction through prescription opioids. That figure came from a 2005 study, said Madras, a professor of psychobiology at Harvard Medical School based at McLean Hospital in Belmont, Massachusetts.

That figure decreased to 67 percent by 2015 as early efforts to decrease opioid prescribing made prescription opioids harder to get and made heroin, a cheap, widely available, and potent illegal opioid, more attractive.

There were 72,000 overdose deaths in 2017, the most recent year with available data, and more than 50,000 of those were from opioids, mainly fentenyl, she told the audience. Opioid overdoses are now the leading cause of unintentional deaths in the U.S.

“The opioid crisis has hit Rhode Island hard, all communities have been impacted,” said Rebecca Boss, director of the state Department of Behavioral Healthcare, Developmental Disabilities and Hospitals.

“It is the most important public health crisis of our time,” Boss said. “The challenges in Newport are no different than in Central Falls, or in Woonsocket or Westerly.”

She stressed the importance of “community-based prevention activities.”

Rebecca Elwell, director of the Newport County Prevention Coalition that includes the prevention coalitions of five Newport County communities, all except Jamestown, said grants are assisting with establishing Safe Stations and locating NaloxBoxes.

Elwell said there could be about six possible locations for a NaloxBoxes — Dugan said he is considering 10. The boss contain a nasal spray of naloxone and a mask so a bystander could give rescue breaths until emergency help arrives.

“Communities have to address addiction as a health issue, not a moral issue,” said Ray Davis, assistant director of the Newport County Prevention Coalition. “It’s an epidemic. People have to get prevention information in a non-threatening way.”

“Prevention starts at the grassroots in every community,” said Catherine Alexander, a member of the Portsmouth Prevention Coalition. “Communities have to get more engaged.”

Family members hit by the opioid crisis also spoke up at the CCRI forum.

“I went through this,” said Chris Carceller of Portsmouth. “We prayed (a family member) would end up in jail so he wouldn’t end up dead. Families like mine are thankful when loved ones are in jail because it saves their lives.”

She said her family could not convince him to seek treatment.

“When you are high all the time, you don’t know you have a problem,” she said. “I would love for government to give family members the option of forcing a loved one into treatment before it’s too late.”

“Most in the medical field are opposed to coercion,” Madras responded. “That’s difficult because I understand the desperation of families.

Some states have laws allowing judges to order people into treatment for drug or alcohol addiction. These laws are similar to civil commitment statutes that allow judges to order individuals into a psychiatric facility if a physician determines he or she is a threat to the safety of him or herself or others.

Legislation introduced by State Sen. Josh Miller, D-Cranston, would help families struggling with a loved one who refuses to seek help in at least one situation, Boss from the state’s BHDDH said. The bill Miller sponsored seeks to allow hospitals to try to contact the patient’s emergency contact and recovery coach upon discharge without their consent.

Pain is the number 1 reported reason for legitimately using opioids, which were widely  introduced in the late 1980s Madras said. She said the pharmaceutical industry spent more than $100 million in 1996 alone educating physicians on treating patients suffering from pain with opioids like Oxycontin.

The massive use of opioids in the late 1990s and early 2000 was seen by drug dealers as an opportunity to introduce more heroin into the country, she said.

Beginning around 2013, a new powerful synthetic opioid began circulating, fentanyl, about 100 times more powerful than heroin. Drug dealers began selling fentanyl in combination with other drugs, like cutting heroin or cocaine with it, to increase their potency and profitably.

A drug dealer selling a kilogram, which is 2.2 pounds, of heroin, makes about $80,000 in profits, Madras said. A drug dealer selling a kilogram of fentanyl can stretch it into a $1.4 million profit, she said.

One kilogram of fentanyl cut up into lethal dosages can kill 500,000 people, she said.

Never accept pills or other medications from an acquaintance, friend or relative, because the source of the medication is unknown, Madras said. For example, people may have a pill marked “Xanax,” commonly used in short term management of anxiety disorders.

There are illegal drug manufacturers that could have produced the pill and added some grains of fentanyl to make it more potent.

“The president’s commission has called for the regulation of pill presses,” Madras said.