Drug Epidemic: RI Taking Lead with Emergency Treatment Standards

PROVIDENCE, RI—Rhode Island has new statewide standards for ER's and hospitals treating drug overdoses and opioid use.

These standards are the first in the nation, according to the health department.

According to the press release, "at least 329 Rhode Islanders died of drug overdoses in 2016. Although Rhode Island has seen a steady decline in the number of overdose deaths caused by prescription medication, the state has seen sharp increases in overdoses caused by the synthetic opioid fentanyl. In 2016, approximately 57% of Rhode Island’s overdoses involved fentanyl, compared to 47% in 2015 and 35% in 2014.

Under the new standards, Naloxone distribution, discharge planning, and opioid-use screenings are now required.

The requirement about comprehensive discharge planning stems from the 2016 Alexander C. Perry and Brandon Golder Law. Perry, the son of former State Sen. Rhoda Perry, and Brandon Goldner, son of Barbara and Brian Goldner, the CEO of Hasbro, had both visited emergency departments because of substance-use disorder issues prior to their fatal overdoses.

"The structure and support included in a discharge plan are intended to help an individual who has overdosed not do so again," the press release said. "For example, a discharge plan could include patient education, connection to a peer recovery specialist, contact with a primary care provider, and contact with the patient’s emergency contact."

Besides addressing treatment, the standards also set the basic criteria hospitals and ER's have to meet.

Sample requirements for a Level 3 facility (all Rhode Island emergency departments and hospitals):

• Dispense naloxone to all patients at risk
• Educate all patients who are prescribed opioids on safe storage and disposal
• Provide comprehensive discharge planning to people who overdose
• Screen all patients for substance-use disorder
• Report all overdoses within 48 hours to RIDOH
• Offer peer recovery support services

Sample requirement for a Level 2 facility:

• Maintain capacity for the evaluation and treatment of opioid-use disorder

Sample requirement for a Level 1 facility:

• Maintain a “Center of Excellence” where patients can receive buprenorphine treatment for opioid-use disorder

"The standards were developed by members of Governor Raimondo’s Overdose Prevention and Intervention Task Force, which is co-chaired by Rebecca Boss, Acting Director of BHDDH, and Nicole Alexander-Scott, MD, MPH, Director of Health. The standards were also developed with input from hospitals and emergency departments throughout the state.

"The complete standards, titled Levels of Care for Rhode Island Emergency Departments and Hospitals for Treating Overdose and Opioid Use Disorder, are available online.

"People can call 401-942-STOP to receive treatment and recovery support.

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