With a population of just over 20,000 people, Smithfield, Rhode Island, is a picturesque city located in historic Providence County. Rhode Island is in the news recently for not so glamorous reasons, however, as residents of the Ocean State abuse illicit drugs and marijuana more than residents of any other state in the nation, the Providence Journal reports. The Cranston Patch publishes that Rhode Island ranks fifth in the United States for drug problems and drug overdose deaths per capita.
Within Providence County, County Health Rankings indicate that residents suffer from frequent mental distress more than state averages (12 percent versus 11 percent) and also have a high rate of drug overdose and overdose mortality. There were 326 drug overdose deaths in Rhode Island in 2016, the Newport Mercury publishes, 57 percent of which involved the powerful and potent synthetic opioid fentanyl. The Naloxone and Overdose Prevention Education Program of Rhode Island, NOPE RI, reports that 75 percent of all drug overdose fatalities in Rhode Island involve a prescription opioid.
Residents of Rhode Island battle serious mental illness (SMI) at rates that are slightly higher than national averages (4.8 percent of the adult population per year between 2013 and 2014 versus a national average of 4.2 percent), the Behavioral Health Barometer: Rhode Island, 2015 publishes. In Rhode Island 7.7 percent of the adult population struggled with alcohol abuse or addiction per year between 2013 and 2014, compared to a national average of 6.5 percent. In addition, 3.4 percent of Rhode Island adults battled drug abuse or addiction as opposed to a national average of 2.6 percent.
In Smithfield specifically, the publication Rhode Island Community Profiles 2016 reports that mental health status and drug use concerns are about equal to the rest of the state on average. Treatment admissions between 2012 and 2014 were higher for alcohol in Smithfield when compared to the rest of Rhode Island (near 50 percent versus 40 percent for alcohol as the primary substance of abuse). Heroin and opiates were cited as the primary substance of abuse around 35 percent of the time in Smithfield and near 40 percent of the time across the state while treatment admissions for cocaine, marijuana, and other drugs were about the same for both (5-10 percent).
Rhode Island is doing work to address these issues. The state has a comprehensive plan in place to treat behavioral health issues and improve the quality of life of its residents.
Opioid Action Plan
In answer to the overwhelming number of Rhode Islanders battling opioid abuse and addiction and suffering from opioid overdoses, Governor Raimondo set up an Overdose Prevention and Intervention Task Force to address the public health crisis in 2015. The Task Force released Rhode Island’s Strategic Plan on Addiction and Overdose, which outlines four main strategies in an effort to reduce overdose deaths involving opioid drugs by one-third in three years. The four strategies include:
Preventative measures in Rhode Island include community-based services and also the resource Prevent Overdose RI, which provides a crisis hotline as well as important information on the opioid epidemic. The Rhode Island Prevention Network also hosts resources to help minimize opioid abuse, including information on local drug take-back days and permanent disposal sites for unused medications. Disposing of unused medications properly can keep these medications from being diverted and misused.
Rhode Island also has a Prescription Drug Monitoring Program (PDMP) in place to track the prescription of controlled substances, such as opioid painkillers and benzodiazepine sedatives – medications that are commonly abused and involved in fatal overdoses. The program requires prescribers to record prescriptions of these medications in order to recognize potentially harmful patterns of use. Opioid drugs also often have limits on how long they can be prescribed to deter addiction.
In July 2017, Governor Raimondo released an executive order addressing the fact that opioid overdoses continue to climb and expressing renewed efforts to combat this health concern. As part of the expanded preventative measures, a community and public outreach campaign is to be launched regarding the potential dangers of opioid drugs.
Within Rhode Island, residents can go to any Walgreens pharmacy (and many others as well) without a prescription and obtain the opioid antagonist regularly used to combat overdose, naloxone. Medicaid even covers the cost of naloxone, and medical providers can write a prescription for the drug as well. Often referred to as the “rescue drug,” naloxone helps to reverse a potentially life-threatening opioid overdose. The action plan and executive order both serve to increase access to naloxone and training on how to administer it. Treatment services for addiction and opioid abuse include connecting overdose survivors with peer support and recovery specialists as soon as possible after an incident.
Medication-assisted treatment programs are to be expanded in high-risk areas across Rhode Island under the executive order as well. Rhode Island also uses drug court programs to try and divert individuals into treatment programs instead of incarcerating them and law enforcement is working to increase efforts to reach individuals battling addiction prior to arrest as well. Rhode Island officials are also working to expand access to transitional housing, sober living environments, and community-based recovery services within the state as well.
Resources for Behavioral Health Care in Smithfield and Rhode Island
Mental health and addiction treatment programs are overseen and managed by the Rhode Island Department of Health (RIDOH), Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH). Mental healthcare is integrated, ensuring that all providers are working together and on the same page.
Addiction treatment is provided through licensed providers. Both public and private treatment options are available in Rhode Island, and public services may be provided for free or at a low cost for eligible individuals. Private treatment programs often accept health insurance to help with costs as well.
Treatment for mental health and addiction generally begins with a detailed assessment in order to determine the type and level of care that will be best suited for the individual person. After evaluation, treatment programs may include the following services:
- Outpatient programs
- Intensive outpatient programs (IOPs)
- Residential programs
- Medication management
- Co-occurring disorders treatment services
- Transitional services
- Recovery and aftercare programs
Within these programs, individuals will generally participate in group and individual counseling and therapy sessions, life skills training, relapse prevention and educational programs, and support groups. Services may be rendered on an outpatient basis where a person attends meetings and sessions around their existing schedule and obligations, or on a residential basis where a person remains on site for the duration of the program.
There are many resources for treatment and recovery within Rhode Island. Some of these include:
- Local crisis lines are published by the Rhode Island BHDDH for immediate help.
- Suicide prevention resources and hotline are hosted by the Samaritans of Rhode Island.
- An interactive map of participating pharmacies for obtaining naloxone without a prescription is hosted by NOPE- RI.
- RIDOH and BHDDH publish a brochure titled Addiction is a Disease, which lists local resources and recovery helplines within Rhode Island communities.
- The Substance Abuse and Mental Health Services Administration (SAMHSA) provides a Behavioral Health Treatment Services Locator where individuals can input their specific zip code and find programs nearby to accommodate their mental health and substance abuse concerns.
- Alcoholics Anonymous (AA) in Rhode Island details information on local self-help, 12-Step, and peer support group meetings around the Ocean State.
- The State of Rhode Island BHDDH provides information on substance use disorder services and prevention information.