The Pulse: Overdose Task Force Puts Plan In Action; Narcan Funding?

Jan 21, 2016

A package of Narcan, available at most pharmacies in Rhode Island.
Credit Kristin Gourlay / RIPR

Hundreds of Rhode Islanders have died from drug overdoses this year – a number that has barely budged from last year, despite numerous state and other efforts to stop it. One of Governor Raimondo’s initiatives was to convene a task force to tackle this crisis. 

For this week’s The Pulse, Rhode Island Public Radio’s Kristin Gourlay speaks with news director Elisabeth Harrison about their progress, plus the trouble on the horizon for the state’s supply of Narcan, the overdose rescue drug.

  

Here's a transcript of their conversation.

ELISABETH: Kristin, welcome. So individuals, groups – lots of smaller efforts – have been dedicated to curbing this painkiller and heroin overdose epidemic. Some progress has been made, but hundreds of Rhode Islanders are still dying every year. Does a big government task force even have a chance making a dent in this problem?

KRISTIN: Well, I can tell you this: this task force is comprised of some nationally recognized researchers and clinicians. People like Dr. Traci Green, an epidemiologist, who’s been asked by the federal Centers for Disease Control to advise them on new guidelines for prescribing addictive painkillers. Also, the group is diverse – insurers, hospitals, treatment program providers, pharmacists, community advocates – they’re all at the table with different perspectives. And finally this task force has the blessing and powers of the governor to change some regulations if necessary. That’s different from previous efforts. So everyone I talk to seems pretty hopeful.

ELISABETH: So they recommended four basic avenues of attack: getting narcan – the overdose rescue drug – to anyone who might need it, expanding access to addiction treatment - and a couple of others. What part of their recommendations have been accomplished so far?

KRISTIN: There’s a group working on preventing opioid addiction in the first place, and part of their plan is to educate more doctors about how prescribe opioids safely and how to prescribe medications that help treat addicts – because we don’t have enough of those doctors, according to this group. They’ve made plans to link Rhode Island’s online prescription drug monitoring database to Massachusetts’ – and we’re already linked to Connecticut, so that should help dissuade people who doctor or pharmacy shop across state lines.

ELISABETH: Kristin Gourlay, going back to Narcan – that’s the rescue drug for people experiencing an overdose. It’s an injection in the arm or a nasal spray. And in seconds you can bring someone who’s overdosed back to life essentially. But there’s not enough of it available to certain distribution groups in the state now (although any Rhode Islander can buy it at a pharmacy without a prescription). What’s happening with the supply?

KRISTIN: This is a dilemma. There’s no single pot of money for buying narcan for Rhode island. There are a few small groups that distribute it for free, but they get donations and discounts. Some emergency departments distribute it, but not all. Anyone can buy Narcan at the pharmacy now, but it’s a prescription for yourself, covered by your insurance or paid out of pocket. But Elisabeth, consider this:  the person who’s overdosing isn’t always going to be able to use the narcan to revive him or herself. A friend or family member will have to. And there’s been some question about whether pharmacies will give a prescription to what they call a “third party.” State officials want to fix that issue – maybe by tweaking a regulation. And they want to distribute a kit to the highest risk populations – people who are being discharged from the emergency department, from jail, or who are in an opioid treatment program. How to pay for it – that’s the question. Insurance? Will they accept Medicaid reimbursement? Those are open questions.

ELISABETH: And what about the Department of Corrections – they’ve been giving out Narcan too, right?

KRISTIN: Right. A group called Protect Families First and PONI, or prevention overdose and naloxone intervention have been providing training for inmates on how to recorgnize an overdose and use narcan, but they’re at a stand-still for the moment. And advocates tell me that more kits will be needed this year than last year.But the Department of Corrections has an even bigger dilemma. Their supply of Narcan going to expire in March, and they have no budget for NARCAN. The state’s department of behavioral health may have some grant money to buy new kits for them. That’s critical, because people leaving prison are at higher risk of overdose than almost anyone else. 

ELISABETH: So it sounds like lots of activity happening – to fix regulations, propose legislation, mobilize advocates – to tackle this problem. We have just a minute left Kristin, what else is in this mix of interventions?

KRISTIN: A team of nearly five people have been hired by the health department to manage this program – that’s a sign I think of how seriously they take it. Their positions are mainly federally funded. One new hire’s job will be to visit doctors and educate them about safe painkiller prescribing, so people don’t get hooked in the first place. Also, lots of doctors are signing up for an upcoming training about prescribing drugs like Suboxone or methadone – these are medications that can help opioid addicts (people addicted to heroin or OxyContin, for example), stay sober. And soon the General Assembly will look at some of the group’s recommendations and figure out if there’s anything they need to do to make them stick or work better.