Delivery of Care/Opinion

How do you tell the stories of 434 deaths in RI?

There were lots of data trends contained in the perverse metrics of the annual death toll of Rhode Islanders who lost their lives to the ongoing opioid epidemic in 2022 – but what was missing were the individual stories of the people’s lives.

Photo by Richard Asinof

The Overdose Task Force Meeting, held on Wednesday, June 14. From left: Cathy Schultz, Task Force Director, Ana Novais, Assistant Secretary, EOHHS, and [on screen] Heidi Weidele, Lead Fatal Overdose E;pidemiologist, R.I. Department of Health.

By Richard Asinof
Posted 6/19/23
The alleged “plateauing” of the annual overdose death rate in Rhode Island by “one less death” between 2021 and 2022 should not serve as a victory lap for Gov. Dan McKee.
Why can’t Gov. McKee give credit where credit is due – to RI Attorney General Neronha? How ironic was it that David Patten, director of DCAMM, demanded that a six-pack of ice-cold beer be provided to him at the start of his March 10 visit to Philadelphia? What are the metrics for the new text messaging campaign developed by Rachael Elmaleh and Ashley O’Shea, in response to increased overdose activity?
The coverage provided by WPRI reporter Matt Paddock of the Task Force meeting was more than commendable: Paddock pointed to the critical role played by the Attorney General, with visuals, even if the AG’s efforts were ignored by the Task Force. Paddock also included an interview with Linda Hurley, CEO of CODAC, who pointed to the lethality of the drugs now on the street as well as her organization’s efforts to create a fleet of mobile vans to meet people where they are.
Also commendable was the messaging from Cathy Schultz, the Task Force Director, who spoke at length about the importance of collaboration by all the colleagues who are working so hard on these difficult issues.

PROVIDENCE – There was something missing, ConvergenceRI realized, as he attempted to listen to the presentation of data trends and analyses surrounding the latest statistics detailing the number of accidental overdose deaths in 2022 in Rhode Island, which, at a total of 434, came in “one less” than the all-time high recorded in 2021, at 435 deaths.

The tortuous rationale for the apparent “plateau” in annual deaths – from 435 to 434 – was, according to the presentation by Heidi Weidele, MPH, the lead fatal overdose epidemiologist, Substance Use Epidemiology Program at the R.I. Department of Health, was that it could have been a lot worse, but the totals for the last six months of 2022 saw a decrease, compared to the first six months of 2022, of some 13 percent.

Here is how the news release explained the data:

• In 2022, 434 Rhode Islanders died of accidental overdose deaths, on par with data from 2021 [when 435 accidental overdose deaths occurred]. The number of drug overdose deaths in Rhode Island had been increasing since 2019, largely because of a more lethal drug supply locally and nationally. This plateauing in 2022 was the result of a significant reduction in the rate of overdose deaths in the second half of the year. There was an 13 percent decrease in overdose deaths between the first six months of 2022 and the second six months of 2022.

What was the cause of the decrease? The news release attempted to give credit to the McKee administration, which was a bit odd, given that the new resources – some $250 million in legal settlements – were the result of the legal interventions by R.I. Attorney General Peter Neronha and his team.

“With several new overdose prevention efforts now being managed or supported by the McKee Administration statewide, data released today by the R.I. Department of Health indicate that drug overdose deaths remained at crisis levels in Rhode Island in 2022, the news release claimed. “However, after increasing for years, the number of fatal overdoses did not increase from 2021.”

McKee’s “achy, breaky heart”
There was no subtlety involved in Gov. McKee attempting to take a victory lap in the news release, on the backs of those Rhode Islanders who had perished from drug overdoses in 2022.

“My heart breaks for each and every person who has lost a loved one to this epidemic. We owe it to the Rhode Islanders who have passed, and to their families, to do everything possible to prevent any additional overdose deaths,” said Gov. Dan McKee, in the news release. “We have many new interventions in place to respond to the dynamic nature of this crisis. We have to keep innovating and collaborating with our partners in the community to do everything we can to prevent overdoses, save lives, and improve the quality of life for Rhode Islanders.”

The problem with Gov. McKee’s quest to take credit for the annual reduction of one death is simply his apparent lack of sincerity and his unwillingness to connect his administration’s ongoing failure to address the breakdown of the safety net for those who are homeless or on the verge of homelessness, the ongoing breakdown of community mental health and behavioral health services in Rhode Island, and the lack of budgetary resources to increase the rates of Medicaid reimbursements for providers.

Zoom, zoom, zoom
The meeting of “Gov. Daneil J. McKee’s Overdose Task Force” started on time, at 11 a.m., and ended on time, at 12:30 p.m., coordinated by Assistant EOHHS Secretary Ana Novais, with most of the participants attending through Zoom.

It left little time for actual conversation and interactions between Task Force members, but they tried. The first questioner wanted to know about the role of alcohol as a contributing factor to overdoses, beyond the measurements for fentanyl, cocaine, xylazine, and methamphetamines. The questioner persisted, until he was cut off.

Another topic of discussion centered on the effectiveness of the strategies around the dispensing of naloxone, or Narcan. What wasn’t discussed was the dramatic intervention by Attorney General Neronha’s office in July of 2022, making sure that ample supplies of naloxone were provided as a result of legal settlements with Teva – which would seem to correlate with the 13 percent decrease in overdose deaths that occurred in the last six months of 2022.

Dr. Jody Rich, who has been a participant in the Task Force meetings for much of the last decade, attended in person. He attempted to frame the story as one where it was important to talk about the evolution of the epidemic – from addictive prescription painkillers to heroin to fentanyl and now to adulterated substances – but his remarks were cut short as the clock ran out on the meeting.

The need for recovery housing, however, was given plenty of time, marked by the personal appearance of Housing Secretary Stefan Pryor at the meeting. Imagine if the Task Force could have become the convergence point where Rich and Pryor engaged in a public debate, ConvergenceRI wondered.

The personal stories were missing, too
The most important possession that we own are our personal stories, and sharing those stories is what makes us human. The sense of connection between people is the antithesis to substance use disorders, which prey upon loneliness and pain – both physical and mental.

So, instead of data breaking down the percentages of how much fentanyl was involved in the overdose deaths – more than 80 percent in 2022, it would have been much more helpful to learn more about the people’s lives who had died – not by their demographic data, but their own stories. How many had been in recovery? How many lacked affordable housing? How many had been struggling with escaping domestic violence? How many had problems finding a job? How many had families who had struggled with alcohol abuse? How many had been poisoned by lead as a child?

Until there is an concerted effort to tell the stories of those who perished from overdoses – making their struggles visible and public – the stigma that surrounds substance use disorders will continue to claim a heavy toll of Rhode Islanders each year.

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