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Overdose Doesn’t Mean It’s Over: Rhode Island’s Response To The Opioid Crisis

Just weeks ago, Lily Rivera saved a life. On the corner of Peace and Broad in Providence, Rhode Island, Lily works at an agency that organizes outreach teams and provides education to high-risk populations struggling with opioid addiction.

“Every day is a different day,” Lily said. “Every day something new might happen. Somebody new comes in with different needs.”

On this one day, Lily was at the right place at the right time when she was walking through a park. She is trained to administer naloxone and carries it with her at all times. Naloxone is a medication designed to rapidly reverse opioid overdose effects. “I saw a need, and without hesitation, I immediately administered naloxone,” she said. “It’s like a weight off. I’ve seen people overdose and die. Saving a life gives you a surge of energy.” Lily was able to use her training and call 911 to get help.

Lily Rivera is making an impact in her community, along with many organizations who are working together to tackle the opioid epidemic. Photo: © Josh Behan / CDC Foundation

As a peer educator, Lily is reaching those in greatest need. “I just love the work because it’s me in reverse,” said Lily. “It’s my life in reverse. I try to let people know that I was there once.”

Lily has had her share of hardship and loss. She was saved years ago by naloxone, and this experience helped her get into recovery. She now uses her experience to help others. “I know what it’s like to be homeless and to lose loved ones,” she said. “We are peers, so they have trust in us as part of their support network.”

Lily is making an impact in her community, along with many organizations who are working together to tackle the opioid epidemic. As in Providence, the opioid crisis is hitting cities and towns across the country.

Each day, 130 people die of opioid overdoses throughout the United States. According to the Centers for Disease Control and Prevention (CDC), in just more than a year, emergency department visits for suspected opioid overdoses increased 30 percent. Communities are struggling with this surge of prescription opioid misuse, addiction and overdose.

The CDC Foundation is working with CDC to increase capacity for states to carry out opioid prevention and response activities and programs. Providing support to 12 states with the highest burden—from California to Rhode Island—the CDC Foundation is building capacity by providing resources, support and staffing to tackle the epidemic.

Overdose Doesn’t Mean It’s Over

Overdose Doesn’t Mean It’s Over is a new campaign, led by the Rhode Island Department of Health, with support from the CDC Foundation. Photo: © Josh Behan / CDC Foundation

The small state of Rhode Island is making a big impact in the opioid response. On buses, on the walls of pharmacies or through social media, a new campaign is sharing a simple message: Overdose Doesn’t Mean It’s Over. The goal is to share the lifesaving impact of naloxone and underscore how anyone can be involved in the opioid response. The new campaign, led by the Rhode Island Department of Health (RIDOH), is showing up throughout Providence, the state’s capital city, with support from the CDC Foundation.

“The saturation of the message through social media, TV, public transit and movie theaters will help normalize naloxone and reduce the stigma around overdose and substance use disorder,” said Jenn Koizol, drug overdose prevention program administrator, RIDOH.

The CDC Foundation, in partnership with CDC, is supporting RIDOH by building staff capacity and working with the team to develop critical messaging related to the opioid epidemic, including how to be a first responder with naloxone.

Central to the messaging is providing public access to naloxone, the non-addictive, lifesaving drug that can reverse the effects of an opioid overdose when it’s given in time. The idea of the campaign is to put naloxone within arm’s reach of need—to make carrying and administering naloxone a new first line of emergency care similar to the use of CPR, the Heimlich maneuver or an Epi-Pen.

“Thanks to the CDC Foundation, we were able to access critically important resources—intellectual, creative and entrepreneurial—to develop a campaign that truly informs Rhode Islanders about the importance of carrying naloxone to save a life,” said Rachael Elmaleh, communications manager, Drug Overdose Prevention Program, RIDOH.

To expand access to the medication and help destigmatize addiction, part of the campaign is pointing to Rhode Island’s innovative solution to making naloxone available outside a pharmacy—the NaloxBox.

What’s a NaloxBox?

Through a seed grant from RIDOH, the NaloxBox concept was initially created through an idea from a partnership with an emergency medicine physician from Lifespan, Inc., which is one of Rhode Island’s networks of health care providers, and an industrial design professor at the Rhode Island School of Design. RIDOH issued a call to action for new and innovative ideas, and this new product emerged. The NaloxBox is a wall-mounted box located in public places, gives bystanders the tools and instructions needed to help someone suffering from an overdose. Each box contains naloxone, a mask for assisting with rescue breathing, a pair of medical gloves and educational materials. Anyone can open the box and save a life.

“The NaloxBox is a community-based effort to counter a nationwide epidemic,” said Erin McDonough, program director of the Rhode Island Disaster Medical Assistance Team’s Medical Reserve Corps. “It treats the opioid overdose like the medical emergency that it is.”

RIDOH wants the NaloxBox to be seen in the same light as a fire extinguisher or defibrillator—a tool for survival in case of emergency. The NaloxBox not only facilitates rescues, but also plays a role in encouraging an open conversation about the opioid epidemic, thus serving as a way to disseminate information and link people to care.

The Rhode Island Disaster Medical Assistance Team, a nonprofit based in Providence, is now managing the operations of the NaloxBox. Individuals in addiction recovery are assembling and shipping the boxes, which are growing in demand as cities throughout the United States are investing in this innovative health intervention.

Partners in Rhode Island, like many organizations across the country, are looking for creative and innovative solutions to this epidemic. Multiple partners are coming together to meet the needs of the response.

The Power of Partnerships

In response to the national opioid overdose epidemic, CDC’s National Center for Injury Prevention and Control funded nine organizations, including the CDC Foundation. CDC is providing technical assistance and support to 48 states and the District of Columbia to address this public health crisis. States facing the highest burden needed further capacity building, including staffing and resources. Through this support, the CDC Foundation is working in partnership with state health departments in 12 states with the most need.

“Through CDC Foundation’s work with CDC, we are able to address the needs on a state-by-state basis, adding capacity where needed most,” said Turquoise Sidibe, MPH, CDC Foundation senior program officer. “CDC works with health departments and community-based organizations to improve data collection and implement evidence-based prevention strategies. We are proud to play a role in extending CDC’s work.”

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