Rhode Island's Response to the Overdose Crisis

Growing up, you watched the opioid epidemic tear through your community. Can you tell us more about your experience?

Yes, I'm originally from West Virginia, and as some of your listeners may know, West Virginia has really been at the epicenter of the overdose crisis in the U.S. Much of the burden of overdose is actually in southern West Virginia, which is where I grew up. The opioid epidemic and the overdose crisis just felt so pervasive.

I remember my mom would read the newspaper—back when people had print newspapers—and look at the obituaries because, I’m from a really small town, so often you knew the people who were listed in the papers. And over and over again, you would see people in their forties, their thirties, and their twenties listed as having died of natural causes. There's a great deal of stigma, of course, and the actual cause of death of overdose was rarely if ever listed.

I also had several friends and some family members who had opioid use disorder. So I feel like I definitely saw some of these struggles firsthand as well.

How would you explain the impact to someone who is unfamiliar with opioid use disorder?

I would say that regardless of someone's path to a substance use disorder, that people who use drugs are people. 

And it's a disease like any other.

Exactly. We don't bat an eye when someone has diabetes or heart disease or anything else. So I think the moralizing around substance use is something I'd really love to see change over the course of my lifetime.

One of my earliest research experiences was conducting interviews with people who used drugs in my hometown. And that experience was so fulfilling because I had the opportunity to chat with people in my community, and talked with them about how they use, what they use, what their safer use strategies were and about the resources that they needed to keep themselves safe. At that time, there was very little naloxone availability in that region of the state and having the opportunity to talk with people from my own community and to build the evidence for expanding access to resources for my own community was really incredible.

So let’s get back to the overdose prevention center here in Rhode Island—you conducted a research study about the community response, right?

Members of our research team went to the community and knocked on doors, entered businesses and spoke with pedestrians in the area. We interviewed people who were over the age of 18 and who lived or worked in the neighborhood of the OPC. And we asked them for their perspectives.

We found overall that 74% of the people we spoke with supported an OPC opening in their neighborhood. And an even greater proportion, 81%, supported an OPC in the opening in another neighborhood in the city.

Did that surprise you?

I was pleasantly surprised to see the high levels of community acceptability, although I would say that this research contributes to a growing body of research that communities are broadly accepting of OPCs in their neighborhood.

How does this compare to what politicians are saying about OPCs?

I think that a lot of politicians cite a lack of community support for OPCs as their personal reason for being in opposition to it. And this really stands in contrast to that narrative. We found that broadly this community was very supportive of an OPC opening in their neighborhood.

The center only opened in January, so it's early, but are there any initial findings or any information you can tell us about how things are going? 

I don't have any initial findings, but I can say from speaking with some of the folks who operate the OPC that things are going about as smoothly as you could imagine. I'm really happy to hear that they've been continuing to enroll clients in the program and that everything seems to be going really, really well, which is awesome.

What do you think is the future for overdose prevention centers? There are only three in the U.S. now. Can we expect more in the future?

That's a great question. And I think that the findings from this research will essentially be guiding that outcome. So if we find that overdose prevention centers are associated with reductions in overdose and better health outcomes for people who use drugs, without any adverse community effects, I think that other communities will be eager to replicate these programs nationwide.

What's your message to people who are hearing about these overdose prevention centers and maybe might not know a lot about them? Why is this work important?

Well, first I would like to emphatically encourage folks who would like to learn more about OPCs to go to opcinfo.org. Our team at the PPHC helped to pull this resource together and it provides loads of information about what the research says about overdose prevention centers. I think it's a really wonderful resource for folks who'd like to learn more. And I would say that OPCs provide a safe space for people to use drugs, and right now people are using in spaces that are really unsafe and in situations that are unsafe. So if we can help keep more people alive, that's the dream.