As the country continues to grapple with the impact of the opioid epidemic, the Pawtucket Central Falls Health Equity Zone is midway through a three-year program designed to address the high rates of overdose deaths in those communities. LISC, as the backbone agency supporting the work in the Health Equity Zone, worked with community members and experts to create a workable action plan to increase awareness, increase the availability of resources, and to de-stigmatize asking for help.
This year, to mark International Overdose Awareness Day on August 31, the HEZ led by its Substance Use and Mental Health Task Force partnered with Weber/RENEW in a community appreciation breakfast which featured panelist Governor Dan McKee, Providence Mayor Brett Smiley and LISC Rhode Island’s Liz Moreira. The coalition of partners held three candlelight vigils across the state and marked the day by distributing more than 5,000 boxes of lifesaving Narcan to the communities.
“Everyone’s life has been touched by the opioid epidemic,” said Liz Moreira, Assistant Program Officer at LISC Rhode Island. “While we’ve seen an increase in the understanding of the huge risk that Fentanyl presents, people are not aware of how insidious it is. And now there is a new concern about another drug in the communities.”
This new threat called Xylazine, also known as “tranq,” is a non-opioid drug commonly used for veterinary purposes which has been showing up more frequently in the illicit drug supply. To address the significant health challenges caused by Xylazine, Governors have begun to implement a variety of policy solutions, ranging from bolstering drug checking initiatives to scheduling Xylazine as a controlled substance at the state level.
“Xylazine is a particularly dangerous contaminant for several reasons,” said Moreira. “But most importantly, it is not an opioid, so opioid overdose reversal drugs such as naloxone, or Narcan, won’t work to pull someone out of an overdose. It’s still recommended to use the recovery treatment since often it's unclear just exactly what drug has been taken.”
The team created a video designed to increase awareness and provide the facts associated with opioid and Xylazine risks. Local leaders and trusted members of the community appeared in the video titled #StatingTheFacts and shared the message during the Overdose Awareness Day Breakfast. The 2:20 minute video is multilingual and designed to present the facts associated with Fentanyl, Xylazine and naloxone, without stigmatizing language or data-shaming.
“It was more important to educate viewers on this complex health issue,” said Moreira. “We asked trusted messengers and highly-recognizable members of the community, as well as people with lived experience, to just ‘state the facts.’”
According to the U.S. Drug Enforcement Administration’s (DEA) One Pill Can Kill Fentanyl Awareness Campaign, illicit opioid use is the number one cause of death of young adults. DEA lab testing reveals that six of every 10 fake prescription drugs contain more than a lethal dose of fentanyl than ever before.
Last year, the DEA seized more than 50.6 million fake prescription pills containing fentanyl, more than double the amount of fentanyl-containing pills seized in 2021. Data from the U.S. Center for Disease Control and Prevention (CDC) shows that two-thirds of deaths from drug poisoning in 2021 involved synthetic opioid-like fentanyl. During that same period of explosive growth, the RI Dept. of Health reports that the rate has remained consistent in Central Falls and Pawtucket, with only a small increase. The team’s goal is to cut that number by half.
“Any death – especially a preventable death – is too many,” said Moreira. “That’s why we’ve conducted anti- stigma trainings with residents, nurses, medical students, recovery workers, Emergency Management staff and others. We are working to deliver the “Words Matter” training to all police, fire, EMS and City Council members, so the facts around this issue are clear.”
Part of the strategy also involves delivering tutorials on Narcan administration and installing Naloxboxes in key areas throughout the community. The Youth Equity Leaders of the Pawtucket Central Falls Health Equity Zone participated in the International Overdose Awareness Day this year by delivering boxes of Narcan to community partners.
“One of the key goals of the Opioid Overdose Prevention plan is to involve the youth,” said Becki Marcus, LISC RI Assistant Program Officer. “And it was an initiative that our Youth Equity Leaders felt passionate about being involved in. We worked that day to go throughout the community to distribute supplies and educate the community on the issue.”
Together with other volunteers, the initiative delivered more than 5,000 Narcan kits across the state and surpassed their distribution goals by more than 30%. The crew in Pawtucket and Central Falls delivered kits to a variety of locations including convenience stores, barber shops, liquor stores and laundromats and distributed more than 2000 kits in one quarter, which fulfilled the goal for the entire year.
“The Youth were truly energized by this mission,” said Moreira. “We’re increasing our goals for Narcan distribution for year three.” Additional changes to milestone goals will include increasing the number of naloxone trainings delivered by the Substance Use and Mental Health Task Force.
There are some signs that the initiatives are having an impact. In the most recent reports from the Rhode Island Department of Health, they show level incidents. In an environment of exploding overdoses, those results offer some encouragement. In addition, the Department of Health tracks overdose spikes by community and found that there were no overdose spikes recorded in the second quarter of 2023, the latest quarter of available data.
“Opioid overdose is obviously a nationwide tragedy,” said Moreira, “but we are working to raise community voices to educate and provide the tools to address it.”
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