The overall goal of the Rhode Island 2022 FR CARA Project is to reduce overdose deaths and increase warm handoff referrals to treatment and recovery support. Project staff will work with EMS and Law Enforcement to fortify existing partnerships to achieve this target. In addition, we aim to establish Leave-Behind programs, safe station programs, and Mobile Integrated Healthcare / Community Paramedicine (MIH-CP) programs across the state. Finally, the project staff seeks to develop and implement evidence-based training, leverage the First Responder Workgroup, and establish data processes, protocols, and mechanisms that facilitate program surveillance.
Accidental drug overdose deaths have affected every community across Rhode Island. The population of focus for this project is first responders in Rhode Island with the intent of equipping them with naloxone, training, and tools to respond to those vulnerable to the opioid overdose epidemic and who have had an instance of overdose. First responders have an active role in addressing the overdose crisis in Rhode Island. In 2021, Emergency Medical Services (EMS) practitioners responded to 1,822 non-fatal opioid overdose-related emergencies, and Law Enforcement Officers (LEOs) responded and administered naloxone on 260 occasions. When LEOs responded, they administered 412 doses of naloxone and saw improvement in 207 (77%) of the cases.
EMS and Law Enforcement officers responded to primarily white males between the ages of 25 and 64, with the majority between 35 and 44. However, our surveillance team has seen overdose death rates for Black and Hispanic Rhode Islanders increase over the last few years. From 2018 to 2020, Black Rhode Islanders' overdose death rates increased from 29.9 to 53.9, compared to 18.4 to 27.2 in Hispanic Rhode Islanders and 29.8 to 39.2 in White Rhode Islanders. Unfortunately, despite the best efforts and amidst a pandemic, Rhode Islanders are still dying of overdoses. As of March 10, 2022, 420 individuals died of an accidental drug overdose in Rhode Island in the calendar year 2021. Therefore, we promote enhancing the first responder's role in preventing overdose deaths. We have seen over the years that equipping first responders with naloxone, enhancing their training, and encouraging them to refer patients to recovery and treatment services have resulted in a positive impact.
The project has five goals, each addressing a key requirement: access to naloxone, access to training, access to mechanisms for referral, access to an advisory leadership, and access to quality data. The project aims to train 3,000 EMS practitioners and refer approximately 900 suspected overdose patients to recovery and treatment services. In addition, the project aims to establish at least ten MIH-CP programs, ten new Safe Stations, and ten new leave behind programs across the state.