Content warning: This article includes references to overdoses and substance use challenges.
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On Sept. 21, Providence Mayor Brett Smiley announced his Opioid Overdose Prevention Strategy, the most recent addition to a network of initiatives, organizations and researchers working to prevent overdoses in Rhode Island.
The City’s plan seeks to address the effects of the opioid overdose epidemic on Providence — “96 individuals lost their lives to opioid overdoses in 2022” and from “2017-2022, there were reports of over 3,000 non-fatal overdoses” within the City, according to the plan. To reduce such substance-related harms, the strategy aims to invoke five priorities — promotion, prevention, rescue and harm reduction, treatment and recovery — through a set of guiding principles that include advancing health equity and building out community capacity.
Samara Pinto, a communications associate for the Office of the Mayor, wrote in an email to The Herald that potential strategies for addressing substance use challenges include increased overdose education, naloxone availability and peer recovery support services.
The City’s new strategy embraces harm reduction: “We’ve focused on minimizing the focus of rushing to immediate abstinence and instead (are) focusing on how people can start by managing their use,” Pinto said.
Providence works on overdose prevention initiatives with both state- and community-based partners. The Mayor’s Coalition On Behavioral Health — which includes CODAC Behavioral Healthcare, Family Services of Rhode Island, the Providence and Pawtucket Housing Authorities, Rhode Island Department of Health Drug Overdose Prevention Program and more — was involved in developing the new plan.
At the state level, the Governor’s Overdose Task Force works to combat overdoses with a team of over 150 professionals and community members brought together at monthly meetings, according to PreventOverdoseRI. The task force’s 11 workgroups focus on different elements under the state’s four pillars: prevention, rescue and harm reduction, treatment and recovery.
Director Cathy Schultz spoke to the importance of community engagement in the task force’s work. “We really need to be out there in the community to see firsthand what is happening to be able to help to guide the amazing work that we’re trying to do within the task force,” Schultz said.
Stressing the importance of outreach teams involving people with lived experience, Schultz, who herself is in recovery, noted that such presence in local communities “has expanded tremendously”
Brandon Marshall, a professor of epidemiology at the University’s School of Public Health, the founding director of the People, Place & Health Collective and an expert advisor to both the state opioid settlement advisory committee and the state overdose task force, said “there is no silver bullet that will get us out of this overdose crisis. Any strategy needs to be comprehensive.”
“That is what the state plan does and I’m happy to see that’s what the city of Providence’s plan aims to do as well,” Marshall said, citing the state’s balanced focus on each of the four pillars of its strategy.
In his overview of the state’s policy changes, Marshall emphasized that “a lot of that policy change has come from the community of people who have lived experience and who bring that voice and their expertise to the challenge.”
Still, Marshall said that policy in Rhode Island overall is “missing an understanding of what the current needs are (and) what the current landscape is like,” because we “do not do enough to engage people who are actively using substances.”
Marshall also emphasized the importance of considering diverse and representative perspectives when crafting overdose prevention policy in general.
“We need to do better in engaging communities of color, people of color who are affected by overdose, people who don't necessarily speak English as their first language,” he added.
Roxxanne Newman, a research assistant at PPHC and community advocate, said that she feels the state’s policies have “swung way too far to harm reduction.”
Reflecting on her own experiences, Newman said that “whether it was going in and out of prison … homelessness … the violence that … happened to me on the streets,” the consequences associated with drug use made it so “I had no other choice but to basically die or get help.”
Newman believes overdose work needs “to come back to … a center where recovery and harm reduction come together and work together.”
Greater attention should also be paid to addressing a lack of resources, particularly housing, for women with children, as well as supporting those seeking employment and attempting to regain their driver's licenses, according to Newman.
Marshall’s research team will be evaluating the impact of Rhode Island’s incoming inaugural overdose prevention center “on people who use the facility and in the communities in which they are located, as they're implemented … in 2024,” he said.
Marshall added that his team spends significant time “engaging with stakeholders and policymakers to share the results of what we’ve learned to try to guide evidence-based policy change.”
This story has been updated for clarity.
Mikayla Kennedy is a Metro editor covering housing and transportation. They are a junior from New York City studying Political Science and Public Policy Economics.
