jennifer.koziol@health.ri.gov

www.RecoveryFriendlyRI.com to learn more about Recovery Friendly Workplaces

Application and FAQ here: https://preventoverdoseri.org/10000-chances-project/

Here is the link to Hidden In Plain Sight Virtual,

https://www.riprevention.org/get-involved/

Thank you, Director Powers, for your ongoing support of the regional prevention coalitions and your leadership.

where can we find the social media posts? would love to repost anything throughout the month!

Connector LLC has recently released an online tool that can be used to gauge COVID-19 risk in groups without violating privacy or HIPAA rights. It gives individuals instant results as to their current COVID risk. We see it great tool for peers to use to engage people suffering from SUD by offering them a non SUD related service to break the ice. Please look it over at https://CovidTestConnector.com for more information and links to the tool.

Hi Shannon. Thanks for asking and for your willingness to share the social media posts. That content hasn't yet been developed. We will definitely send links to share via direct email and through the Task Force e-newsletter. If you need to get on our email distribution list, please reach out to Carol.Stone@health.ri.gov.

Was testing for/status of COVID-19 known for the decedents (2020)?

Hi In the dataset we used for the analysis, we did not know the status

HousingFirst model critical - house people without all the barriers and wrap around the services!

4x growth of ODs for people recieiving unemployment payments. How can we use DLT as a vehicle to deliver treatment & recovery support resources?

Yes!!!!

HousingFirst model, a harm-reduction model, has 85% success rate nationally

I have to weigh in on Peer Recovery Specialists and how critical they are; right now in particular. I represent DCYF CPS. While our call volume is down, our investigations primarily involve SUD, DV and other BH challenges. The number of overdoses and parents who have relapsed after years of recovery is compelling. The Peer Recovery Specialists working with Peter Slom are CRITICAL. They have life experience, child welfare experience and can speak to families in ways that we can not. They have been critical to our ability to engage families, help them to accept help, understand that we truly want to help and ultimately safety plan with us to avoid removing children from home. We need MORE...

I agree Stephanie with everything you said! We need more, a diverse group of peers are critical to put out the message - folks DO trust their peers

Yes Stephanie, excellent point!

The Family Task Force is recruiting family members to become Certified Family Recovery specialists

Were methadone deaths related to people in currently treatment ?strongly support overdose prevention site as a way to intervene, engage, and inform

There is a training in January that trains in the CRAFT methodology how it relates back to being a peer and the peer model.

The FTF has connected with BH Link so connect families with family Peers

Amen to that Marti!

Strategies to reduce wait time for treatment beds and recovery housing

We need rate increases for our providers so they can pay more and recruitment is key . Macdonald`s pays more.

Great job Marti and Kim and all your team members! This is great information!

If anyone is interested in taking the training, there is great description on the registration page. It is designed for professionals, peers and family members.

Great work folks

https://www.eventbrite.com/e/restallies-in-recovery-craft-based-training-jan-21-22-28-29-registration-129030771511

Thank you Marti and Kim!!

thank you Marti and Kim

More recovery housing is the best way to reduce wait time. Recovery housing is meant to be long term and stable, it’s not a quick stop on the recovery route. 18 months is the gold standard. More Oxford and more beds for long term residency. :)

Great work and leadership, Kim and Marti! This was a heavy lift and took a lot of time. Kudos to you for a job well done!

Really great to see this explicit emphasis on racial equity in this work. Thank you Marti and Kim!

Great job! A lot to work through and understand! Thanks for the hard work!

Really appreciate this deep dive and recommendations to improve the strategic direction of the Task Force. Thank you all!

Brilliant presentation!! Thanks, everyone, for all of your incredible work on this

A New Certified peer recovery specialist training scheduled shortly needs individuals to join to increase our diverse workforce. Please help by encouraging friends with 2 yrs or more in recovery to join the training and join our amazing workforce!

Great work, Marti and Kim! We appreciate your work so much!!

can people who have not gone through recovery themselves, but have had family members go through it be a peer recovery specialist?

Great Job Marti and Kim!

Great work Kim and Marti. Concise and a deep dive in areas that will help us move forward. Strong partners with housing colleagues and elected officials is critical to address this SDOH issue. It comes up all time with the HEZs and many other partners.

Hi Shannon - yes, people with experience supporting loved ones in recovery can be peer recovery specialists.

Given this analysis, Methadone deaths may be a good topic for the overdose fatality review team (ROAD) in the future.

@Mike Rizzi--that is a really important point! We know that abruptly stopping methadone is very high risk for fatal overdose. The overdose prevention imparted by methadone is huge.

I believe the overdose numbers are higher for people on MAT because they have to do more opiates to her the effects if they are on mat

*feel the effects

Lt. Justin Dutra, Cranston PD - The numbers compiled here at CPD based on call logs January - November, and have shown very similar statistics as far as the demographics but the total OD calls for services and OD deaths were slightly down here in Cranston opposed to last year. Any ideas as to why our numbers would indicate a decrease contrary to the overall increases we saw in this presentation?

Lt Dutra - one hypothesis is what Marti just mentioned: people may have been less willing to call for services broadly during this period, but that won't reduce (and actually may increase) overdose deaths

Good question Senator Miller

I’ve been compiling info about potential legislative changes to the Good Samaritan law. Please feel free to message or email me if you have ideas about things you would like to see changed (ayolken@weberrenew.org)

I believe there was a study done in Narcotics Anonymous.

We will be having a show on recovery radio on the good sam law

there are ongoing current rate issues for community treatment. I’m sorry to continue the conversation. and it is necessary. current decreased utilization and increased COVID related cost with insufficient rates is increasing the threat to comprehensive effective care. Does anyone know any initiatives to assist?

John is right about the pay

What percentage of the fatalities were previously diangosed with SUD?

Please define “medication-first treatment”

Medication first treatment was how someone described treatment that could begin as soon as someone said that they wanted it - no waiting for tox screens or insurance approvals

Tom, are you referring to safe supply? It is something that has proven to work in other parts of the world.

Medication First is a strategy being used in Missouri: https://www.nomodeaths.org/medication-first-implementation https://www.careinnovations.org/wp-content/uploads/MedicationFirstApproach_1pager-1-1.pdf

Thanks for the link, Liz! Fantastic recommendation

@Tom-great question! The presence of 4ANPP at deaths seems to suggest more precursors (which could be LESS potent fentanyl, as well as more inconsistent supply). That may mean more withdrawal, and more watered down drug supply....this could influence behavior and risk in important ways. We see a large increase in many and varied precursors in drug supply for fentanyl synthesis.

yes, what Jody says

@ Jonathan: for the Medicaid population, we see ~46% with an SUD diagnosis in 12 months before death for the 2019 group. For the 2020 group, it drops to ~43%.

I agree COVID has certainly had an impact, however it does not account for the rise that started in December, prior to COVID. So I don’t think loss of tolerance alone is responsible for the increase in deaths. Although may certainly play a roll since COVID.

Sounds like the HousingFirst model - remove barriers, focus on what the client says they need and want and wrap around the services backdoor

Yes it is based off Housing First!

One thing that may help on the supply side is to provide people more security while they use drugs. Overdose Prevention Centers can do that. Creating an environment where people don't have to worry about law enforcement harrassment as much by defelonizing possession. The environment in which people use impacts their ability to use more safely.

I also strongly support the recommendation to implement pilot overdose prevention sites

Absolutely Michelle. 100%

Agreed — drug testing at a place like an overdose prevention site would be helpful for users and for data collection so we have a better sense of what’s in the supply

looking forward to EOHHS support for Legislation or EO supporting a pilot overdose prevention site

Most definitely!!!!

I absolutely support!

Agree

Definitely support

Yes!

Yes!

Yes!

Definitely yes!

In support. Thank you, Marti and Kim

Yes!

In support!

In support

We do need to stop doing the same thing and expecting different results! Forward untried actions should be the next steps.

Yes, thanks

Very true Dr. Samuels the question is what happened or changed in December and January? Yes - Housing First is harm reduction for overdoses, SUD, mental health, removes barriers and addresses homelessness and unsheltered that has increased tremendously.

Yes in support

The information sharing at COVID testing sites is really interesting, Jonathan. Could provide information for economic support, mental health services, SUD treatment, harm reduction, etc. brilliant.

In support.

Great point Jonathan. Figuring out to provide recovery, harm reduction, treatment resources in more everyday settings is critical.

Fully support!!!

Yes, in support

In support

Yes, in support. And great ideas Jonathan to reach general public!

Yes, in full support

support totally

Thank Marti, Kim and the entire team that made this possible!

A specific request is getting law enforcement support for overdose prevention sites. We need to ensure they are not going to target these sites in order for them to operate safely.

Engaging with LatinX population and leveraging outreach efforts that we are doing due to COVID is another great way to reach them.

And always ask constituents to test anything we think we know!

Thank you Marti, Kim and your team for this deep data dive.

yes, very important to get law enforcement support!

EOHHS will work with the Gov's office and Task Force Co-chairs to move the work and recommendations to implementation! Thank you

Yes Dr. Rich!

Task force members have a task to help outreach to people of color to join our workforce team in order to diversify. It starts with us.

What Jody said!

Agreed. Portugal has demonstrated that it works!

Karen, Carol, target the uninsured

Yes!!

Yes!!!

Yes, Dr. Rich, so true, but I feel RI may be not as progressive!

I agree with Dr. Rich but RI is still behind on resoucres avail to those living with addiction

Thank you!!