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Discussing fatal overdoses with RI's top doc

Public Health
By PHILIP EIL  |  March 5, 2014

WARNING SIGN A new Department of Health billboard.

Dr. Michael Fine gave Rhode Island a “B-” in his first-ever “State of the State’s Health” address at the State House on February 26. Standing in the lush House Lounge — a room lined with leather chairs, polished wood columns, and gold-framed oil paintings of past house speakers — the Department of Health Director ticked off the factors behind our state’s passing, if middling, bill of health.

Thanks to screening and treatment, instances of colorectal-, breast-, and prostate cancer are all on the decline in Rhode Island. So, too, is lung cancer, after widespread smoking cessation. (Fine wants to eliminate smoking in Rhode Island by 2030.) Meanwhile, hypertension, obesity, and diabetes are all on the rise in the Ocean State. So are cases of hepatitis C. And while statewide teen pregnancy rates are declining, in 2013, according to the United Health Foundation, nearly one in four Rhode Islanders reported no physical activity or exercise other than their regular job in the previous 30 days. “Too many of us are couch potatoes,” Fine said.

And then there are fatal overdoses. Over the past several years, ODs have surpassed motor vehicle accidents to become Rhode Island’s single largest cause of death from unintentional injury. Deaths from pharmaceutical drug ODs have dipped since then, but overall drug death rates are higher than ever. Over the first weekend of 2014, the Rhode Island state medical examiner reported 10 fatal drug intoxications. The next weekend, eight more people passed away from ODs.

This crisis was the subject of a conversation with Dr. Fine office at DOH headquarters on the Friday after his speech. Our conversation has been edited and condensed.

WHAT ARE THE LATEST FATAL OVERDOSE NUMBERS? Fifty, in the months of January and February. [Note: Since this interview took place, the number has risen to 55.] That’s about twice our normal rate. These are deaths that are happening in every community of Rhode Island. I think we have [deaths in] 18 or 19 communities, so not truly “every,” but all across Rhode Island.

It’s not concentrated in one place. It’s not one community, one ethnicity, one of anything. It’s one of everything. People from [age] 20 to 62. More men than women. More white than black. Its racial complexion basically matches the racial complexion of the state. So these are exactly our brothers and sisters and children and parents and spouses, husbands and wives. This is everybody.

Dr. Fine
SO WHAT DO WE DO WITH THIS INFORMATION? First of all, if you’re using, stop. And stop today. This is not a time to be using . . . illicit drugs. And nothing [that was] bought from a pharmacy [and not prescribed to you] should you be putting in your body at this point, because you don’t know what you’re getting. Some of what people are getting [is] killing them and killing them in pretty big numbers.


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