Influence of a Pandemic on an Epidemic: A Population-Based Ecological Study of the Association Between COVID-19 Diagnoses and Drug Overdose Deaths in Rhode Island, 2023.

Objectives: In Rhode Island, drug overdose deaths increased by 28% in the first 6 months of the COVID-19 pandemic in 2020 as compared with the previous year (2019), mirroring national trends. We explored how the spatial distribution of overdose deaths overlapped with that of COVID-19 cases to identify levels and increased prevalence of these health issues among census tracts in Rhode Island.

Methods: We used data from the Rhode Island Department of Health and the US Census Bureau to calculate annualized COVID-19 case rates (from March 20, 2020, through December 31, 2021) and unintentional overdose death rates by census tract (from January 1, 2018, through December 31, 2021).

Bystander Presence and Naloxone Administration During Fatal Opioid-involved Overdoses in Rhode Island: Implications for Naloxone Coverage Among Families and Peers.

Objective: This study investigated community bystander presence and naloxone administrations by location type during accidental fatal opioid-involved overdoses in Rhode Island.

Methods: We analyzed accidental opioid-involved overdose fatalities among adults in Rhode Island between 2020 and 2022, obtained from the State's Unintentional Drug Overdose Reporting System (SUDORS). Variables of interest included location of death, community bystander presence, and naloxone administration.

Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island.

Objective: Policy ramifications of the COVID-19 pandemic shape the concurrent housing and overdose crises in the USA. Housing insecurity is a known risk factor for overdose, yet how residential eviction may influence fatal overdose risk is understudied. We sought to evaluate the spatiotemporal relationship between neighbourhood-level residential eviction rates and overdose mortality in Rhode Island (RI) before and during a statewide eviction moratorium in response to COVID-19.

Time-space characteristics of emergency medical service attendance and layperson naloxone administration during non-fatal opioid overdoses in Rhode Island: A retrospective, event-level analysis.

Purpose: As the opioid overdose crisis worsens in the United States (U.S.), emerging scholarship has uncovered time-and-place variations in substance use and overdose response efforts in community settings.

Enhanced Emergency Medical Services Case Definition to Identify Suspected Nonfatal Opioid Overdose-Related Incidents in Rhode Island.

Objectives: To improve rapid detection and response to spikes in suspected nonfatal opioid overdoses in the community, the Rhode Island Department of Health (RIDOH) sought to modify its case definition to align with newly released guidance from the Council of State and Territorial Epidemiologists (CSTE).

Methods: RIDOH used CSTE guidance to create 2 alternative criteria (CSTE-guided and RIDOH-modified CSTE) to replace one of RIDOH's original criteria. We gathered emergency medical services (EMS) records from 4 months in 2022 to determine whether they met any criteria, and we reviewed them to determine the accuracy of identifying an opioid overdose.

Statewide Trends in Medications for Opioid Use Disorder Utilization in Rhode Island, United States, 2017-2023.

Background: Buprenorphine and methadone are US Food and Drug Administration-approved medications for opioid use disorder (MOUD). Although utilization of MOUD was increasing pre-COVID-19, it is not well understood how this trend shifted during and "after" the COVID-19 pandemic in Rhode Island. This analysis will consider the differential utilization of MOUD over time and by key demographic factors.

Engagement in substance use disorder treatment after an emergency department visit among persons at high risk of opioid overdose: A prediction analysis.

Background: Certified peer recovery specialists (CPRS) and licensed clinical social workers (LCSWs) can facilitate substance use disorder (SUD) treatment engagement for emergency department (ED) patients at risk for overdose. Predictors of treatment engagement after such behavioral services are unknown.

Methods: This secondary analysis included Rhode Island ED patients at high risk for opioid overdose participating in a randomized controlled trial comparing the effectiveness of CPRS and LCSWs services (2018-2021).

Statewide Ketamine and Esketamine Prescribing Trends in Rhode Island, 2017-2023.

Ketamine is a versatile anesthetic that has been widely used off-label to treat a variety of indications. Esketamine, a derivative of ketamine, is FDA-approved to treat treatment-resistant depression. This report compares statewide prescription ketamine and esketamine trends.

Effect of a peer-led emergency department behavioral intervention on non-fatal opioid overdose: 18-month outcome in the Navigator randomized controlled trial.

Background And Aims: Emergency departments (EDs) provide an opportunity to identify people at risk of overdose and reduce the risk. We evaluated the effect of an ED behavioral intervention delivered by peer recovery support specialists (PRSSs) on non-fatal opioid overdose.

Design: Two-arm, randomized trial.

Trends in recurrent overdose and treatment initiation following emergency department visits for opioid overdose between 2016 and 2021.

Background: Overdose remains a pressing public health concern in the United States, particularly with the emergence of fentanyl and other potent synthetic opioids in the drug supply. We evaluated trends in recurrent overdose and opioid use disorder (OUD) treatment initiation following emergency department (ED) visits for opioid overdose to inform response efforts.

Methods: This retrospective cohort study used electronic health record and statewide administrative data from Rhode Island residents who visited EDs for opioid overdose between July 1, 2016, and June 30, 2021, a period with fentanyl predominance in the local drug supply.

Association Between Emergency Department Operational Metrics and Substance Use Disorder Treatment Interest in Two Rhode Island Hospitals.

Objective: This study examined if emergency department (ED) operational metrics, such as wait time or length of stay, are associated with interest in substance use disorder (SUD) treatment referral among patients at high risk of opioid overdose.

Methods: In this observational study, 648 ED patients at high risk of opioid overdose completed a baseline questionnaire. Operational metrics were summarized using electronic health record data.

Buprenorphine prescribing and treatment accessibility in response to regulation changes due to the COVID-19 public health emergency.

Background: In 2021, over 80,000 fatal overdoses occurred in the United States. Since 2020, the federal government has enacted multiple regulatory changes around buprenorphine prescribing for opioid use disorder (OUD) to increase access to buprenorphine. This study aims to explore trends in buprenorphine treatment initiation pre- and post-public health emergency to evaluate changes in the context of X-waiver relaxations and telehealth allowances.

Bystander Presence and Response During Accidental and Undetermined Drug Overdose Deaths: Rhode Island, January 1, 2016-December 31, 2021.

With timely intervention from a bystander, drug overdose victims are more likely to survive. To characterize the frequency of bystander presence and identify overdose response barriers, we analyzed data from overdose fatalities occurring in Rhode Island from 2016 to 2021. Overall, about half (n=1,039; 48.

Public Health Dashboards in Overdose Prevention: The Rhode Island Approach to Public Health Data Literacy, Partnerships, and Action.

As the field of public health rises to the demands of real-time surveillance and rapid data-sharing needs in a postpandemic world, it is time to examine our approaches to the dissemination and accessibility of such data. Distinct challenges exist when working to develop a shared public health language and narratives based on data. It requires that we assess our understanding of public health data literacy, revisit our approach to communication and engagement, and continuously evaluate our impact and relevance.

PROVIDENT: Development and Validation of a Machine Learning Model to Predict Neighborhood-level Overdose Risk in Rhode Island.

Background: Drug overdose persists as a leading cause of death in the United States, but resources to address it remain limited. As a result, health authorities must consider where to allocate scarce resources within their jurisdictions. Machine learning offers a strategy to identify areas with increased future overdose risk to proactively allocate overdose prevention resources.

Differences in Substance Use and Harm Reduction Practices by Race and Ethnicity: Rhode Island Harm Reduction Surveillance System, 2021-2022.

Context: In the United States, minority populations are disproportionately affected by the overdose epidemic, have higher mortality rates, and unequal access to harm reduction and treatment services.

Objective: This analysis aims to better understand harm reduction utilization and substance use patterns among minority populations to improve overdose outreach and prevention initiatives in Rhode Island.

Design: The present analysis used data from the Harm Reduction Surveillance System from January 2021 to December 2022 (N = 393).

"I Don't Go Overboard": Perceptions of Overdose Risk and Risk Reduction Strategies among People Who Use Drugs in Rhode Island.

: North America experiencing an unprecedented overdose epidemic, with data estimating almost 110,000 overdose deaths occurring in 2022 in the United States (US). To address fatal overdoses in the US, community organizations and local health departments in some jurisdictions have expanded community distribution of naloxone, and increased overdose prevention education, and other harm reduction supplies and services (e.g.

Association between comorbid chronic pain or prior hospitalization for mental illness and substance use treatment among a cohort at high risk of opioid overdose.

Introduction: Chronic pain and serious mental illness increase risk of opioid use, and opioid use can exacerbate both conditions. Substance use disorder (SUD) treatment can be lifesaving, but chronic pain and serious mental illness may make recovery challenging. We evaluated the association between current chronic pain and prior hospitalization for mental illness and 90-day SUD treatment engagement, among emergency department (ED) patients at high risk of opioid overdose.

Correlates of healthcare-seeking behavior for acute gastroenteritis-United States, October 1, 2016 -September 30, 2017.

Background: In the United States, public health surveillance systems often underestimate the burden of acute gastroenteritis (AGE) because they only identify disease among those who interact with the healthcare system.

Objective: To identify factors associated with healthcare-seeking behavior among individuals experiencing community-acquired AGE.

Methods: From October 2016 -September 2017, we conducted a weekly, age-stratified, random sample of Kaiser Permanente Northwest members located in northwest Oregon and southwest Washington, United States.