Comprehensive Addiction Treatment in Rhode Island's Correctional Facilities Yields Dramatic Drop in Overdose Deaths

February 28, 2018 | ASTHO Staff

Gina M. Raimondo became the 75th governor of Rhode Island and the state’s first female governor on Jan. 6, 2015. She graduated magna cum laude from Harvard and later won a Rhodes Scholarship to Oxford University, where she earned a doctorate. Gov. Raimondo was also recognized by Fortune as one of the World’s 50 Greatest Leaders in 2016.

ASTHO spoke to Gov. Raimondo to learn more about a Rhode Island Department of Corrections initiative to help prevent and treat addiction among incarcerated individuals and other statewide efforts to combat the opioid epidemic.

Rhode Island is addressing the opioid overdose crisis with one goal in mind: to save lives. To help achieve this goal, Gov. Gina M. Raimondo launched a comprehensive set of initiatives to address the epidemic throughout the state. One of these initiatives is a program within the Rhode Island Department of Corrections (RIDOC) aimed at providing incarcerated individuals with the support and tools needed to prevent and treat addiction. Since its development in 2016, the RIDOC program has helped decrease post-incarceration overdose deaths by 61 percent. “As we continue to work to prevent overdoses and save lives throughout Rhode Island, we must use data to identify differences in health outcomes and be sure that treatment and care are in place when and where they are needed most. Addiction is a disease, and recovery is absolutely possible because of life-saving treatment programs like the one at RIDOC,” says Nicole Alexander-Scott, MD, MPH, director of the Rhode Island Department of Health.

ASTHO spoke with Gov. Raimondo to learn more about the RIDOC program and other statewide efforts to combat the opioid epidemic.

How does Rhode Island’s Adult Correctional Institute (ACI) program play a role in the state’s larger overdose response work?

People who were recently incarcerated, unfortunately, are among those at highest risk for an overdose. In Rhode Island, we’re proud to be the first state in the country to provide comprehensive treatment in our correctional system. A recent study in the Journal of the American Medical Association shows that as overdose deaths among the recently incarcerated dropped, that trend has contributed to an overall statewide decline in overdose deaths. Our top goal in fighting the opioid overdose crisis is to save lives. Doing that means getting tools and resources to places where they are going to have the greatest impact. I have hugged too many parents at too many funerals because of this overdose crisis. The best way for us to love and honor those we have lost is to do everything we can to prevent overdoses and save lives

What was a major challenge in implementing the ACI program? How did you overcome this challenge?

Identifying resources to put policies in place is a challenge for any leader, but this issue is an absolute priority for me. That’s why, in 2016, I included $2 million in new funding in our state budget to launch this first-in-the-nation comprehensive program that screens all Rhode Island inmates for opioid use disorder and provides access to medication-assisted treatment at the ACI. The ACI program was part of a comprehensive set of initiatives that we launched in Rhode Island to combat our addiction and overdose epidemic. Another one of our initiatives provides funding to support the creation of nine Centers of Excellence—treatment centers where people can go to get all the social and medical support they need on the road to recovery. My budget proposal for FY19 continues funding for these programs because, despite the progress we have made, there’s more work to do. Even one death is one too many.

How has Rhode Island used partnerships and collaboration to make this treatment program successful?

Collaboration has been critical to our overdose response work. This crisis is impacting every community throughout our state. We will only be able to overcome it by bringing in perspectives and expertise from throughout Rhode Island. The Overdose Prevention and Intervention Task Force that we formed in 2015 includes healthcare providers, law enforcement personnel, first responders, insurers, pharmacists, legislators, people in recovery, and families who have lost someone to an overdose, among others.

What advice do you have for other leaders doing overdose prevention work in their states?

I would tell leaders to be bold and not be afraid to follow the data. Our data in Rhode Island showed that people who were recently incarcerated were at an extremely high risk for overdose. Investing as much as we did in a treatment program in a prison system was a little unconventional, but we were not afraid to take action and we’re saving lives for that reason.