RI Releases Statewide Standards for Treating Overdose & Opioid Use in Hospitals

Thursday, March 09, 2017

 

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Governor Gina Raymond’s Overdose Prevention and Intervention Task Force released a set of statewide guidelines for treatment in hospitals on Wednesday. The guidelines are the first such guidelines in the country. “Ensuring that people who are living with the disease of addiction get the same high-quality care at hospitals and emergency departments throughout Rhode Island is essential to preventing overdoses and saving lives. My heart breaks for each and every person who has lost a loved one to this epidemic. We need to come together as families, as communities, and as a state to give people who are living with addictions the resources and support they need. Change is possible, healing is possible, and recovery is never out of reach,” said Raimondo. 

The Guidelines 

The standards establish a three-level system of categorization that defines each hospital and emergency department’s current capacity to treat opioid-use disorder. All emergency departments and hospitals in Rhode Island will be required to meet the criteria for Level 3 facilities. 

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As a facility’s capacity to treat opioid-use disorder develops, that facility can apply for a higher designation.

Hospitals and emergency departments will be categorized based on initial self-assessments and follow-up evaluations by the Rhode Island Department of Health (RIDOH) and the Rhode Island Department of Behavioral Healthcare, Developmental Disabilities, and Hospitals (BHDDH).

Requirements 

Sample requirements for a Level 3 facility (all Rhode Island emergency departments and hospitals):

  • Dispense naloxone to all patients at risk
  • Educate all patients who are prescribed opioids on safe storage and disposal
  • Provide comprehensive discharge planning to people who overdose
  • Screen all patients for substance-use disorder
  • Report all overdoses within 48 hours to RIDOH
  • Offer peer recovery support services

 

Sample requirement for a Level 2 facility:

  • Maintain capacity for the evaluation and treatment of opioid-use disorder

 

Sample requirement for a Level 1 facility:

  • Maintain a “Center of Excellence” where patients can receive buprenorphine treatment for opioid-use disorder

 

Development of Standards 

The standards were developed by members of Governor Raimondo’s Overdose Prevention and Intervention Task Force, which is co-chaired by Rebecca Boss, Acting Director of BHDDH, and Nicole Alexander-Scott, MD, MPH, Director of Health. The standards were also developed with input from hospitals and emergency departments throughout the state. Leadership from several hospitals, including Butler Hospital, the Miriam Hospital, and Kent Hospital, attended today’s Task Force meeting to show their support for the standards.

“The development of these standards by Governor Raimondo’s Overdose Prevention and Intervention Task Force will ensure that best practices in the treatment of opioid use disorder are replicated at Butler and at each hospital throughout Rhode Island. A public health issue as significant as the overdose crisis demands this kind of careful coordination throughout the state,” said Lawrence Price, MD, President and Chief Operating Officer of Butler Hospital. 

The complete standards, titled Levels of Care for Rhode Island Emergency Departments and Hospitals for Treating Overdose and Opioid Use Disorder, are available here. 

Drug Overdose in RI 

 At least 329 Rhode Islanders died of drug overdoses in 2016.

Approximately 57% of Rhode Island’s overdoses involved fentanyl, compared to 47% in 2015 and 35% in 2014.

 

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