“One Saturday, I was sitting in my office, and I got a call from Josh, saying ‘Have I got an idea for you,’” said Dean of the School of Public Health, Terrie Fox Wetle. During her introduction of Dr. Joshua Sharfstein, keynote speaker at Bridging Health Disparities to Address the Opioid Epidemic, a conference jointly sponsored by the Brown University School of Public Health and the Warren Alpert Medical School of Brown University, she recollected that Dr. Sharfstein inquired about “the names of good contact people here in Rhode Island to work on an idea he had for a multistate project to reduce opioid overdose deaths.” That ‘idea’ has since evolved into Rhode Island Governor Raimondo’s Overdose Prevention and Intervention Task Force, a collaborative effort to address the opioid epidemic that has been widely lauded as a model for other states.
In his keynote, Dr. Sharfstein explained that “when I called Fox, I knew I was calling someone who could make things happen.” Bridging Health Disparities to Address the Opioid Epidemic was borne out of the efforts of the Task Force, the School of Public Health, and the Alpert Medical School to curb the opioid overdose epidemic in Rhode Island, with a specific focus on how disparities compound opioid addiction and complicate treatment. Dr. Sharfstein, Associate Dean of Public Health Practice Training at the Johns Hopkins Bloomberg School of Public Health and former Commissioner of Health for Baltimore City, is a national leader in opioid addiction prevention and treatment. As he said in his keynote speech, “This event is so important because disparities still exist that make opioid treatment difficult.”
Rhode Island is certainly no stranger to the dangers of opioid addiction and overdose. In 2015 there were 258 opioid overdose deaths in the state, more than those due to homicide, motor vehicle accidents, and suicide, combined. This represents the 6th highest rate of opioid overdoses in the nation.
The epidemiology of opioid addiction is even more troubling considering that evidence-based treatments are available. Medication-assisted treatment for opioid addiction has been shown to be quite successful in curbing the risk of negative health outcomes, including overdose. Unfortunately however, only about 1 in 5 individuals struggling with an opioid addiction has access to treatment. As Dr. Sharfstein articulated, several barriers to health equity inhibit widespread uptake of prevention and treatment strategies. These include access to treatment, as well as the incidence of trauma, particularly in childhood, poverty, the stigma of treatment, and failures in the criminal justice system. Considering the influence of disparities on outcomes related to opioid addiction, the Task Force, the School of Public Health, and the Alpert Medical School have committed to a multi-level, lifespan approach to prevention and treatment.
Dr. Sharfstein’s keynote was followed by several smaller training sessions, including Local Efforts to Address the Opioid Crisis, led by Dr. Brandon Marshall, Associate Professor of Epidemiology and member of the Task Force Expert Team. Methadone Treatment in Prisons was led by Dr. Jody Rich, Professor of Epidemiology, member of the Task Force Expert Team, and Director of the Center for Prisoner Health and Human Rights. Dr. Marshall drilled into the specifics of the Task Force’s Strategic Plan, which has set empirical goals related to four areas: Prevention, Rescue, Treatment, and Recovery. The event also included poster presentations from community members and students from both the School of Public Health and the Alpert Medical School who are engaged in research related to opioid addiction and treatment.
The event was well attended by a diverse crowd; over 250 students, physicians, nurses, pharmacists, and community members were present to discuss the strategies currently being employed to tackle this epidemic in Rhode Island, and the challenges we face in the future. Event coordinators, including the School of Public Health, have already indicated a desire to make this event an annual gathering.