An Update from The Rhode Island Department of Health

Spring 2018


Recently the Rhode Island Department of Health (RIDOH) announced that there was a four percent reduction in the number of overdose-related deaths from 2016 to 2017. This is a slight decrease in accidental overdose deaths, with 323 in 2017 compared to 336 in 2016. Given that many states throughout the country are still seeing increases, Rhode Island’s slight decrease offers some encouragement that our community partnerships and innovative initiatives are working. We will continue to build on this momentum in 2018, in honor of the many Rhode Islanders whose lives been affected by this crisis.

One initiative in particular has made an impact on the reduction of overdose deaths in our state.

In March 2017, RIDOH updated regulations on the prescribing of opioids for acute pain with the goal of reducing opioid dependence and accidental overdose. Implementation of these updated regulations followed the 2016 Food and Drug Administration (FDA) “black box” warnings for opioid prescription pain medications and benzodiazepines taken in combination. One key change to the regulations was that initial prescriptions for acute pain are limited to 20 doses and to no more than 30 Morphine Milligram Equivalents (MMEs) per day. Specifically, this applies to individuals who have not taken opioids within the last 30 days. These prescribing limitations do not apply to patients receiving opioids for chronic pain.

A reinforcement mechanism went into effect in July 2017 at Rhode Island pharmacies to help ensure compliance of these updated regulations. Simply put, if a pharmacist finds that a patient’s opioid prescription is not compliant with the updated regulations, the pharmacy’s computer system automatically prevents the prescription from being submitted for reimbursement. This success would not have been possible without the amazing support and dedication of statewide insurance companies and Pharmacy Benefit Managers (PBMs) who made significant investments in re-programming and re-coding of company databases and algorithms.

Thanks to our “PBM Champions,” Rhode Island is likely the first state in the nation to implement such a reinforcement mechanism at pharmacies, ensuring an added layer of compliance with these updated regulations. This is something that we all should be proud of!

Be a part of the solution and continue to use Rhode Island’s Prescription Drug Monitoring Program (PDMP) to monitor any patient who has received a prescription for opioids and/or benzodiazepines from any healthcare provider. Doing so will help avoid prescription diversion, misuse, and/or abuse.

Together, through the amazing work that happens every day, we are keeping Rhode Islanders healthy and safe. Thank you for your continued partnership.