The Fix: Examining Rhode Island's Opioid Epidemic
Introduction
The Fix takes viewers inside Rhode Island’s opioid epidemic through the experiences of people who use drugs and the frontline workers responding to the crisis. Paramedics, harm reduction advocates, treatment providers, families, and people in recovery share their perspectives on overdose, addiction, and the challenges of helping people stay alive and access treatment.
The documentary also looks at the steps Rhode Island has taken to reduce opioid-related deaths, including harm reduction, peer recovery support in emergency departments, prescription drug monitoring, and continued treatment for people leaving incarceration. Alongside the realities of addiction and loss, The Fix highlights the progress being made and the people working to create more opportunities for recovery.
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Quotes
"Fentanyl – a highly potent opioid, which experts say is 100x stronger than morphine and 50x stronger than heroin, and drug dealers are mixing it with everything from pills to heroin, and even pot."
"From February 2016 to March 2018, there has been more than 900 emergency department visits for overdose in Providence alone. During that time, there were 3450 visits in Rhode Island for overdoses. To put that in perspective, that's an average of 129 visits a month or 4.2 every day."1
"Nobody wants to see people coming in with repeat overdose, but you can't let that frustration be present in your work. It's a matter of offering what we know is the right thing based on the best available evidence and research that we have and repeatedly offering it to them in hopes that every time it's building a bridge, and one day somebody will walk over it."
"Today I am a father, a son, and I am a boyfriend – just things that I have never dreamed of being in the past three years, I am."
"Within 30 days, he was completely hooked on prescription pills and not long after that he made the switch to heroin."
"I didn't want to be in denial. As much as you don't want to face it as a parent, you have to."
Recovery Efforts
"Another protocol of the Perry-Goldner Act is providing a peer recovery specialist in every emergency department across the state [of Rhode Island]."
"The Prescription Drug Monitoring Program is a means by which I can access recent prescriptions, generally for the past year, for patients I might consider prescribing opioids to. I can see if they have gotten other controlled substances … that might help me decide whether or not it is safe and appropriate to give someone an opioid prescription."
"RI Achieves 100% Enrollment in Prescription Drug Monitoring Program: One hundred percent of healthcare providers who are authorized to prescribe opioids and other potent medications are now enrolled in the state's prescription drug monitoring database, marking an important step in Rhode Island's work to prevent overdose deaths..."
"Our ultimate goal is to keep people alive long enough that they can get to the point where they are ready for sustained recovery. Recovery is a process that is often prolonged and often involves relapse, but people do recover from opioid dependence and do come out on the other side of that and do achieve sustained recovery. We want to give people the opportunity to achieve sustained recovery, and we do that by trying to keep them alive in the meantime."2,3
"When an inmate walks out the door, their treatment does not end. Discharge planners at Codac (the oldest and largest non-profit, outpatient provider of treatment for Opioid Use Disorder in Rhode Island) coordinate schedules and counselling so recovery continues without interruption. This helps with transportation to and from 7 locations so patients can receive treatment, and they also help with housing and even jobs."4
1 Rhode Island overdose surveillance data showed a dramatic rise in opioid-related emergency department visits throughout the 2010s, increasing from 417 opioid overdose ED visits in 2011 to 1,417 in 2016. Between 2014 and 2017, opioids were involved in 82% of overdose deaths in the state, while fentanyl-related deaths continued to rise sharply, accounting for 63% of overdose fatalities in 2017.
2 The National Institute on Drug Abuse (NIDA) notes that relapse rates for substance use disorders are comparable to those of other chronic medical conditions such as asthma and hypertension, emphasizing that addiction recovery often requires ongoing treatment, long-term management, and repeated support rather than a single intervention.
3 Addiction specialists often describe relapse as a gradual process that unfolds in three stages: emotional relapse, mental relapse, and physical relapse. Early warning signs—such as isolation, cravings, and romanticizing past substance use—can appear long before a person returns to drug use.
4 The period immediately following release from incarceration is associated with a significantly elevated risk of overdose, particularly for individuals with opioid use disorder who did not receive medication treatment while incarcerated. Research shows that continued access to medications for opioid use disorder (MOUD), discharge planning, housing support, transportation assistance, and uninterrupted treatment services can substantially reduce overdose deaths and improve long-term recovery outcomes after release.
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