Rewrite this title RI uses political campaign strategy to fight overdose epidemic

PROVIDENCE, R.I. (WPRI) — The last time Zach Kenyon used naloxone to rip someone back from the edge of a fatal drug overdose, he wasn’t even working.

The Providence Fire Department EMS chief was on his way home from work when he came across a car crash. The driver was slumped across the wheel, so he stopped, grabbed his personal supply of the life-saving nasal spray — often referred to by the brand name, Narcan — and revived the dying driver.

“You’ll have somebody who’s pretty much dead in front of your eyes, turning purple, not breathing, and you administer naloxone … within minutes, the person is breathing, sitting up and talking to you,” he told Target 12. “It truly is an amazing event.”

Naloxone has been a lynchpin in the yearslong fight against the opioid epidemic, which has fueled overdose deaths totaling at least 860 Rhode Islanders in 2021 and 2022.

“Just to put that in perspective, that means more than one Rhode Islander every single day is dying of a drug overdose,” R.I. Department of Health spokesperson Joseph Wendelken said.

Emergency responders are confident the death toll would be far greater if not for naloxone. In 2022, Providence firefighters and police responded to about 1,100 overdoses and administered naloxone at least 600 times, according to data provided to Target 12. So far in 2023, the first responders have administered the drug more than 260 times.

To build off the ongoing public health response, state officials this year have launched a new initiative aimed at getting more private citizens to carry naloxone with them personally. The officials argue greater prevalence of naloxone in the community will only increase the possibility of saving lives.

In January, the health department used a federal grant to hire Systems Change Strategies to target regions of the state where overdoses are surging. They then send text messages to people in those areas, both warning them of the public health threat and encouraging them to request naloxone.

“Naloxone is available,” Wendelken said, highlighting that it’s free to request online and available at pharmacies, where clerks will show recipients how to use the nasal spray. (The process is the same as administering nasal spray for allergies.)

In April, health officials sent texts to about 74,000 cellphone carriers in Providence, Johnston and North Providence, an effort that cost about $17,000. Health officials argue it was well-worth the money, as they subsequently received 166 requests for naloxone.

The officials also point to North Kingstown where they had only received one request for naloxone in January. After an alert went out in mid-February, the Health Department reported receiving 50 requests from the one community.

“You can just go online and you can request it,” Wendelken said. (The text messages come with a link where people can sign up for naloxone, similarly to signing up for free COVID-19 tests.)

The direct messaging strategy isn’t new. It’s borrowed from a tactic used in political campaigns, who pay for cellphone data in a specific region or ZIP code so they can drum up votes and money.

Health officials took the campaign idea and adapted it to public health, which Wendelken argued it’s especially helpful when trying to reach people directly, as 82% of overdose deaths happen inside private residences.

“I carry it in my personal vehicle,” Kenyon said, adding his wife and family members also carry it. “I’ve gotten my daughters to carry it in their personal vehicles.”

It’s too early to know whether the new initiative will save lives, as the state is still finalizing its overdose death data through the first four months of the year. And even if it is effective, health officials and emergency responders know they have to remain nimble in the fight against drug overdoses, as the public health threat is constantly evolving.

Kenyon said his team is increasingly seeing an emerging drug — known as Xylazine — popping up on the street more often, which is getting mixed with fentanyl. Naloxone — designed to combat opioids — doesn’t work on Xylazine, which is a tranquilizer that veterinarians use for large animals including horses.

Regardless, Kenyon said it’s critical people always try to use naloxone when they see someone overdosing, as it’s nearly impossible to know what’s causing the deadly reaction. Naloxone is also safe to administer, even if it doesn’t revive someone.

“If you give it and it’s not an overdose, you’re not going to harm somebody,” he said.