Tackling the Opioid Use Disorder crisis in Rhode Island. Attitudes of Black American Church Leaders toward Harm Reduction and Policy Implications for Intervention Models

Abstract

The drug overdose crisis is at an all-time high in the United States. Reports estimate that opioid overdoses have caused more than 600,000 deaths in the United States and Canada. Without an aggressive response intervention, the current death toll will double by the end of the decade. The proliferation of fentanyl has further heightened the spike in opioid overdose deaths among Black Americans, shifting the distribution of opioid overdose deaths back towards urban Black communities. As of 2019, Rhode Island had a markedly higher opioid overdose fatality rate of 23.3 per 100,000 compared with the national average of 15.5 per 100,000. From 2019 to 2020, the state recorded the highest increase in fatal overdoses among non-Hispanic Blacks compared to other racial and ethnic groups, with fentanyl being a primary driver of this disproportionate trend. To combat the crisis, the Rhode Island government passed legislation for a two-year pilot program for harm reduction centers, effective March 1, 2022. Further, the Rhode Island government has embraced Connecticut's successful Imani Breakthrough Recovery Intervention program, based in churches of color, to mitigate the opioid use disorder (OUD) crisis disproportionately affecting the Black American community. Despite assumptions to the contrary, qualitative analyses of 30 Black Rhode Island church leader interviews reveal that Black American clergy are, in fact, medically and scientifically knowledgeable about OUD. Furthermore, church leaders and the church community are poised to help address the profound issues of meaning, purpose, and identity, which allow people with OUD to live and flourish beyond medical interventions, which only keep people alive. There are opportunities for greater collaboration from church leaders, state agencies, and the medical community to provide holistic intervention and policy approaches in the OUD for the Black American community. This thesis adds to the evolving line of research at the intersection of faith and medical science in mitigating the opioid overdose epidemic.