For the first time since 2023, the R.I. Department of Health in March issued a statewide overdose spike alert.
From March 10-16, the state health department recorded 55 nonfatal overdoses in Rhode Island, just reaching the threshold of overdoses needed to trigger the alert.
While a grim reminder of the public health crisis in the Ocean State, the alert doesn’t necessarily signal that Rhode Island is seeing more overdoses than two years ago. In the last few days of 2025, RIDOH launched a new portal, the Overdose Spike Alert System, which expands the range of substances tracked throughout the state.
Prior to rolling out the alert system, RIDOH’s overdose reporting was limited to opioids such as heroin and fentanyl under the now-retired Integrated Surveillance System. Reports now include overdoses caused by substances such as stimulants, benzodiazepines, prescription and over-the-counter drugs. The system also updates every 15 minutes, reduced from every 48 hours.
Due to the expanded range of substances tracked, RIDOH officials anticipated that, from day one, the Overdose Spike Alert System will show higher rates of overdoses compared with the Integrated Surveillance System.
So far, that’s proven accurate.
A week before the statewide notice, RIDOH issued regional overdose spike alerts for Burrillville, Cranston, Foster and Glocester. In mid-April, RIDOH released an alert for Providence after the city saw 20 nonfatal overdoses in one week, surpassing the regional threshold of 19.
While the increase in overdose alerts can be alarming to those unfamiliar with the new system, Alex Gautieri, assistant director of advocacy for Rhode Island Communities for Addiction Recovery Efforts Inc., or RICARES, says that the new influx of notices “just means that we’re better at detecting [overdoses] because we’re expanding the definition of overdose.”
Nonfatal overdoses in Rhode Island have actually decreased in recent years, according to ESSENCE [Electronic Surveillance for the Early Notification of Community-Based Epidemics], a countrywide surveillance system used by the U.S. Centers for Disease Control and Prevention. ESSENCE, which RIDOH uses for its own tracking system, reports data that hospitals automatically send based on emergency department visits.
Rhode Island emergency departments recorded 1,384 nonfatal overdoses in 2024, according to the federal database, down from 1,516 in 2023 and down from a seven-year high of 2,239 in 2019. Opioid-specific nonfatal overdoses have also declined in that period, steadily falling from 1,211 in 2019 to 593 in 2024. ESSENCE does not currently provide data for 2025 or 2026.
The updated portal won’t provide a truly comprehensive report, Gautieri said, noting that people who overdose and are treated in a non-emergency room setting, such as an ambulance, wouldn’t be reflected in the available statistics.
Linda Hurley, CEO and president of CODAC Behavioral Health, also highlighted this concern. With increased public distribution of naloxone, a drug that reverses an opioid overdose, Hurley says it’s likely that more overdoses go undetected by ESSENCE.
“There has been remarkable and wonderful proliferation of naloxone across the nation and in all communities,” Hurley said, “so it doesn’t always reach that [emergency department] level. There’s serious concern nationally that nonfatal overdoses may actually be increasing.”
But OSAS data is still an essential source of information for behavioral health providers and partner organizations, Hurley said. Representatives from these groups meet weekly to discuss the data, and when a community is experiencing a spike, or just below spike levels, public health leaders can take measures such as increasing naloxone distribution in impacted communities.
While it doesn’t catch all nonfatal overdoses, the Overdose Spike Alert System provides a significantly more accurate window into substance use prevalence in the Ocean State when compared with the old system, Gautieri said.
“It’s giving a more holistic picture of the drug supply right now,” he said. “Overdose isn’t just an opioid issue. We were missing a really big piece of the picture before.”
RIDOH reports fatal overdoses through its Opioid and Stimulant Use Data Hub. Though updated weekly, the department notes that the R.I. Office of State Medical Examiners takes up to 90 days to confirm that a death was caused by an overdose. Like overdose-related emergency department visits, fatal overdoses are also decreasing in Rhode Island.
Annemarie Beardsworth, RIDOH spokesperson, said that the broader range of substances tracked will help public health officials better tailor their efforts to fit the reality of the drug supply.
“When we have more specific information about what substances are causing overdoses, that information improves our situational awareness and helps us align our prevention, outreach and education efforts across the state,” Beardsworth said.
Gautieri also touted this benefit, adding that comprehensive data will better demonstrate that anyone can be impacted by substance use disorder.
“I think it will help keep moving the narrative forward that there are drugs in every community,” Gautieri said. “Sometimes there’s that NIMBYism of, ‘It’s not in my backyard, it’s not an issue in my family,’ or it’s only opioids.
“It’s not just concentrated in one area,” he said. “It’s not just a Providence issue ... so I think it will really dispel the myth that it’s not a ‘those people’ problem. It’s everyone’s problem.”
