Benjamin D. Hallowell

Rhode Island Department of Health

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Co-Authors

Brandon D. L. Marshall

Brown University

Laura C. Chambers

Rhode Island Department of Health

Rachel P. Scagos

Providence College

Francesca L. Beaudoin

Brown University

Mackenzie Daly

Providence College

Magdalena Cerdá

New York University

Elizabeth A. Samuels

Brown University

William C. Goedel

Brown University

Mona Saraiya

Centers for Disease Control and Prevention

Maxwell S. Krieger

Brown University

Cooperative Institutions

Centers for Disease Control and Prevention

157

Providence College

Rhode Island Department of Health

Brown University

National Center for Immunization and Respiratory Diseases

National Center for Emerging and Zoonotic Infectious Diseases

National Institutes of Health

Computer Emergency Response Team

Epidemic Intelligence Service

CDC Foundation

Author Statistics

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Accidental Drug Overdose Deaths in Rhode Island: January 1, 2016-December 31, 2022.

PubMed (2023)

Heidi R Weidele Justina Omari McClaren Rodríguez Benjamin D. Hallowell

Accidental

Drug overdose

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Citations (4)

Translating Predictive Analytics for Public Health Practice: A Case Study of Overdose Prevention in Rhode Island

American Journal of Epidemiology (2023)

Bennett Allen Daniel B. Neill Robert C. Schell Jennifer Ahern Benjamin D. Hallowell

Abstract Prior applications of machine learning to population health have relied on conventional model assessment criteria, limiting the utility of models as decision support tools for public health practitioners. To facilitate practitioners’ use of machine learning as a decision support tool for area-level intervention, we developed and applied 4 practice-based predictive model evaluation criteria (implementation capacity, preventive potential, health equity, and jurisdictional practicalities). We used a case study of overdose prevention in Rhode Island to illustrate how these criteria could inform public health practice and health equity promotion. We used Rhode Island overdose mortality records from January 2016–June 2020 (n = 1,408) and neighborhood-level US Census data. We employed 2 disparate machine learning models, Gaussian process and random forest, to illustrate the comparative utility of our criteria to guide interventions. Our models predicted 7.5%–36.4% of overdose deaths during the test period, illustrating the preventive potential of overdose interventions assuming 5%–20% statewide implementation capacities for neighborhood-level resource deployment. We describe the health equity implications of use of predictive modeling to guide interventions along the lines of urbanicity, racial/ethnic composition, and poverty. We then discuss considerations to complement predictive model evaluation criteria and inform the prevention and mitigation of spatially dynamic public health problems across the breadth of practice. This article is part of a Special Collection on Mental Health.

Public health surveillance

10.1093/aje/kwad119

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Citations (3)

Adapting to changing risk environments: examining overdose risk and socio-spatial patterns of unstably housed people who use drugs during converging public health crises

Drugs Education Prevention and Policy (2024)

Alexandra B. Collins Jacqueline Goldman Sarah Edwards Benjamin D. Hallowell Megan Smith

Background The COVID-19 pandemic exacerbated the US overdose crisis and disproportionately impacted unstably housed people who use drugs. Measures to address the pandemic within the context of crisis produced differential effects, particularly among people who use drugs. Examining how unstably housed people who use drugs adapted to shifting risk environments is imperative to responding to future crises.

10.1080/09687637.2024.2324977

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Citations (2)

Dispensed Opioid, Buprenorphine, Benzodiazepine, and Stimulant Prescriptions among Rhode Island Residents, 2017-2021.

PubMed (2023)

Taylor J Paiva Adam Z. Nitenson Dana Antinozzi Collette Onyejekwe James McDonald

The Rhode Island Prescription Drug Monitoring Program (PDMP) requires dispensers with an active Controlled Substance Registration to report Schedule II-V substances and opioid antagonists within 24 hours of dispensing. This database was designed to surveille diversion and identify high-risk prescribing to prevent drug related harms. Using PDMP data from January 1, 2017, to December 31, 2021, opioid, buprenorphine, stimulant, and benzodiazepine dispensing trends were explored. During this time, opioid prescriptions dispensed annually decreased by 27.3% (from 576,421 to 419,220), and benzodiazepine prescriptions dispensed annually decreased by 12.3% (552,430 to 484,496). High-risk prescribing also decreased with opioids prescriptions > 90 daily MME decreasing by 52.1% and instances of overlapping benzodiazepine and opioid prescriptions decreasing by 34.1%. Buprenorphine and stimulant dispensing have increased by 11.1% and 20.7%, respectively. Prevention interventions will continue to educate providers on appropriate prescribing practices and work to further reduce unnecessary prescribing within the state.

Stimulant

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Statewide Ketamine and Esketamine Prescribing Trends in Rhode Island, 2017-2023.

PubMed (2024)

Taylor J Paiva Benjamin D. Hallowell Staci A. Fischer Jeffrey Bratberg Kristen St. John

Ketamine is a versatile anesthetic that has been widely used off-label to treat a variety of indications. Esketamine, a derivative of ketamine, is FDA-approved to treat treatment-resistant depression. This report compares statewide prescription ketamine and esketamine trends. Using PDMP data from 2017-2023, prescription and prescriber characteristics, and patient demographics were compared between esketamine and ketamine prescriptions. During this time, ketamine prescriptions, patients, and providers rose 55.8%, 30.6%, and 2.8% since 2017. Esketamine prescriptions increased 1289.4% since 2019. In 2023, ketamine prescriptions were primarily in powder form (98.7%) and paid for out-of-pocket (83.9%), whereas esketamine prescriptions were primarily paid for by insurance (80.2%). The proportion of ketamine prescribed in RI but dispensed out-of-state have increased 22% since 2022 (18% of total dispensations). As more people seek treatment for mental health disorders, ketamine and esketamine prescriptions continue to rise. Understanding ketamine and esketamine use can help mitigate associated adverse events.

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Increased Stimulant Prescribing Following the COVID-19 Pandemic - Rhode Island, 2017-2021.

PubMed (2023)

Taylor J Paiva Kristen St. John Rachel Wightman Adam Z. Nitenson Collette Onyejekwe

Pandemic

Stimulant

2019-20 coronavirus outbreak

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Citations (2)

Cancer mortality rates among US and foreign-born individuals: United States 2005–2014

Preventive Medicine (2019)

Benjamin D. Hallowell Meheret Endeshaw Matthew T. McKenna Virginia Senkomago Hilda Razzaghi

Foreign born

Relative survival

10.1016/j.ypmed.2019.105755

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Citations (25)

Spatiotemporal analysis of the association between residential eviction and fatal overdose in Rhode Island

BMJ Public Health (2024)

Alexandra Skinner Yu Li Victoria Jent William C. Goedel Benjamin D. Hallowell

Objective Policy ramifications of the COVID-19 pandemic shape the concurrent housing and overdose crises in the USA. Housing insecurity is a known risk factor for overdose, yet how residential eviction may influence fatal overdose risk is understudied. We sought to evaluate the spatiotemporal relationship between neighbourhood-level residential eviction rates and overdose mortality in Rhode Island (RI) before and during a statewide eviction moratorium in response to COVID-19. Methods We conducted an ecological study at the census tract level in RI (N=240) by modelling the association between quintiles of eviction rates and fatal overdose rates from 2016 to 2021. We applied a Bayesian spatiotemporal approach using an integrated nested Laplace approximation and adjusted for an a priori determined set of time-varying demographic and policy covariates. Results Descriptively, we observed a direct, dose–response relationship between quintiles of eviction incidence rates over the full study period and fatal overdose. Prior to the implementation of a statewide eviction moratorium, census tracts in the highest eviction quintile had increased rates of overdose mortality, relative to those in the lowest quintile (posterior mean relative rate = 1.49, 95% credible interval: 1.05 to 2.13). Associations during the periods of eviction moratorium were non-significant. Conclusion This work highlights the neighbourhood-level relationship between residential eviction and fatal overdose risk in the absence of an eviction moratorium. Enhanced investment in eviction prevention policies, such as rent relief and limitations to the circumstances under which landlords can file for eviction, may complement harm reduction efforts to reduce neighbourhood-level overdose inequalities.

Eviction

Association (psychology)

10.1136/bmjph-2023-000756

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Citations (0)

Bystander Presence and Response During Accidental and Undetermined Drug Overdose Deaths: Rhode Island, January 1, 2016-December 31, 2021.

PubMed (2024)

Justina Omari Heidi R Weidele Benjamin D. Hallowell

With timely intervention from a bystander, drug overdose victims are more likely to survive. To characterize the frequency of bystander presence and identify overdose response barriers, we analyzed data from overdose fatalities occurring in Rhode Island from 2016 to 2021. Overall, about half (n=1,039; 48.7%) of all overdose deaths in Rhode Island had at least one bystander present. Among decedents who had at least one bystander who was unable to respond (n=338), top reasons of non-response were because they were spatially separated (64.8%), failed to recognize the signs of overdose (54.1%), or were unaware the victim was using drugs (40.2%). To promote by- stander presence and address barriers to bystander response during an overdose, intervention strategies should include efforts that reduce solitary drug use and maximize bystander efficacy, including increasing awareness on the dangers of using drugs alone, increasing the availability of naloxone, and education on recognizing signs of overdose.

Bystander effect

Drug overdose

Accidental

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Citations (0)

Neighborhood-level association between release from incarceration and fatal overdose, Rhode Island, 2016–2020

Drug and Alcohol Dependence (2023)

Abigail R. Cartus William C. Goedel Victoria Jent Alexandria Macmadu Claire Pratty

Drug overdose

Opioid Overdose

10.1016/j.drugalcdep.2023.109867

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Citations (2)