Opioid Overdose Case Report Form - Department of Health - RI.gov - s3 documentcloud 2026

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The document provides instructions for submitting an Opioid Overdose Case Report Form to the Rhode Island Department of Health. It outlines the objective of collecting data on suspected opioid poisoning cases, details the required patient and overdose information, and specifies reporting guidelines for emergency departments. The form includes sections for patient demographics, overdose specifics, and referral options.

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Click ‘Get Form’ to open it in the editor.
Begin by filling out the 'Patient Information' section. Enter the hospital record ID, age, city/town, gender, state, and zip code. Ensure accuracy as this information is crucial for tracking.
In the 'Self-reported race' and 'Self-reported ethnicity' sections, check all applicable boxes. This data helps in understanding demographic trends related to opioid overdoses.
Proceed to the 'Patient Overdose Information' section. Fill in the hospital code and dates for both suspected overdose event and ED admission. Specify the location of the overdose event.
Indicate whether naloxone was administered and provide details on dosage and who administered it. This information is vital for emergency response analysis.
Complete any additional fields such as principal diagnosis, attending physician details, and comments before submitting your form.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is the biggest cause of the opioid crisis?

Alarming statistics suggest that opioid overprescription has been a key factor in the US opioid crisis. Opioid addiction is also a big problem among physicians themselves.

Which state has the highest opioid crisis?

The highest rate of opioid overdose-related death occurred in West Virginia (40.03 per 100,000).

What is the opioid law in Rhode Island?

INITIAL OPIOID PRESCRIPTIONS FOR ACUTE PAIN for an opioid-nave individual cannot exceed 30 Morphine Milligram Equivalents (MMEs) per day for a maximum of 20 doses. LONG-ACTING OR EXTENDED-RELEASE OPIOIDS, including methadone, must not be prescribed for acute pain.

What is the opioid crisis in Rhode Island?

The annual number of drug overdose deaths in Rhode Island has jumped nearly 30 percent since 2019, largely due to the presence of illicit . In 2023, contributed to more than three in four overdose deaths. Data shows a drop in deaths from the first 6 months of 2024 compared to the same time in 2023.

What are the investigations for overdose?

Autopsy remains the gold standard for evaluating overdose deaths. While scene findings may highlight the presence of substances of abuse, autopsies evaluate their actual impact on the cause of death and identify potential additional causes.

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What is the leading cause of death in Rhode Island?

The leading causes of death in Rhode Island in 2022 were heart disease, cancer, and accidents. Of the 5,308 deaths that year, 50% of the total were due to one of these three causes. The fourth and fifth most common causes were COVID-19 and Alzheimer disease.

How many people have died from overdose in Rhode Island?

3. Results. From January 1st, 2019 to December 31st, 2021, the period of analysis, Rhode Island experienced 1072 fatal overdoses, averaging 179 fatal overdoses per six-month period with fatal overdoses increasing moderately with time.

Opioid Overdose Case Report Form - Department of Health - RI.gov - s3 documentcloud 2026

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What is the biggest cause of the opioid crisis?

Which state has the highest opioid crisis?

What is the opioid law in Rhode Island?

What is the opioid crisis in Rhode Island?

What are the investigations for overdose?

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What is the leading cause of death in Rhode Island?

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