Spring 2017 REPORT: Rhode Island Multidisciplinary Review of Drug Overdose Death Evaluation Team (MODE) Team Quarterly Trends.  For quarters 3 and 4 of 2016 (July 1 through December 31), there were 157 unintentional drug overdose deaths in Rhode Island, compared with 179 during quarters one and two of 2016, and 136 during quarters three and four of 2015. Fentanyl continues to be a causal agent in the majority of unintentional drug overdose deaths. During quarters 3 and 4 of 2016, 65.6% of unintentional drug overdoses were attributed to fentanyl (103 out of 157). Prescription drugs alone accounted for 16.7% of the unintentional drug overdose deaths in Rhode Island in 2016 and 83.3% involved one or more illicit drugs (alone or in combination with a prescription drug). Note that the definition of prescription drugs includes any prescription drug, including opioid agonist and partial agonist medications used for the treatment of opioid use disorder. The majority (72.9%) of unintentional drug overdose deaths in 2016 were among males. The highest numbers of unintentional drug overdoses in Rhode Island during 2016 were among adults aged 25-34 and 45-54 years (n = 96 and 97, respectively). The proportion of unintentional drug overdose deaths in Rhode Island among young adults aged 25-34 years rose from 15.9% in 2009 to 28.6% in 2016. For quarters 3 and 4 of 2016, 94.3% of the unintentional drug overdose deaths were among whites, 4.4% among blacks. In quarters 3 and 4 of 2016*, there were 10 overdose deaths in public places (e.g., roadway, wooded area, sidewalk) and five overdose deaths in semi-public places (e.g., institutional nursing home, treatment facility, shelter), compared to less than five public and eight semi-public overdose deaths for the same time period in 2015. In 2016, there was more variation in the types of public locations of overdose deaths. In quarters 3 and 4 of 2016, there were eight overdose deaths that occurred in a location where another overdose death had also occurred, totaling four separate locations. Two of these deaths occurred in the same location and time. In quarters 3 and 4 of 2015, there were no overdose deaths that occurred at the same location. There has been an increase in the number of overdose deaths in public locations linked to fentanyl exposure. There has been an increase in the number of overdose deaths in locations where a previous overdose death had occurred. It is unknown if this correlation also exists for the occurrence of nonfatal overdose. Rapid detoxification protocols are in place and can put patients at high risk of death by overdose. Discharge from such programs without providing relapse prevention and overdose prevention education with take-home naloxone endangers patients. In a 5 year period from 2011-2015 in Rhode Island, there has been a 50% increase in opioid-related deaths due to overdose. Rhode Island addiction statistics and national trends are provided to help understand the scope and consequences that addiction can have if left unchecked. Rhode Island’s percentage of the state’s population drug use in the fiscal year 2015 the latest SAMHSA statistics available. Marijuana use in Rhode Island in the past month estimates for the age group 12-17 is estimated at 10.19% of the population and 13.28% for those in the group over 18. Cocaine use statistics in Rhode Island are estimated at 0.74% for the 12-17 age group and for those over the age of 18, it is estimated that 2.68% of the population has used cocaine in the past year. Heroin use in Rhode Island for the age group 12-17 is estimated to be 0.14% and over 18 the percentage of people that use heroin is estimated to be 0.43% of the population. Alcohol use among those 12 to 17 years of age is 13.23% of the population and for the 18 and over demographic 63.56% used alcohol in the last month. Those that have had serious thoughts of suicide in the state of Rhode Island over the past statistical year 2015 is only available for the population over 18 and is at 4.42%of the population.