Here’s how they can earn our respect.
By Philip Eil, Rhode Island Current
On the same day Helena Foulkes launched her second gubernatorial run, Gov. Dan McKee’s campaign team released a 60-second digital ad titled “She Knew.” The ad accused CVS of fueling the opioid crisis during Foulkes’ tenure as president of the pharmacy division, and it strongly implied that Foulkes had specifically profited from this.
“Not all drug deals look alike” the ad’s narrator says, as images of powders, pills, and cash flash onscreen. The ad echoed a line of attack from McKee and Foulke’s first Democratic-primary showdown in 2022.
In response, Foulkes told WPRI’s Ted Nesi that, on her watch, CVS pharmacy reduced its dispensing of opioids by almost 40%, and specifically stopped filling scripts for 600 “pill mill docs.” She said the pharmacy completed a massive drug take-back campaign and partnered with other drugstores to pursue legislation to reduce the number of pills patients received after minor surgery. And as for McKee’s not-so-subtle suggestion that she was a drug dealer?
“I think the governor is either attacking our biggest companies or losing our biggest companies,” Foulkes said. “And this is what you do when you’re a desperate man and you know you haven’t done anything for the people of Rhode Island.”
There it was: The 2026 governor’s race was only hours old, and the conversation had already turned to opioids.
As both a longtime reporter on Rhode Island politics, and the author of a nonfiction book about the opioid epidemic — specifically, a “pill mill doc” of the kind Foulkes referenced in her Nesi interview — I watched this uneasily.
The scale of the opioid crisis is staggering: according to the CDC, more than 800,000 people died from an opioid overdose between 1999 and 2023. The amount of pain and grief caused by this problem defies comprehension. It’s a subject that ought to be approached with tact, care, and precision. I worry that in the coming months we’ll see it reduced to mere point-scoring political fodder.
They didn’t ask me, but I have some advice for what the candidates — and the rest of Rhode Island — should keep in mind as we embark on a bitterly fought campaign where overdoses are a key issue.
None of what follows is an attempt to shield Foulkes from scrutiny over her record at the helm of CVS Pharmacy. CVS, like Walgreens, has agreed to pay billions to settle lawsuits over its role in the opioid epidemic. More recently, the Department of Justice sued CVS for what it described as years of knowingly filling illegitimate prescriptions. That lawsuit, which covers activity beginning in 2013, includes the four years Foulkes was at the helm of CVS pharmacy, from 2014 to 2018. It’s entirely fair to ask Foulkes about this and let her answer those questions.
But this is a public health crisis that can be influenced by the things our leaders say and the policies they enact. So here are a few points for the candidates to keep in mind as ever-larger audiences tune in to what they’re saying.
1. The human toll should be centered in any conversation about overdoses. People who struggle with substance use are discriminated against while they’re alive, and then treated as lifeless statistics after death. It’s a cliche at this point to note that every person who dies from an overdose was someone’s child, someone’s sibling, someone’s parent, someone’s friend. But it’s necessary because of the pernicious stigma they face. Like thousands of people in Rhode Island, I know someone in the state who died from an overdose. I have seen the agony etched on their family members’ faces at the funeral service. And I know the unceasing pain that those folks still carry. To McKee and Foulkes, I’d ask, “Are you speaking in a way that honors this pain or cheapens it?” They would be wise to discuss drug use as if they’re in the presence of someone who’s grieving a loved one’s overdose or actively battling substance use themselves.
2. This crisis is ongoing. In 2024, the last year for which we have complete data, 329 Rhode Islanders died from overdoses. And you only have to go back to 2023 to see that rate surpass an average of one death per day. That’s not to say this is the same crisis of 2005 or 2010 or 2015 or 2020. As the CDC notes, what began as a pill problem became a heroin problem, then became a fentanyl problem. In recent years, researchers have written that a problem once dubbed the opioid epidemic is now “a polysubstance-overdose death crisis.” Accurate communication about life-and-death matters of public health is important for a governor. When speaking about overdoses, they should communicate that this isn’t over and it isn’t the same problem it was a decade ago.
3. Political punch-throwing about overdoses does little to stop them. It wastes precious air time that could be used to actually combat the issue. Clearly, McKee and Foulkes both have points they want to make; I’m not going to suggest they stop talking about it. But whenever possible, they should focus on messaging that’s in the public interest, not just their own. Public health advocates could only dream of the kind of airtime that McKee and Foulkes will have in the coming months. So the candidates could use it to remind Rhode Islanders that Substance Use Disorder is an illness, not a moral failure, and that folks affected by this problem deserve dignity and compassion. They could point people to the wonderful Prevent Overdose RI website. They could call for wider access to life-saving harm reduction tools, like naloxone, fentanyl test strips, and sterile needles. They could urge more cities and towns to open Overdose Prevention Centers like the groundbreaking one that launched last year in Providence. They could discuss the ways they’ll make it easier for any Rhode Islander, in any financial situation, to access treatment.
One of the only potential benefits of the politicization of overdoses is if it sparks a competition for the most aggressive plan to address them.
Now, I’m not naive. I don’t foresee McKee and Foulkes avoiding the subjects of opioids and overdoses any time soon. But how they discuss this issue matters.
It is, in fact, its own test of leadership.
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