Gov. Peter Shumlin says the growing “opiate epidemic” in Vermont will be a “major focus” of his administration this legislative session, along with resolving a $70 million budget gap and laying the groundwork for his signature single-payer health care system in 2017.
Opiate addiction will be the overarching theme of the governor’s State of the State address on Wednesday. Shumlin will mention the documentary “Hungry Heart,” a film by Bess O’Brien that documents the lives of Vermonters who are struggling with addiction. Dustin Machia, a recovering addict, and his doctor, Fred Holmes, will be in the audience.
“I’m really concerned about the growing opiate epidemic in Vermont, and I want to spend time using my voice as governor to do a better job of fighting a battle that we’re losing,” Shumlin said in an interview. “I’m willing to be creative and innovative and deal with all the players to reduce the number of folks who are becoming addicted and find more innovative ways to succeed in more immediate recovery.”
The governor says he will offer a set of recommendations to the Legislature to address what he describes as a “frightening” rate of increase in opiate addiction.
“We are gaining addicts to opiates at a rate that, if it continues, it will make it difficult for us to offer treatment in a system that’s already overrun with demand,” Shumlin said.
About 4,293 Vermonters were treated for some form of opiate addiction — for heroin or prescription drug abuse — in fiscal year 2012. That number is up from about 1,000 in fiscal year 2005, according to a Dec. 15 study from the Vermont Department of Health and Vermont Department of Vermont Health Access.
Though the state expanded programs for treatment last year, and as of October provided methadone to 1,482 people, the treatment centers can’t keep up. Another 1,200 Vermonters are on a waiting list for methadone, a commonly used medical therapy for heroin addicts. The typical wait time is two weeks; in Chittenden County the wait times can be as long as 12 to 18 months. The Chittenden Center, which serves Franklin, Grand Isle, Addison and Chittenden counties, provided methadone treatment for about 600 Vermonters by October. Centers in Brattleboro and the Northeast Kingdom also have high caseloads.
In a recent editorial board meeting with VTDigger, the governor alluded to property crimes related to opiate addiction.
“This is one thing, on a long-term basis, that could degrade the quality of life, the sense of safety and security that we take for granted, in Vermont,” Shumlin said.
Even though the state does not yet have enough methadone treatment facilities available (once another Chittenden County center is online, that will help), the governor wants to move ahead with a plan that would divert addicts and people with mental illness who have been arrested from the criminal justice system into treatment.
Over the last few years, the state has struggled to hold down the number of detainees, that is people who are being held without bail. Though the state does not have statistical information citing what percentage of the more than 400 detainees cycling through the system are opiate addicts, increasingly, the Department of Corrections is stepping up programs to provide “medication assisted treatment” to help people detox in jail. The steady number of detainees has been a budget buster for the Shumlin administration, though it has slightly lowered the total number of inmates in the system to about 2,000 over the last few years.
Shumlin says the state must do more to “successfully move people into treatment who aren’t ready to go who are charged with a crime.” The resistance to treatment, he says, “is a big challenge.”
“What’s the place where you’re most vulnerable, and are we meeting the point where they’re most open to treatment? I would say we’re not,” Shumlin said.
Lawmakers in the Senate and House Judiciary committees have teed up S.295, a bill that would move arrested individuals with a substance abuse problem or mental illness immediately out of the criminal justice system and into treatment — prior to arraignment. The accused would be required to undergo a “risk assessment” for substance abuse within three days of an arrest. The Senate, which is taking the lead on the legislation, will begin taking testimony on the draft legislation this week.
Sen. Dick Sears, D-Bennington, chair of the Senate Judiciary Committee, says he is concerned that the state is putting more people with substance abuse addictions, mental illness or serious functional impairments — a developmental disability, a traumatic brain injury, or other serious mental impairment — in jail.
“If you go to the doctor complaining of chest pain, they don’t open you up without doing some testing beforehand,” Sears said. “We make decisions without knowing what’s the real risk for the person. My hope is these folks will end up in treatment.”
In Chittenden County, the state’s attorney and the Burlington Police Department have developed a Rapid Intervention Community Court that diverts addicts and people with mental illness into treatment. Sears says S.295 would create a uniform system for pre-arraignment diversion across the state based on the sequential intercept model developed in Missouri.
“There is no reason if you are arraigned in Brattleboro that you would be treated differently than if you’re arraigned in Burlington,” Sears said.
It’s unclear whether prevention and education efforts will be part of the governor’s recommendations. In an interview, Shumlin didn’t directly answer a question about how the state might try to keep people from becoming addicted in the first place.
“We’re in this situation for a lot of reasons, in some cases it’s people who aren’t born with mountains of opportunity and have lost hope, but we have to be very careful when the community assumes it’s low income folks who are struggling,” Shumlin said. “This hits every income group.”
Shumlin will acknowledge the struggles of a couple of Vermonters who have tried to overcome opiate addiction and were featured in O’Brien’s film. Dr. Fred Holmes, a pediatrician in St. Albans who has helped teenage patients deal with the devastating effects of heroin, will be in the audience on Wednesday. His patient, Dustin Machia, who has mastered his addiction, and is featured in the film, will also be on hand.
O’Brien says she’s thrilled that opiate addiction is the topic the governor will focus on this year. Shumlin and his staff recently watched “Hungry Heart,” and were moved by the film.
“I’m thrilled that the people in the film will be honored in this way,” O’Brien said. “They are the ones who took the risk to tell their stories and put themselves out there, and I’m thrilled that the governor is recognizing them. As a filmmaker, it’s thrilling to see that the film’s message is making a difference and moving politicians to take further steps to deal with recovery and prevention around drug addiction.”
The movie humanizes the issue, O’Brien said, and that’s why people are affected by it.
“What I say about all my films is that change can’t happen unless people have empathy for the issue,” O’Brien said. “Then you can talk about the issue and see things move forward. Without that, it becomes those people with that problem.”
