Editor’s note: This commentary is by Bob Bick, who is the CEO of the Howard Center in Burlington.
“I wish I didn’t know now what I didn’t know then!”
[R]ight now heroin abuse in Vermont qualifies as a major health epidemic — even as alcohol remains our most costly drug of abuse — affecting an individual’s health, family and social relations, and often leading to death and illness.
The abuse of heroin in Vermont has been skyrocketing. Statewide, clients seeking treatment who have identified as using heroin is up 300 percent in the last five years. This is compared to 13, 15 and 2 percent for pot, cocaine and alcohol respectively.
Just think, in the absence of this heroin data how concerned we all would be if we were only considering how to deal with a 15 percent increase in cocaine use?
In Chittenden County, heroin use is up almost 400 percent from five years ago. At our Act-I/Bridge, clients report that heroin abuse is up over 40 percent in the last five months!
This is a problem that is primarily affecting our young adults — kids who are 18 to 24 years old who are just finishing high school.
For those who remember Frank Sinatra in “Man with The Golden Arm,” the torturous withdrawal from drug use remains fixed in our collective cultural consciousness. However, because of the increases in purity and reductions in costs, we are seeing dramatic increases in other routes of administration. While injection use is up 100 percent in the last five years, smoking is up 200 percent and inhaling is up 400 percent.
While long-term pharmacological interventions demonstrate considerable positive outcomes, short-term pharmacological interventions offer temporary respite but not particularly promising long-term outcomes, showing a greater than 70 percent chance of relapse after discontinuance.
Long-term residential treatment offers a milieu for habilitation, but there are very limited slots (none available in Vermont) and the dropout rate is high. Short-term residential options (14+ days) and outpatient treatment have limited applicability except for the most highly motivated clients.
Heroin is readily available on Church Street and in apartments in Burlington and is being sold out of and by delivery in all the suburbs of Shelburne, South Burlington, Charlotte, Williston and Essex.
Heroin is readily available on Church Street and in apartments in Burlington and is being sold out of and by delivery in all the suburbs of Shelburne, South Burlington, Charlotte, Williston and Essex.
As legislators you are encouraged to:
• Make sure that the various state agencies are providing you with the latest information on use and abuse and emergency room contacts in Vermont.
• Understand the impact and availability of current resources.
• Consider your own views on this topic self-critically, your biases and prejudices.
Prohibition may be institutionalized, but it has been clear for a very long time that it doesn’t work and only serves to criminalize large segments of our population, forcing us to build more correctional capacity. Heroin and other drug abuse is a health problem and we will not arrest our way out of it.
• What legislation is necessary to address this?
• What resources are needed?
• What coalitions of stakeholders can be mobilized?
• And what mechanisms for state funding are most desirable?
Consider going home tonight to learn that your wife or husband or son or daughter has become addicted to heroin. What resources would you want, need, demand for the person you love? Make no mistake about it, your social status, where you live, your loving family, your education — none of it makes you immune.
We may not be able to legislate morality, but we can legislate resources to relieve the suffering.
I drafted the above comments in December 2000, to use as the basis for testimony for the incoming January 2001 legislative session, two years before Howard Center was able to open the state’s first Medication Assisted Treatment program for opiate addiction and 14 years before Gov. Shumlin’s State of the State address that focused exclusively on the opiate abuse issue in Vermont.
In the intervening 16 years, even as we have greatly expanded and enhanced access to care to address the continued explosion of demand from those who are seeking treatment for opiate addiction, the number of our family and friends who are dying from an opiate overdose continues to grow and we seem to have had little success in stemming the health epidemic trend.
We are still facing the same public health crisis today as we were in 2000. Recent local and statewide efforts to more assertively coordinate strategy, engage multiple voices, and facilitate communication offer hope and an opportunity to change the trajectory. We must learn from our history. Otherwise, in the words of philosopher and writer George Santayana, “Those who cannot remember the past are condemned to repeat it.”
