Editor’s note: This commentary is by Scott Pavek, a Burlington resident, who is in recovery from substance use disorder.
[I] urge you to support passage of H.162, a bill decriminalizing misdemeanor possession of buprenorphine, a medication used to treat opioid use disorder (OUD).
I support the decriminalization of buprenorphine for a number of reasons. I first used buprenorphine at age 18, after two years of using opioids had damaged my health, robbed me of hope, and left me disconnected from those around me. I had not disclosed my struggles with anyone — and I didn’t know how, or was too scared, to pursue treatment through a medical provider. At that point in my life I wasn’t sure if I needed, or was ready for, treatment.
One day I was presented with the opportunity to acquire buprenorphine; it was explained to me that I would be unable to use opiates while using buprenorphine, but I wouldn’t experience the agony of withdrawal. For the first time in years, I experienced a period of stability and health.
What has been most difficult about the past six years of recovery hasn’t been abstaining from opioid use, securing employment or rebuilding relationships — it has been watching our friends and neighbors die. Again in 2018, more Vermonters died due to opioid-related fatalities than in the year before.
We have reasons for hope.
Policy initiatives implemented in Chittenden County resulted in a 50% reduction in fatal opioid overdoses last year. Leaders like Burlington Police Chief Brandon del Pozo and State’s Attorney Sarah George championed common sense approaches to drug policy reform — including decriminalization of buprenorphine — which promoted progress while the rest of the state continued to see opioid overdose fatalities trend upwards.
Why decriminalize buprenorphine?
Decriminalization of buprenorphine sends a clear message: choosing buprenorphine over heroin or fentanyl is a decision to be encouraged. We should empower people to keep themselves safe and to begin the journey to recovery.
It is estimated that 60 to 70% of Vermonters who need treatment for OUD are not receiving it. While our treatment system is laudable, there are many reasons why a person may not receive treatment. Perhaps you do not have insurance, cannot find a doctor or do not have access to reliable transportation. Perhaps your circumstances are so restrictive that you simply do not have the time or resources required to see a doctor. Maybe you aren’t ready for treatment or do not think it will work for you. Maybe, out of fear of further stigmatization, you don’t trust medical professionals.
So long as roadblocks to recovery exist, the state must do all that it can to open new pathways out of addiction for people living with OUD.
Why are some people concerned?
Despite the Chittenden County’s success and the continued uptick in lives lost due to opioid overdose fatalities across the state, some legislators are wary about passing H.162.
Some assume that buprenorphine is only effective when prescribed. This is not true. Numerous studies published in the Journal of the Medical Association since 2010 have found, using randomized controlled trials, that buprenorphine use reduces mortality and improves other health outcomes among people with OUD, even when this medication is not prescribed. Furthermore, beginning buprenorphine treatment outside of a medical setting doesn’t preclude a person from seeking additional medical care in the future.
I have heard some legislators express concern that decriminalization would only exacerbate our substance use disorder crisis. As someone who lived through the horrors of untreated substance use disorder, I understand these concerns completely.
I have known hundreds — if not thousands — of people with substance use disorder, in treatment or in recovery. It’s true that I have met people who developed substance use disorder through recreational use of buprenorphine — exactly three individuals, all of whom are alive today. A far greater number of Vermonters continue to struggle with OUD, using adulterated heroin or fentanyl to stave off withdrawals, often with fatal consequences.
How you can help: It is not too late to support decriminalization of this life-saving medication:
• Call your legislators — 802-828-2228 — and ask them to support H.162.
• Email your legislators — find addresses on legislature.vermont.gov — and ask them what they think about H.162.
• Share responses from your legislators widely on social media — keep the conversation going!
If your legislators are opposed to H.162, your feedback could help them adopt a new position. If your legislators are currently in support, thank them and give them a reason to advocate loudly for passage of this bill. No matter your legislator or their response, your outreach has an impact.
We can change our laws to encourage people to keep themselves safe. If you are living in a safer way, you are more likely to stay alive — and as we all know, you must be alive to begin recovery. Please support decriminalization of buprenorphine.
