State data released on Tuesday shows that 210 Vermonters died of an opioid overdose last year, the first time Vermont has crossed the threshold of 200 such fatalities in a year.
Last year’s death toll is 33% higher than the 158 fatal opioid overdoses the state logged in 2020 — and came as the second year of the coronavirus pandemic unfolded. It’s the second year in a row the state has set a new record for opioid overdose deaths whose causes are either accidental or undetermined.
“That’s a horrific number,” said Gary De Carolis, director of Recovery Partners of Vermont, a network of addiction recovery centers around the state. “I think we're really in a horrible crisis right now as a state and as a country.”
Last year’s overdose fatality numbers are preliminary and could still go up as death certificates from 2021 continue to be processed.
For the fifth straight year since 2016, Vermont’s fatal overdoses were dominated by fentanyl, a powerful synthetic opioid that is relatively inexpensive to produce and widely available.
Last year, the drug was involved in 196 deaths, or 93% of the total. That’s an increase from the 139 fentanyl-linked deaths (88% of the cases) in 2020, according to a brief the Vermont Department of Health released on Tuesday.
Next to fentanyl, the drugs most commonly seen in overdose deaths were cocaine (48%) and prescription opioids excluding fentanyl (23%), continuing a trend from 2020.
A new development last year was the detection of xylazine — an animal sedative not approved for human use — in overdose deaths. Along with alcohol, it ranked No. 4 among the substances present in fatal overdoses.
Most opioid deaths involved multiple substances, according to the brief. Some 83% of the cases last year involved two or more substances.
Since the department released its first report on xylazine in October, officials have learned that users likely don’t know they’re ingesting a substance mixed with the animal drug.
Health experts have warned that because xylazine is not an opioid, it does not respond to opioid antidotes such as naloxone — which increases the risk of accidental overdose deaths.
“I think we're just seeing a shift in what might be in the drug supply and how we have to react to that,” said Nicole Rau, the health department’s substance use prevention manager. Still, she and other health officials advise users to always carry naloxone, commonly known by the brand name Narcan, and to call 911 in case of an overdose.
The state’s opioid overdose fatalities last year translate into a rate of 33.7 deaths per 100,000 Vermonters. That’s significantly up from the death rate of 25.3 in 2020, according to the health department brief.
Some counties have posted much higher rates, particularly those in southern Vermont. Rutland County has registered the most opioid overdose deaths among its residents, with 28 deaths or a rate of 48.1 fatalities per 100,000 people.
Rutland County is followed by Windham County, which saw 20 deaths or a rate of 47.4, and Bennington County with 16 deaths or a rate of 45.1.
Public health experts and recovery professionals recognized a few months into the pandemic that the surging opioid overdose deaths were closely tied to the Covid-19 health emergency, which upended people’s lives with fear, anxiety, depression, stress, isolation and loneliness.
These led some people to start using substances as a coping mechanism, and others who had stopped using to relapse.
“That lack of engagement and connection with people leaves people in their own headspace and that's not always a good place to be,” said Tracie Hauck, director of the Turning Point Center of Rutland.
Officials said normal drug supply chains may also have gotten disrupted, and people could be getting drugs with unfamiliar quality from new or unknown sources.
Crucially, social distancing to mitigate the virus’ spread has led to more people using drugs on their own — meaning no one is around to administer naloxone should they overdose.
The Covid-19 pandemic appears to be winding down, but recovery professionals said its devastating impact on people who started or returned to using substances will take years to fix.
“The after-effects of the Covid pandemic has really affected our community,” Hauck said. “I think we're still seeing the worst of it.”
