This commentary is by Ed Baker of Burlington, host/producer of “The Addiction Recovery Channel” on Town Meeting TV and the 2021 recipient of the Jack Barry Award for Excellence in Recovery Advocacy. He has a lived experience of addiction and injection drug use, and has been in recovery for 38 years.
With all due respect, I’m somewhat disappointed at the posturing, baseless arguments and questionable assertions offered by these men of influence, sworn to abide by oaths of either professional conduct or medical ethics.
First off, let’s look at the thinking that argues: “Convincing those who hold the pursestrings that people troubled by addiction are as worth saving as people with cancer or diabetes is hard enough without fighting for interventions that are controversial and of unknown utility.” This comment is in reference to overdose prevention sites and the controversy surrounding them.
Since when do we withhold lifesaving interventions to fellow Vermonters at risk for overdose death as a guard against increasing controversy or stigma?
If Rosa Parks thought thusly, some of the people I know and love best would still be sitting in the back of the bus and drinking from water fountains marked “Colored Only.” Where would we be today if the mighty Rev. Martin Luther King Jr. remained silent because speaking out against a racist system was “controversial”?
And what of this idea of overdose prevention sites “showing a small decrease in mortality for people living within walking distance of the site.” Dr. Brandon Marshall’s research is clear on this. There was a 35% decrease in overdose mortality in the area surrounding the site in question, and a 9% decrease outside that circumference. There were no deaths within the overdose prevention site.
Furthermore, what’s known as “all-cause mortality,” or death from causes other than drug overdose, markedly decreased for people with addiction using the site.
Small looks a lot better than none.
The existing treatment system in Vermont has resulted in Vermont’s having the highest rate of overdose death increase in America for the aggregate years 2019, 2020 and 2021. We were followed by West Virginia and Kentucky. Overdose deaths in Vermont, the preventable deaths of our loved ones, have nearly quintupled since 2010.
To advocate for more of the same in this environment of accelerating overdose death, in my humble opinion, is near-unethical.
And what of our governor’s “intuitive” veto of H.728?
This bill, passed by the elected representatives of the people of Vermont, called for an overdose prevention site working group for the purposes of:
- conducting an inventory of overdose prevention sites nationally.
- identifying the feasibility, liability and cost of both publicly funded and privately funded overdose prevention sites.
- making recommendations on municipal and local actions necessary to implement overdose prevention sites.
- making recommendations on executive and legislative actions necessary to implement overdose prevention sites, if any.
- developing an action plan for the design, facility fit-up, and implementation of one or more overdose prevention sites in Vermont.
There was hope in this bill. There was scientific inquiry in this bill. There was the possibility of joining others, both globally and nationally, in implementing proven, lifesaving programming in Vermont in this bill.
The threat posed to people who use drugs by the contamination of the unregulated drug supply with fentanyl is our responsibility. We, as a state, are obligated, it is our duty, our primary purpose, to protect them.
Gov. Scott’s veto of H.728 was nothing less than a shirking of this responsibility — unacceptable. He left Vermonters unprotected.
OnPoint, America’s first sanctioned overdose prevention site, with two sites and two mobile-units in New York City, has surpassed all expectations since opening in November 2021.
At the six-month mark, OnPoint had:
- 1,400 participants
- 24,000 uses
- 350 overdose reversals
Of the 350 overdose reversals, only five required the assistance of ambulance services. None of these interventions required any New York City police involvement. Public injections and public disposal of syringes has been immensely curtailed. The cost saving to the city of New York is already estimated to be in the millions of dollars.
Kailin See, OnPoint senior project director, in a recent interview I conducted with her, explained that “no one is ever discharged to the street,” meaning all participants at OnPoint are offered additional support. People who utilize the services at OnPoint are approached with “respectful curiosity”; they are engaged, cared about, protected.
Contrary to assertions being made here in Vermont to the effect that overdose prevention sites, because they are controversial, will worsen stigma, it appears that when the will of the people is valued and these sites are opened, stigma retreats in defeat, as it should.
An overdose prevention site, scaled to the population at-risk and overdose death rate in Burlington and its surrounding area, will open. We will protect the lives of our loved ones.
The science is clear. The need is urgent. The population of Vermonters at-risk for overdose death here has expressed willingness to use this service.
Vermont can easily fund a site.
I’d like to take this opportunity to publicly invite Gov. Scott’s team, including Dr. Mark Levine, our health commissioner, along with Dr. Morrison, to personally visit OnPoint in New York City and witness compassion in action. Seeing is believing.