Reported overdoses in Burlington have reached “unprecedented heights” and have already surpassed last year’s total, Burlington Mayor Miro Weinberger announced Friday.
According to a presentation that Weinberger’s office gave to a meeting of Community Stat, a monthly forum focused on substance use, there were 265 reported overdose incidents as of July 23. For all of 2022, that number was 252.
“Our officers and firefighters now respond to overdoses every single day,” Weinberger said in a press release. “When confronting these numbers and the heartbreak behind them, it is easy to feel lost and overwhelmed by the magnitude of this issue.”
Weinberger went on to suggest that the “tactics” used to treat substance use disorder in prior years are no longer as effective, given the dominance of fentanyl and methamphetamine.
According to data from the Vermont Department of Health, there were 80 fatal overdoses among Vermont residents from January through April this year. Of those, 78 drug samples tested positive for fentanyl and only three tested positive for heroin.
Scott Pavek, Burlington’s substance use policy analyst, said in the press release that the drug market is “rapidly changing” and becoming more dangerous.
“Adulteration of illicit drug supplies with increasingly potent opioids and novel psychoactive substances have eroded the efficacy of treatment programs and harm reduction services tailored to address the misuse of heroin or common prescription opioids,” Pavek said.
Dan Hall, director of outpatient services for the Howard Center, said fentanyl is “a different drug.” Compared to heroin, fentanyl acts faster but also wears off faster, so users often require more doses. That is a major factor in why reports of discarded needles have risen so sharply in Burlington recently.
According to the Community Stat presentation, in 2022 there were nearly 800 reports of found needles on SeeClickFix, a website used to track municipal repair requests. So far, 2023 is on pace to match that.
Hall said in order to address Burlington’s substance use problem, the opioid crisis needs to be placed “back at the forefront,” and the state needs to rethink the “hub and spoke” model of substance use treatment. That model, adopted about a decade ago, means that treatment is initiated at a “hub,” where more intensive services such as rehabilitation take place and often involve medications like buprenorphine or methadone. From there, those receiving treatment transfer out to the “spokes” — usually office-based and less intensive — for ongoing care.
“I think we do need to look at it and really be creative, innovative and match interventions to what we’re seeing now versus to what worked five years ago,” Hall said.
Since overdoses first spiked in Burlington last year, Weinberger and other city leaders have pushed for state action. In March, the City Council passed a resolution calling for overdose prevention sites, where people can use drugs that they’ve already obtained, but in a supervised setting where trained staff can intervene in the event of an overdose. Such sites would need state approval.
Weinberger said other solutions his administration is exploring include a policy that would allow easier access to medications such as buprenorphine or methadone.
Kim Mercer, marketing and development director at the Turning Point Center of Chittenden County, a substance use recovery organization in downtown Burlington, said the staff at Turning Point have seen and experienced the rise in overdoses.
“We at the Turning Point Center are armed with and equipped with (Narcan) and many of our staff people are more experienced than they want to be with overdose reversal,” Mercer said. “But it’s not really our business model.”
Mercer also stressed that people recover from substance use disorder all the time. She said that 80% of people who get a visit from a Turning Point recovery coach in the emergency department at the University of Vermont Medical Center end up following up for services.
But another troubling trend that Weinberger cited was the number of people who are not transported to the hospital following an overdose reversal. According to the Community Stat presentation, the Burlington Fire Department responds to one-third of all overdoses in Chittenden County, and those incidents increasingly do not result in hospital transport. So far in 2023, of the 221 overdose incidents in which the fire department responded, 53 of those involved did not go to the hospital.
Mercer acknowledged that there might not be a “magic bullet” with a substance as deadly as fentanyl.
“You have to be alive to be in recovery,” she said.
