This commentary is by Will Eberle of Northfield. He is executive director of The Vermont Association of Mental Health and Addiction Recovery and Recovery Vermont, and the founder of Mission Driver Consulting.
A total of 1,450 people have died of an accidental drug overdose in Vermont in the past decade. Like all of ours, these lives were marked by triumph and joy, as well as pain and failure. They were people who — like all of us — had their demons and their challenges — but they were also funny and smart and honest and loyal and beautiful and kind — they were people with immense talents and gifts to offer the world. They had friends and families who loved them. Many of them had children who needed them. They had so much more living left to do.
Each of these people had complicated stories and all of them were different but one thing unites them: none of them had a place where they could go to receive medical oversight and life-saving treatment while they used the substances that formed the basis of their medical condition, their substance use disorder. Instead, they had to rely on people working to connect them to life-saving medical treatments and the harm reduction resources which so often bridge to treatment and recovery after they used these substances. On 1,450 different occasions in the past decade in Vermont, that didn’t work.
There is no question about which direction this trend is going. Vermont’s rate of fatal accidental drug overdoses has increased, significantly, eight of the past 10 years — ending the decade with a rate three and a half times greater than it started. This is particularly apparent in Burlington, where at a recent CommStat meeting Fire Department Chief Mike LaChance indicated his department’s response to overdoses in 2023 was two and a half times higher than the preceding three-year average.
In 2023, in just nine months, Vermont had 180 overdose fatalities, compared to an average of 148 for the preceding three years in the same time period. Of those 180 deaths, only nine did not include fentanyl, and 58 included Xylazine — which naloxone doesn’t work on. Conclusion? Tainted drug supplies are killing Vermonters faster and more often than ever before, and the existing tools we’ve been using to combat this are not slowing the tide. Vermont needs Overdose Prevention Centers, and we need them now.
As substance use disorder continues to spread at historic levels across Vermont communities it has left virtually no family unaffected, and we have begun to see a reduction in stigma associated with using substances. But despite our slow march toward empathy and science-based thinking about this topic, our policies and statutes continue to lag behind. We still continue to lean on the blunt and un-nuanced tools of arrest and incarceration as our primary investments and interventions associated with substance use in this state.
Since the COVID pandemic, between a third and a quarter of all incarcerated Vermonters are diagnosed with opioid use disorders each year. Incarcerating people in Vermont costs taxpayers roughly $95,000 per person per year. Providing supported housing, peer support and recovery resources cost a fraction of that and is instrumental in interrupting cycles of addiction, homelessness and recidivism. These are structural changes in strategy and investment that must be made to address the root causes of substance use disorder and crime and incarceration.
These changes are critical, but they will be slow. In the meantime we must talk about what must be done immediately — implementing overdose prevention centers right now, to save the lives of the people who cannot wait for us to bring ourselves to fund a holistic and compassionate system of care at scale.
You would be hard pressed to sit at any dinner table in Vermont today and talk about substance use disorder for five minutes and find someone there who is not affected by it. Despite our collective efforts at substance use stigma reduction and empathy, we’re all still subjected to terrible comments about “those people” who made their “choices” and have to “live with them.” But that’s not what you hear from people whose lives this has touched directly.
When you talk to people who have experienced this firsthand and watched it in their loved ones, you hear that people still struggling with substance use need more help than we’re giving them. You hear that, sure they or their affected loved ones have maybe made some poor choices, maybe done some bad things along the way — like all of us — but that shouldn’t be a death sentence.
You hear that we should do anything in our power to save their lives, or the lives of their brother, sister, son, daughter, mother, father, etc., that is still in the thralls of substance use disorder, despite all their work and heartache to overcome it. If the thing they’re addicted to is opioids we know there’s an astronomically high risk they’ll encounter fentanyl and Xylazine sooner than later, and that will have a greater chance of being fatal then we’ve ever seen before.
Opioid prevention centers are not a silver bullet. They’re not a panacea. They won’t solve our opioid crisis alone. They won’t save everyone. But they’re safe and effective and they’ll save many lives. We can’t afford to wait any longer. It is time to fund and create a legal path forward to operating Overdose Prevention Centers in Vermont — now.