The group guiding the distribution of Vermont’s opioid settlement money is urging lawmakers to focus spending on harm-reduction initiatives such overdose reversal and outreach.
The Vermont Opioid Settlement Advisory Committee outlined $7.3 million in funding requests to the House Appropriations Committee this week.
Health Commissioner Dr. Mark Levine told lawmakers that the “opioid death crisis” in the state compelled the committee to prioritize harm reduction over prevention.
Levine said that over the past four years, 75% of Vermonters who died of an opioid overdose had “no connection to the treatment system.”
“So they might as well have been invisible to us,” Levine said. “And the only time we knew who they were was when they were in the morgue, and that can’t be.”
“They might as well have been invisible to us. And the only time we knew who they were was when they were in the morgue, and that can’t be.”Health Commissioner Mark Levine, speaking about three-quarters of Vermonters who died of an opioid overdose in recent years
If Vermont wants to reduce the record 237 overdose deaths it experienced last year, Levine said, it’ll need to find ways to connect people using opioids with the network of treatment options available to help them.
“We need to make sure that we have pathways to that connection that meet people where they are,” he said. “Because generally if you don’t want that connection, it may be you don’t like something about the system that’s in place rather than you’re just against treatment, and so we want to make sure there are pathways into the system that work better for them.”
To that end, Levine said, the committee wants to spend $2.2 million to fund 30 new “outreach staff” in communities across the state. He said the new positions would be embedded in existing community-treatment centers, as well as at four syringe service programs.
Outreach workers and naloxone vending machines
Levine said the work done by the outreach staff would be “different and new.” And he said their jobs would involve finding and connecting with opioid users — in shelters, transitional housing programs and streets, for example — that the state has been unable to reach so far.
“The whole goal for outreach is to engage people with the substance use disorder system and try to make some kind of trusted connection,” Levine said.
The committee also wants lawmakers to spend nearly $2 million to expand distribution of the overdose-reversing drug naloxone, often known by the brand name Narcan.
Levine said the money would be used to increase the state’s supply of naloxone to existing providers, but also create new distribution mechanisms, including naloxone vending machines.
“The machine is like anywhere you want — it’s like going to an ATM,” Levine said. “You don’t have to announce to the world that here I am to get Narcan, and you can get a harm reduction pack straight from that machine.”
What about overdose prevention centers?
The committee’s recommendations notably do not include funding for overdose prevention centers — sometimes called safe injection sites.
At a press conference this week, a coalition of nearly two dozens organizations urged the Scott administration and Legislature to provide legal protections for overdose prevention centers, and to fund their startup costs.
More than half of fatal opioid overdoses in Vermont involved people who were at home and alone, according to data from the Vermont Department of Health. Jess Kirby, a who works at a low-barrier recovery program in Chittenden County, said supervised consumption is one of the most immediate ways to avoid overdose deaths.
“We need to bring people out of parking garages and tents and cars and hidden areas and people who are alone in bathrooms and bedrooms and hotel rooms,” said Kirby, who also sits on the Opioid Settlement Advisory Committee. “We need to bring people inside and allow people to use drugs in a safe environment.”
Though four of the committee’s members voted to include funding for overdose prevention sites in the first set of recommendations, Levine said he thinks Vermont should wait for more data before moving forward.
“My conclusion is we need a little more information,” he said. “But we are certainly not categorially against using opioid settlement money for these, and we’re going to do everything we can as a committee to learn about them.”
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