Vermont's Legislature-opening State of the State speech is usually a predictable affair where the governor outlines a laundry list of accomplishments and priorities. But on Jan. 8, 2014, Gov. Peter Shumlin deviated from that script and told lawmakers that he wanted to “focus exclusively” on the “rising tide” of opiate addiction.
“What started as an OxyContin and prescription drug addiction problem in Vermont has now grown into a full-blown heroin crisis,” Shumlin said during his 2014 speech.
Shumlin pitched lawmakers on a multi-point plan, largely focused on expanding the state’s recovery centers and increasing access to addiction treatment.
Ten years later, the state has largely implemented the plan Shumlin pitched, and by some measures, made progress.
"What started as an OxyContin and prescription drug addiction problem in Vermont has now grown into a full-blown heroin crisis."Former Gov. Peter Shumlin, in his 2014 State of the State speech
South Burlington resident Jess Kirby, who first took opiates as a teenager, got on a waiting list for methadone in 2006 and languished on that list for two years.
“In that time, you had to call every month and make your case basically on a voicemail that, ‘Hey, I'm still here, I'm calling, I still need treatment, please keep me on the list,’” Kirby recalled during a recent interview. “And if you didn't call, then you would get put back to the bottom of the list.”
The state expanded its “hub-and-spoke” treatment system and largely eliminated waiting lists for those programs. According to Vermont Health Commissioner Mark Levine, there are nearly 12,000 Vermonters currently in treatment — about double the number in 2014.
But Kirby as well as other recovery workers and health officials say Vermont’s progress has stalled as the opioid crisis morphed to include more powerful drugs, a pandemic that isolated people, and a rise in homelessness.
Former Gov. Peter Shumlin said in an interview last week that he doesn’t think public policy has kept up.
“Frankly what we've done, in my view, and the tragedy is, we've accepted this as sort of part of life, as opposed to attacking it with everything that we have,” Shumlin told Vermont Public. “And I think we've got to get back to focusing on this is not acceptable.”
More from Vermont Edition: Addressing Vermont’s increase in opioid overdose deaths
Kirby, who’s been in recovery for more than a decade and now works at Vermonters for Criminal Justice Reform, agrees. She thinks the state needs to improve access to methadone, which is more tightly regulated than buprenorphine, another medicine used to treat opioid use. But methadone can be more effective at getting people off fentanyl — a powerful synthetic opioid that has essentially replaced heroin.
“We have a serious opioid crisis [and] a serious fentanyl crisis that is leading to a very serious overdose crisis,” she said.
The number of fatal overdoses in Vermont has quadrupled in the past decade. When Shumlin gave his speech in 2014, there were 63 fatal opioid overdoses. In 2022, that number was 243.
The dramatic spike in overdoses led Burlington, Vermont’s largest city, to launch a new overdose response team within the fire department.
On a recent morning, Burlington firefighter Jenny Bronson was preparing for a 10-hour shift with the Community Response Team — known as the CRT. She opened up bags stored in the back of the department pickup truck the team uses and pulled out first aid supplies and fentanyl test strips. While the two-person team was created to respond to overdoses, a lot of their job is walk around the city, talk to people living outside and hand out supplies, like bandages and Narcan — an overdose-reversing medicine.
It’s taken a little while, but two months into the six-month pilot program, Bronson said the team has built up trust with people.
“Now they know that we are there to try to help them and give them anything that we can and help them before they need to call 911,” Bronson said.
The CRT is funded with $182,000 from Vermont's portion of settlements in national lawsuits against opioid manufacturers.
Burlington’s effort is an example of a larger shift in the past decade toward treating opioid misuse as a disease — in some cases, that means providing users with safe supplies to consume the drug.
Organizations like AIDS Project of Southern Vermont in Brattleboro run needle exchanges and have fentanyl test strips on hand. In late 2022, the group also started operating the state’s first drug-checking program, where people who use drugs could get their supply tested. That’s been important as opioids are increasingly mixed with other drugs like xylazine, an animal tranquilizer that doesn’t respond to Narcan and causes large gaping wounds.
“When they come consistently to get their supply tested it's a good indicator… they want to stay alive," said Dakota Roberts, a harm reduction specialist at AIDS Project of Southern Vermont.
“We have a serious opioid crisis [and] a serious fentanyl crisis that is leading to a very serious overdose crisis."Jess Kirby, Vermonters for Criminal Justice Reform
A more controversial strategy that’s been pushed by advocates for years appears to be gaining traction: overdose prevention centers, also known as safe injection sites, where people can use drugs under medical supervision. New York City is the only place in the United States where there are overdose prevention centers, though several countries, including Canada, have had these facilities for years.
A bill in the state Legislature would carve out legal protections for facility operators and people who use them. In late December, an advisory committee recommended Vermont use money from opioids settlements to fund overdose prevention centers, likely in Burlington to start.
Mark Levine, Vermont's health commissioner, is on the advisory committee, and said in a recent interview overdose prevention sites could help.
“I don't see them as the panacea, unfortunately,” Levine said. “But I do see them as something that is certainly missing in our current structure — but it’s also missing from 49 other states."
Even if the Legislature greenlights an overdose prevention center, it’s unclear if Gov. Phil Scott would support the measure. In 2022, he vetoed legislation that would have studied the issue.
Roberts, who works at AIDS Project of Southern Vermont, thinks the state also needs a holistic approach.
“We are too stuck on the image that the solution [is] to just have the Narcan there so they don't die, get them on methadone so they don't steal,” he said. “And then what? People are still on the street, people are still homeless, people are still cold and hungry and miserable, and feel like there's no future.”
That’s a big part of what the state needs to address, Roberts said: Giving people more stability — and hope.
Have questions, comments or tips? Send us a message or contact reporter Liam Elder-Connors:
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