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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Report Examines Overdose Deaths, How To Stop Them

Fentanyl was the drug identified most often in a report that examined a year's worth of deadly overdoses in Vermont.
Rick Bowmer
Associated Press
Fentanyl was the drug identified most often in a report that examined a year's worth of deadly overdoses in Vermont.

In 2017, 109 people in Vermont died of overdoses. A new report from the Health Department provides a deeper dive into demographics, what drugs were involved, where people who overdose died and former interactions with various state agencies, from the state police to emergency medical services.Mitch Wertlieb spoke about the report with Deputy Commissioner of Alcohol and Drug Abuse Programs Kelly Dougherty. Their interview is below. It has been edited and condensed for clarity.

Kelly Dougherty: So this report was actually modeled after some work that was done in West Virginia, and a lot of it was out of respect for all of the Vermonters who have died of overdoses. We feel that we owed it to them and to their families to look for potential missed opportunities and give us a chance to act on those to decrease overdoses in the state.

Mitch Wertlieb: There is a lot of information in the report. Can you can walk us through just a few bullet points of what you think are the most important data points here?

Nearly all of the people, 95% of them, who died of an overdose in 2017 had a diagnosed substance use disorder. Now, that might not sound surprising, but what it tells us is that they had had contact with a health care provider at some point who had given them this diagnosis. So they did interface with a system there who, you know, potentially could have helped them.

And most of the people who overdosed in Vermont in 2017 overdosed in their home or a friend's home, about 75%.

Which kind of drugs or combination of drugs are we talking about here that most often contributed to overdoses?

Well, 93% of the overdoses in 2017 had opioid involvement. Typically, there was a combination of drugs, most commonly fentanyl with heroin, or fentanyl with cocaine. For individual drugs, fentanyl is the most frequently identified — and that's a synthetic opioid — followed by heroin, cocaine and prescription opioids. Only 5% had an overdose related to ... prescribed medications.

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I want to make sure I'm getting this number right, that 98% of people who died from overdoses in 2017 had some kind of interaction with state agencies in the years before their death. I'm not trying to place blame here, but I wonder if you can drill down to what that means. The range of these interactions, what they looked like, and what you take from that information —that a lot of these people who died had interacted with state agencies before.

Ninety-eight percent did have some kind of interaction with a state agency in the year before their death. And two thirds interacted with three or more state agencies. So the state agencies that we looked at were Human Services, Medicaid, and Department of Corrections and Department of Children and Families. We also looked at the Vermont State Police.

When we look at Medicaid, nearly half of the people who are enrolled close to their death, had a claim related to substance use treatment. This is interesting because the treatment numbers show the greatest drop in the number of people enrolled closer to the day of death, suggesting that leaving treatment is a risk factor for a fatal overdose.

As far as Department of Corrections, that equated to 19 people. Of those 19 people, 11 of those, their overdose occurred within the first three months after they were released from the correctional facility.

We also looked at Vermont State Police, and 82% of those who overdosed in 2017 had interacted with Vermont State Police at some point before they died. But I want to be really clear: People can have a variety of different interactions with law enforcement. They could be a witness, a person of interest, or they could be an offender or an arrestee. So this isn't to say that 82% were involved or implicated in a crime.

Well, how can the state use this data to determine ways of better interacting with people, perhaps, and offer more opportunities to help that don't end with such deadly outcomes?

That's the whole purpose of this report, to try to improve things so that we can decrease the number of deaths. There is some work already happening. The Agency of Human Services is convening to review the recommendations, so really looking at an overdose death prevention working group.

This data was collected obviously well before the COVID-19 pandemic. We're talking about 2017 here. And that sense of isolation that's happened since the pandemic, I'm wondering if that has increased risk factors. Could this be contributing to even greater numbers when you track post-pandemic numbers?

Absolutely. And we do have limited data, since COVID-19 hit. But this year through June, we are averaging about 12 overdoses per month, whereas last year there were just over nine per month. And in March alone, there were 10 overdose deaths this year versus four in March in 2019.

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We also think that people may have had a disruption in their normal supply chains. Maybe they were getting product from a source that was unknown to them, so may have been more deadly. So we're really trying to get the word out. If you are going to use, don't use alone, have naloxone, have someone with you.

VT Helplink was launched in March, which is a free and confidential service that is available to connect people to treatment and recovery services. You know, it's a one-stop shop: get an appointment, an assessment for treatment. And one bright spot is we actually have seen an increase in people using medication-assisted treatment for opioid use disorder since the pandemic.

Copyright 2020 Vermont Public

A graduate of NYU with a Master's Degree in journalism, Mitch has more than 20 years experience in radio news. He got his start as news director at NYU's college station, and moved on to a news director (and part-time DJ position) for commercial radio station WMVY on Martha's Vineyard. But public radio was where Mitch wanted to be and he eventually moved on to Boston where he worked for six years in a number of different capacities at member station a Senior Producer, Editor, and fill-in co-host of the nationally distributed Here and Now. Mitch has been a guest host of the national NPR sports program "Only A Game". He's also worked as an editor and producer for international news coverage with Monitor Radio in Boston.
Sam held multiple positions at Vermont Public Radio for several years, including managing editor of the award-winning programVermont Edition, and morning news editor.
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