Vermont health officials confront record number of opioid overdose deaths
The state of Vermont reached a grim milestone this month when the Health Department reported that 210 Vermonters died from opioid overdoses in 2021. It is the highest number of fatal opioid overdoses the state has ever recorded.
Overdose deaths jumped by one-third last year compared to 2020. Rutland County had the highest fatality rates in the state, followed closely by Windham and Bennington counties.
Gov. Phil Scott is calling for $8 million in new spending on prevention programs aimed at addressing substance use disorders.
VPR’s Mitch Wertlieb spoke with Deputy Health Commissioner Kelly Dougherty about the issue of fatal overdoses in Vermont. Their conversation below has been edited and condensed for clarity.
Mitch Wertlieb: You know, these numbers are obviously grim and perhaps not surprisingly, reflect an increase in overdose deaths since the pandemic started two years ago. But opioid overdoses were a big issue, a serious issue in Vermont even before COVID made things worse. The state of Vermont has been tackling this issue for some years now. So why is the data moving in the wrong direction?
Kelly Dougherty: Well, Mitch, I think there are a few factors at play. As you mentioned, we did see an increase in overdoses with the COVID-19 pandemic, and that's something that we saw across the country. So that was definitely a factor. The thing that is really the biggest part of the picture right now is fentanyl. And fentanyl is a synthetic opioid that is extremely powerful, much more powerful than heroin, and so a very small amount of fentanyl can be fatal.
So when it comes to something like fentanyl, what is the strategy that the administration has for dealing with that? Is it a public service thing where the word has to get out to people how dangerous fentanyl is, or is there something else that the administration could do?
Yeah, so we are getting the word out. And we do have an overdose awareness campaign that is running now. It's called KNOW OD, alerting people to ways that they can prevent overdoses: not using alone; carry Naloxone, which is an opioid overdose reversal drug; call 911.
In case of an overdose, Vermont does have a Good Samaritan law that will prevent people from being prosecuted for drug possession or paraphernalia when they're involved in an overdose. And test your drugs for fentanyl. We do provide — in many locations across the state — harm reduction packs that contain fentanyl test strips so that people can check their drugs for fentanyl.
One thing I will mention, however, is that we are seeing fentanyl appear in counterfeit prescription drugs — Oxycontin or Percocet, not from a pharmacy and not the prescription. They need to be very careful.
This makes me think about the issue though of stigma when it comes to substance use. Because I know that is a problem. And I know that a lot of people look at this sort of thing like, you know, if they don't have a problem with substance use, they're just saying, "Well, why don't people just not do this?"
You know, it goes back to the old 80s — "just say no" kind of thing. We know that doesn't work. So if these campaigns are already in place, things like KNOW OD, the problem of stigma of addiction, how does the state deal with that? How does the state deal with that perception?
I'm glad you brought that up, Mitch, because stigma is a huge issue when it comes to substance use. And we actually have a stigma campaign that we're running right now. People feel that it's a choice to have a substance use disorder, and that is not the case. And particularly when you're talking about something like opioids that are so addictive and so powerful.
In emergency departments across the state, if someone presents to an emergency department because of an overdose, they can be started on medication-assisted treatment in the emergency department so that they don't have to wait to get an appointment at one of our community-based locations. They can get enough medication to carry them over until they're able to get connected to the community-based system of care.
When you asked about what we can do to address this, we are distributing Naloxone — the overdose reversal drug — in many, many locations across the state. It's really important to have that on hand, because an overdose can happen very quickly. You can visit VT Helplink, our information and referral website, and you can find places in your community where you can pick up Naloxone for free.
I have to ask a natural but difficult follow-up question to what we were just talking about. Things like Naloxone can really help — should the state of Vermont though, consider going a step further and think about having sites where people who are going to use drugs can use them safely and under supervision, and not have to worry about doing it in the shadows getting arrested — again, that stigma problem? Nobody wants to go to jail. Does the state of Vermont have to start thinking about having these safe spaces to allow people to use these drugs so that they don't die? They don't have these overdoses? And is that something that the Scott administration would be open to?
There actually are people looking into that right now in the state of Vermont. And it's something that we've certainly talked about and thought about here at the Health Department.
I do have to say, Mitch, however, I don't think it's a panacea. The places where these sites have operated traditionally are in very urban environments. In Vermont, people would have to travel to such a location. And when you're addicted to opioids, you're often using several times a day. So I have a hard time conceptualizing how a site like that could be successful in Vermont, without the critical population mass.
There is a group in Burlington that's exploring that, and it may be feasible to do something in Burlington. And we've had a little bit more experience nationally and internationally with the sites that we might be able to draw upon to reevaluate whether, you know, it does make sense in Vermont. You know, we're open to any ideas that can help us reverse this trend, because it's terrible to see so many Vermonters dying of overdoses.
What can you tell us about how this breaks down, what state officials know about factors such as age, gender, race, ethnicity?
In 2021, most of our overdoses were among males. It's about a 70[%]-30[%] split between male and female. The large majority of the overdoses were in those middle age, like 30 to 50. About 60% of our fatal overdoses were in that age range. Ninety-four percent of the fatal overdoses were among white non-Hispanic Vermonters geographically.
You mentioned Rutland, Windham, Bennington — those counties have been hardest hit. We have a grant through the Centers for Disease Control and Prevention, and we've actually put some grant funding into those communities to assess where there might be gaps and needs, so that they can address overdoses in those communities.