This commentary is by Grey Gardner, a senior staff attorney for the Drug Policy Alliance, which is a member of the Decriminalize Vermont coalition.
The overdose crisis in Vermont continues to worsen. Last month the Department of Health reported that a record number of Vermonters were lost in 2022 due to an overdose involving opioid drugs. The Centers for Disease Control and Prevention reports that, in the 12 months through October 2022, there were 262 fatal overdoses in Vermont. In 2010, there were 78 such fatalities.
It should be cause for alarm among policymakers at all levels.
Vermont’s Opioid Settlement Advisory Committee recently outlined recommendations for spending opioid settlement funds that would enhance some important efforts, but left out several key harm-reduction interventions. Despite pleas from some advocates to use settlement proceeds for rolling out overdose prevention centers and drug-checking services, those requests were left off the list.
For Vermonters who may be at extreme risk of overdose right now, and for families who fear their loss every day, the lack of investment in these proven harm-reduction strategies could be disheartening.
While improving access to naloxone, opioid treatment medications, fentanyl test strips, and outreach workers (all recommended by the committee) is necessary and important, it’s increasingly clear that bolder solutions are also needed, and that the status quo of criminalizing people for drug use and leaving people to use in unsafe situations is not working.
If there’s agreement to distribute fentanyl test strips, it’s hard to understand not including the funding for more robust drug-checking services that can provide far more detailed information about the composition of a substance. Expanding availability of naloxone is vital, but it should be complemented by services that can prevent some overdoses from happening.
Increasing the number of outreach workers is great, but it’s hard to understand withholding support for overdose prevention centers, which encourage people who use drugs to come into a fixed location where they can get basic health care, have their substances checked for contaminants, and be revived by trained professionals if they overdose.
For over five years, proposals to authorize overdose prevention centers have been advanced by community members, yet the state Health Department seems reluctant to offer a proposal to deploy such centers throughout the state and provided little opportunity to discuss funding them during the Advisory Committee process. Instead, the commissioner suggests that the committee will hold discussions about them in future meetings.
Overdose prevention centers and drug-checking services are evidence-based solutions. They have been effective in saving lives throughout the world for decades, and they help build bridges to treatment and recovery by developing trusted relationships and compassion-centered care. Such centers are presently operating and saving lives now in New York and will soon be operating in Rhode Island.
Community drug-checking programs using spectrometers and other portable testing technologies are operating across the world, including many locations throughout Massachusetts as part of the StreetCheck program, providing people who use drugs with meaningful information about substances that may lead them to change how (or whether) they might use them.
Decriminalization of small amounts of drugs for personal use is happening now in Oregon and has been shown effective in other countries for decades. Oregon’s 2020 decriminalization ballot measure has already made over $300 million of cannabis tax revenues available to vastly expand harm reduction and treatment programs throughout the state.
Ending the use of the criminal penalties to deal with drug possession in Oregon is not only helping reduce stigma, overdose risk caused by incarceration and other harms of criminalization, but will also result in even more funds being reinvested into health, housing and treatment services in future years.
For many Vermonters, there is no more time for study. There are lives on the line right now as these proposals continue to get kicked down the road. It’s time we stop relying on archaic systems of rationing care and stigmatizing drug use through criminalization, remove barriers (such as the threat of arrest) that drive people away from needed services, and instead provide more wrap-around supports.
Meaningful solutions to the overdose crisis require a full commitment to building a public health response to drugs. Other states are implementing these proven strategies and Vermont should join them by moving forward on overdose prevention centers, drug checking and eliminating criminal penalties for low-level drug use and possession. There is no time to waste.
