Baker/Diaz: Overdose Prevention | Perspective
Overdose prevention sites will save lives. What is Vermont waiting for?
Vermont is experiencing a real overdose crisis. A record 210 Vermonters died from preventable opioid-related overdoses in 2021, or 33.7 overdose deaths per 100,000 people. That’s a 500% increase since 2010.
For context, Portugal, which has been committed to managing addiction with a public health approach since the early 2000s, recorded less than one overdose death per 100,000 people from 2008 to 2018.
The scale of this crisis is shocking, not least because Vermont has a relatively strong addiction treatment infrastructure. But accessible treatment is insufficient if we don’t keep our friends and neighbors alive long enough to access treatment when they are ready. Obviously what we are doing is not working.
Unfortunately, heads of state still ignore common sense strategies that would save lives. One such necessary and proven step would be the opening of overdose prevention sites, medical facilities that allow people to use opioids in a safe, non-judgmental space where they can receive life-saving medical services if needed.
Opioid users at an overdose prevention site have access to sterilized syringes, fentanyl test strips, overdose reversal medication and other life-saving tools. They also have the ability to connect to long-term treatment services that can be critical to recovery.
Not only do these facilities save lives, they also make our communities healthier and safer. They help reduce the transmission of HIV, hepatitis C and other blood-borne pathogens, while reducing the incidence of endocarditis, a deadly heart infection resulting from dirty syringes.
In addition, overdose prevention sites can reduce the costs of our public health and safety systems. Because they provide on-site medical care to people who overdose, local emergency rooms, law enforcement, paramedics, firefighters, and ambulances may draw attention elsewhere. Providing safe places to use also results in less public drug use and fewer discarded syringes in public spaces.
A review of the scientific literature shows that overdose prevention sites save lives, help reduce rates of crime and drug use, and help alleviate the countless other harms that drug criminalization has caused to our neighbors and to our loved ones.
There are currently over 120 overdose prevention sites worldwide. They exist everywhere in Canada, Australia and Europe. Every country that has implemented these sites has seen substantial reductions in overdose deaths. New York City just opened the first official sites in the United States, and Rhode Island recently became the first state to statutorily allow overdose prevention sites. To date, there have never been an on-site overdose death at an overdose prevention site.
The Senate Health and Welfare Committee is considering a bill, H.728, that would create a task force on overdose prevention sites, but the task force’s report would not be due until the end of 2023. In the meantime, people in Vermont will continue to die preventable deaths. We need to act with much more urgency.
Of course, overdose prevention sites are only one piece of the harm reduction puzzle. The overdose crisis requires a multi-pronged approach, and that includes making naloxone and fentanyl test strips more widely and easily available; expanding access to sterile and safe injection devices and disposal boxes; improving protections for good Samaritans to seek emergency health care in the event of an overdose; and providing mobile treatment, mobile overdose prevention and better access to transportation for people seeking treatment. Each of these proposals should be on the table now.
Without these kinds of public health strategies and science-based innovations that are succeeding in countries around the world, we can expect more of the same grim results. For many Vermonters struggling with substance use disorder and the families who love them, time is running out.
Vermont has a choice to make. Will we continue to allow Vermonters to die of preventable drug overdoses – wasting tens of millions of dollars of the opioid settlement fund on failed and incomplete strategies? Or will we implement bolder and more effective policies to save lives?
Before the Legislature adjourns in May, Vermonters should call on Governor Phil Scott and lawmakers to see this crisis for what it is and take decisive action to address it. This includes the immediate authorization of overdose prevention sites in Vermont.
Ed Baker is a retired alcohol/drug counselor for 30 years, he resides in Burlington and has been recovering from addiction for over 37 years. Jay Diaz is general counsel for the ACLU of Vermont and lives in Williston.