Vermont Business Magazine Chittenden County experienced a 50 percent reduction in opioid-related overdose deaths in 2018, from 35 deaths in 2017 to 17 in 2018. This reduction marks a reversal of what has previously been a steady upward trend in overdose deaths since 2014, and the total was lower than in any year since the State began publishing county-by-county results in 2013.
The City, State, and nation continue to contend with the lethal effects of fentanyl and other powerful opioids, and any significant reduction in fatal overdoses is both welcome news and a cause for hope and examination.
But just as Chittenden County has seen a significant decline in deaths, there's been a shocking increase in southern Vermont. The four southern counties increased 72 percent and more than made up (28) for the decline in Chittenden.
Windham County reported the most fatalities with 24 (up from 14), Windsor 18 (up from 12), Rutland 15 (up from 10) and Bennington 10 (up from 3). Washington was the only other county to report an increase (10 to 13). Windham also had by far the highest per capita rate (56 per 100,000).
Of the 110 cases in Vermont, both fentanyl (74 to 83) and heroin (42 to 60) saw an increase from 2017 to 2018, while prescription opioids saw a small decline (34 to 31).
“While we continue to lose neighbors, coworkers, and children to this epidemic at a heartbreaking and unacceptable rate, and while our work is far from done, it is with great hope that we announce that the Vermont Department of Health has determined that Chittenden County opioid-related overdose deaths dropped by 50 percent in 2018,” said Mayor Miro Weinberger. “No one believes that our job is done. This long epidemic has shifted and evolved numerous times over the last decade, and all of us are concerned that new setbacks may be lurking right around the corner. At the same time, we have full confidence that there will be enduring value to Chittenden County’s full embrace of the life-saving potential of addiction medicines. Our work is based on past precedents, and we are hopeful that Chittenden County’s strategies can, in turn, be replicated and scaled in other regions with similar success.”
NOTE: The data tables include place of death and place of residence. The data above shows place of death. The data revealing the place of residence show somewhat lower totals, but very similar ratios.
To announce this news, partners in this effort – including the Chittenden County Opioid Alliance, Howard Center, University of Vermont Medical Center, Chittenden County State’s Attorney Sarah George, and others – gathered at the Burlington Electric Department Spark Space, the site of the monthly CommunityStat meetings. At these meetings, dozens of local stakeholders have convened each month for the past two and a half years, with the stated goal that, “We will be relentless until our City and its people are free from the grip of the opioid crisis.”
Analyses offer confidence that this 50 percent reduction in overdose deaths is statistically significant, and that the probability that it is due to chance is less than 1 in 100. While it is difficult to pinpoint precise cause of this reduction, the City believes the strongest contributors to this decline is likely to be the embrace of the life-saving potential of addiction medicines by all partners working in Chittenden County. Strategies to increase access to the use of medication assisted treatment (MAT) include:
- Eliminating the waiting list for MAT at the County level (i.e., an increase in the capacity of the County’s “hub” as part of the “hub and spoke” system created by the State);
- Rapidly growing the number of primary care physicians treating opioid addiction using medication (i.e., the expansion of the “spoke” capacity);
- Embracing of the Howard Center Safe Recovery syringe exchange as a trusted place for people with opioid use disorder (OUD) to come so that they can both obtain clean syringes and also promptly access addiction treatment;
- Leveraging Safe Recovery as a low-barrier site for the distribution of buprenorphine, the medicine of choice for treating opioid addiction and the symptoms of withdrawal;
- Commencing a low-barrier buprenorphine pilot at the University of Vermont Medical Center’s emergency department;
- Strongly supporting the 2018 Vermont statute requiring buprenorphine, methadone, and Vivitrol, a trio of lifesaving medicines, be provided to all state prisoners grappling with addiction who have a medical necessity for them; and
- Deciding, on the part of the Chief of Police and the Chittenden County State’s Attorney, to not arrest or charge individuals with possession of un-prescribed buprenorphine.
For a list of additional opioid interventions in Chittenden County since 2015, please see the attached timeline.
Principles for consideration by other communities struggling with the opioid epidemic:
The City of Burlington has based much of its focus on lessons from Baltimore, MD and France where there are strong precedents for reducing opioid-overdose deaths through the widespread distribution of addiction-medicines. The medicines are proven to reduce mortality, treat addiction, and assist in recovery. Other communities seeking to understand and replicate Chittenden County’s results should consider these principles:
- Make medicines readily available, especially both in prison and at places that people with opioid addiction trust;
- Allow people seeking treatment to get it immediately, and design treatment around the medicines that have been proven the most effective; encourage people to remain in treatment and on these medicines for as long as they feel the need to be, even if it is several years.
- Ensure that people are not punished for seeking them, even without a prescription;
- Make Naloxone universally available to everyone, at all times;
- Recognize that success is only possible when a wide range of stakeholders and leaders at every level of government make a true commitment to working together for the long haul.
As we continue this work in 2019, the City of Burlington will persist in its focus on ending the opioid crisis.
In response to this progress, partners in this work shared the following statements:
Brandon del Pozo, Chief of Police, Burlington Police Department: “The opioid epidemic continues to evolve, and its threats may shift accordingly. We have already had opioid-related overdose deaths in 2019, and we have a very long way to go before this epidemic is behind us. Cutting deaths in half from one year to the next, while unprecedented in nearly all American communities, may well only be a temporary reprieve. But it is a signal that we are capable of making real progress when we are relentless in our approach.”
Scott Pavek: “As a person in recovery, I am heartened to see the policies and tools which would have benefited me while in active addiction – namely, low-barrier buprenorphine – are saving lives today. The reduction in opioid-related fatalities within Chittenden County this past year affirms the good work being done by the Chittenden County Opioid Alliance and its partners. The practices championed in Burlington must be replicated throughout the state, and we must continue to develop innovative approaches to reducing harm and treating substance use disorder."
Tom Dalton, Executive Director, Vermonters for Criminal Justice Reform: “I witnessed a remarkable acceleration in progress once the City of Burlington made addressing the opioid crisis a priority and took the lead in making change happen. Over one third of incarcerated Vermonters are now participating in drug treatment for opioid used disorder and they will be returning home to their families and communities in recovery and prepared for success.”
Sarah George, Chittenden County State’s Attorney: “It is my opinion that by criminalizing the possession of this life-saving medication we are telling the user that possessing suboxone is the same as possessing heroin. Then we are surprised that they pick the option that is cheaper and far easier to find. Individuals who are possessing misdemeanor amounts of this drug for personal use and committing no other crimes, should not be in our criminal justice system. We should be using those resources to fuel more mental health and addiction services in our community.”
Dr. Stephen Leffler, UVM Health Network Chief Population Health and Quality Officer and Emergency Department physician, University of Vermont Medical Center: “At the UVM Medical Center, we are proud of this community partnership. We must continue to diligently track our own prescribing habits, and innovate new ways to get people into treatment.”
Jesse Bridges, Chief Executive Officer, United Way of Northwest Vermont: “Our community has told us time and again that the opiate epidemic is a major priority for our work. United Way’s more than 7,000 donors have provided resources to fund programs, strategic initiatives, pilots and staff time in order to make this positive progress possible. We thank them as well as our partners for working with us in this continued fight to improve and positively impact people’s lives.”
Bob Bick, Chief Executive Officer, Howard Center: “With the vision of our Board of Trustees and agency leaders in 2001 defining a path forward, and with the support, commitment, and perseverance of so many of our staff and community and state partners since, we have held fast to confronting stigma, keeping the focus on meeting the needs of those we serve, saving lives, supporting families, and strengthening our community.”
Jackie Corbally, Opioid Policy Manager, Burlington Police Department: “To change the tide of this deadly epidemic requires everyone. Communities everywhere must rethink how we approach this epidemic, and ours is doing just that. We will continue fighting for all of those who we have lost, and we will be relentless until we are no longer losing members of our community to this addiction.”
Source: Mayor. 2.14.2019