The Deadly Nexus Between Covid-19 and Overdose

Published by VTDigger on September 11, 2020

by Tom Dalton

This commentary is by Tom Dalton, of Essex Junction, who is the executive director of Vermonters for Criminal Justice Reform. He is an attorney and a licensed alcohol and drug counselor.

Drug overdose deaths have skyrocketed in Vermont, in large part because of Covid-19. The Vermont Legislature should take immediate action to improve overdose prevention as part of a comprehensive response to the pandemic.

Covid-19 has demanded much of the Legislature’s attention in recent months and the simultaneous overdose crisis has perhaps seemed like a separate issue. But the social disruption caused by the pandemic has significantly contributed to the alarming spike in overdose fatalities. People at risk for overdose have experienced increased social isolation, economic hardship and mental health distress. Covid-19 has made accessing drug treatment and recovery supports much harder, especially residential drug treatment.

We now know that, here in Vermont, many more people have died of overdose than the virus itself during the Covid-19 crisis.

About two or three people are dying of preventable overdose every week in Vermont. According to the Vermont Department of Health, 72 people died of overdoses from January to June of this year, compared to 48 in the same period last year.

These preventable tragedies are happening every few days, in homes and communities in every corner of the state. Many are succumbing to overdose in the prime of life, and their grieving children and families will never fully recover from their loss.

To save lives now, the Legislature should focus urgent attention on the lethal intersection between the overdose crisis and the Covid-19 crisis. Prompt and bold action is required.

The Vermont House of Representatives was working on an important overdose prevention bill when the pandemic hit. Bill H.162 had unanimously passed the House Human Services Committee, having previously passed the House Judiciary Committee, but was set aside. It is time to take that bill up again.

H.162 is designed to improve access to the opioid use disorder survival medication buprenorphine. Buprenorphine is a medication shown to effectively treat opioid use disorder and cut overdose deaths in half. Here in Vermont, hundreds of people have died because they did not have effective access to the addiction treatment medication that could have saved them.

Vermont is nationally recognized for our “hub and spokes” buprenorphine treatment model. But even under the model many point to as the best in the country, only a fraction of those who need buprenorphine actually get it. Twenty years into the opioid crisis, our current system still fails to reach over half of those in need. Many people who have been unable to successfully access the prescription buprenorphine system of care have turned to non-prescribed buprenorphine to survive.

In recent years, Vermonters for Criminal Justice Reform has been calling for a new approach that maximizes access to both prescribed and non-prescribed buprenorphine to reach as many people as possible with this life-saving medication.

Use of buprenorphine by people living with opioid use disorder dramatically reduces risk of overdose and is protective. As lived experience has shown, and a growing body of scientific research has confirmed, this is true of both prescribed and non-prescribed buprenorphine. H.162 improves access to buprenorphine by removing criminal penalties for misdemeanor possession of small amounts of buprenorphine without a prescription.

The policy set forth in H.162 was first adopted by Chittenden County State’s Attorney Sarah George in 2018 and contributed to a 50% drop in overdose deaths in Chittenden County. George noted at the time that buprenorphine can “block the craving for heroin or other street opioids” and “help individuals reduce or abandon their use of heroin or other opioids, which in return, reduces crime, the likelihood of fatal overdoses, and recidivism.”

This pragmatic approach, which prioritizes saving lives, has since been adopted in jurisdictions in Massachusetts, Pennsylvania and Hawaii. The policy was included in Sen. Bernie Sanders’ criminal justice and drug policy plan as a candidate for president and has the support of many Vermont policy leaders including Vermont Attorney General TJ Donovan and Burlington Mayor Miro Weinberger.

Thousands of Vermonters are already successfully engaged in self-help recovery using non-prescribed buprenorphine. Research shows that use of non-prescribed buprenorphine increases the likelihood of entry into drug treatment and predicts drug treatment success.

In effect, non-prescribed buprenorphine is the “gateway drug” to drug treatment and recovery from opioid use disorder. Non-prescribed buprenorphine has been and will be the door to recovery for many Vermonters.

We should help those who are willing to transition from heroin and fentanyl to non-prescribed buprenorphine – not criminalize them. And we should make transitioning from non-prescribed buprenorphine to prescribed buprenorphine much easier by implementing low-barrier buprenorphine programs.

Access to buprenorphine protects Vermont children and families, reduces crime, saves taxpayers money and saves lives.

H.162 deserves the Legislature’s immediate attention.