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A decade after Vermont announced an effort to address the state's opioid epidemic, fatal overdoses have quadrupled, and the crisis is more visible because more people are living on the streets. Liam Elder-Connors with Vermont Public has this report.
LIAM ELDER-CONNORS, BYLINE: The annual State of the State is usually a predictable affair where the governor outlines a laundry list of accomplishments and priorities. Ten years ago this week, Vermont Governor Peter Shumlin deviated from that script to focus exclusively on what he called the rising tide of opiates.
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PETER SHUMLIN: What started as an OxyContin and prescription drug addiction problem in Vermont has now grown into a full-blown heroin crisis.
ELDER-CONNORS: Shumlin, a Democrat, pitched lawmakers on a multipoint plan largely focused on expanding the state's recovery centers and increasing access to addiction treatment. Ten years later, Vermont has largely implemented Shumlin's plan and, by some measures, made progress. South Burlington resident Jess Kirby, who first took opiates as a teenager, says she got on a list for methadone in 2006 and waited for two years.
JESS KIRBY: You had to call every month and make your case, basically, on a voicemail that, hey, I'm still here. I'm calling. I still need treatment - please keep me on the list type of thing. And if you didn't call, then you would get put back to the bottom of the list.
ELDER-CONNORS: The state has since expanded its treatment system and largely eliminated waiting lists. There are nearly 12,000 Vermonters currently in treatment, about double the number in 2014. But Kirby and other recovery workers say progress in Vermont and the rest of the country has stalled, largely due to more powerful drugs, pandemic isolation and a rise in homelessness. Former Governor Peter Shumlin, in an interview last week, said he doesn't think public policy in Vermont has kept up.
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SHUMLIN: Frankly, what we've done, in my view - and the tragedy is - we've accepted this as sort of part of life as opposed to attacking it with everything that we have. And I think we've got to get back to focusing on - this is not acceptable.
ELDER-CONNORS: The number of fatal overdoses in Vermont has skyrocketed, driven by the rise of fentanyl, a powerful synthetic opioid that's essentially replaced heroin. The dramatic spike in overdoses led Burlington, Vermont's largest city, to launch a new team of paramedics who exclusively respond to overdoses.
JENNY BRONSON: We have a red trauma bag, and then we have blue for airway bags.
ELDER-CONNORS: On a recent morning, Jenny Bronson was preparing for a 10-hour shift with the new team. A big part of the job is to drive around the city and talk to people living outside.
BRONSON: Anything that we need to be able to do - CPR on-scene, administer Narcan. We have minimal medications, but basics that we would need - we carry it all around with us all the time.
ELDER-CONNORS: They also hand out first aid supplies and Narcan, an overdose-reversing medication. Bronson says, two months in, they've built up trust with people.
BRONSON: Now they know that we are there to try to help them and give them anything that we can and help them before they need to call 911.
ELDER-CONNORS: Burlington's effort is an example of a larger shift in the past decade towards treating opioid addiction as a disease. Recently, a more controversial harm-reduction strategy is gaining support in Vermont - overdose prevention centers, also known as safe injection sites. Those are facilities where people can use drugs under medical supervision. A bill in the Vermont legislature would carve out legal protections for facility operators and people who use them, but it's unclear if Republican Governor Phil Scott would support the measure. Jess Kirby, the woman who spent two years on the methadone waitlist, now works at a recovery center in Burlington. She says the state needs these facilities.
KIRBY: People really need more options to be able to stay safe. We're up against an extremely deadly, potent supply of drugs.
ELDER-CONNORS: But Kirby says overdose prevention centers alone won't solve the opioid crisis. She says other efforts need to be prioritized, like making it even easier to access methadone, which tends to work better for treating fentanyl use.
KIRBY: Methadone has allowed me to have a full life and a healthy life and to have recovery and all of those things.
ELDER-CONNORS: Kirby says expanding access to treatment could help other Vermonters who are struggling begin to stabilize.
For NPR News, I'm Liam Elder-Connors in Burlington, Vt.
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