Lawmakers address opiates, harm reduction, saving lives

Over the past two years fatal overdoses in Vermont, and nationwide, have increased at an unbearable rate, largely due to the disruptions caused by the COVID-19 pandemic, as well as an increased prevalence of fentanyl, a powerful and often fatal synthetic opioid.

In 2021 alone, at least 181 Vermonters died of fatal overdose from opioids, over 90 percent of which involved fentanyl. Over half of these deaths were Vermonters under 40, and the numbers for December 2021 have not yet been released. These are our family, friends and neighbors.

The committee I chair in the House, human services, received testimony that if primary prevention is reducing substance use disorder for future generations, then tertiary prevention is providing a lifeline for the Vermonters who today are at immediate risk of overdose. It saves lives today. The programs and policies within H.728 and H.711 were created with the goal of saving Vermonters’ lives, through the pathways of treatment, recovery and harm reduction.

H.728, now in the Senate, creates initiatives to provide mobile substance use treatment units for rural communities for substance use treatment, connect justice involved Vermonters to substance use counseling and peer support, and foster collaboration between emergency medical services, recovery coaches and treatment providers.

It also expands the organizations eligible to provide safe syringe exchange services, addresses barriers to treatment for Medicaid and investigates the logistics of establishing overdose prevention sites in Vermont. The work in H.728 is in addition to over $9 million of investments in substance use programming contained within the budget as passed by the House.

Additional funding for other initiatives focused on prevention, treatment and recovery will also become available through the designation of an opioid settlement fund outlined in H.711. The Vermont Attorney General’s Office, along with other state attorneys general and thousands of other state subdivisions — cities, towns and counties — have been fighting to end the opioid crisis and hold industry accountable for its role in promoting and profiting from the opioid epidemic.

As a result of these efforts, settlements have been reached with major opioid distributors and manufacturers. H.711, now in the Senate, will establish an Opioid Settlement Advisory Committee and Opioid Abatement Special Fund in compliance with any settlements to which Vermont or municipalities are parties. The state anticipates approximately $60 million over 18 years to address the opioid use disorders.

Uses of the fund are specified in the terms of the settlements and an advisory committee must be established to make recommendations to the designated state agency, the Vermont Department of Health, for spending the money. The advisory committee must be comprised of an equal number of state and local representatives. The settlement agreement also requires the advisory committee to have written guidelines for the appointment, removal and terms of service for its members, a meeting schedule, and a process for receiving information from cities and towns regarding their needs and proposals for abatement.

Fifteen percent of funds will be allocated directly to municipalities, 15 percent will be allocated directly to the state, and the remaining 70 percent will be placed within an abatement fund. This special funding must be used to support a wide variety of public health evidence-based interventions directed at prevention and treatment of opioid use disorders rather than general state revenue.

This is how we save lives.

I appreciate the input of so many of my neighbors on the importance of addressing this critical issue and for sharing their expertise as the Legislature has crafted responses.