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What’s the Drug Deal? Diagnosing Vermont’s Opiate ‘Crisis’ b y M A R k dA vi S
SEVENDAYSVt.com 01.15.14-01.22.14 SEVEN DAYS 14 LOCAL MATTERS
• A 2013 Vermont Department of Health report found the number of people hospitalized for opiate overdoses in the preceding 10 years has remained “consistent.” • The number of opiate-related deaths in Vermont has not changed significantly since 2006, and actually dropped 8 percent from 2011 to 2013. The Department of Health said it could discern “no specific trend” in opiate deaths in the past decade. (In 2013, as Shumlin noted, the number of heroin deaths nearly doubled, from nine to 17. Deaths from prescription opiates fell from 46 to 39.) • Shumlin correctly stated that the number of Vermonters in treatment for opiate addiction has surged nearly 800 percent since 2000. However, health experts say that figure likely overstates the increase in new addictions; at least some of the jump can be traced to existing addicts claiming a greatly expanded array of treatment slots. • While Shumlin accented the growing problem of heroin, he also suggested
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ov. Peter Shumlin grabbed state and national headlines last week when he used his State of the State address to launch a campaign against a “rising tide” of opiate addiction and related crime. “In every corner of our state, heroin and opiate drug addiction threatens us,” Shumlin declared to a packed House chamber as the 2014 legislative session began. “It is a crisis bubbling just beneath the surface that may be invisible to many, but it’s already highly visible to law enforcement, medical personnel, social services, addiction treatment providers and far too many Vermont families. It requires all of us to take action before the quality of life that we cherish so much is compromised.” There is little doubt that Shumlin was correct in identifying opiate addiction, and a shortage of treatment options, as serious problems. Vermont had the nation’s highest rate of illicit drug use in 2010-2011; police are making more arrests for heroin and other drug-related crimes; and 1,000 people are on waiting lists for treatment. But was the governor correct to assert that there is a “growing epidemic” and a “rising tide” of addiction and drug-related crime spreading across Vermont? The answer to that question is far from simple. While the measures of opiate addiction and drug-related crime cited by Shumlin and his supporters are going up, other key indicators have remained unchanged — or even fallen — in recent years. Consider:
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Recovering opiate addict Dustin Machia speaks at a Statehouse press conference last week
that prescription drug abuse was part of the “rising tide.” However, 2013 Vermont Health Department surveys of adults, high school students and middle school students have shown that the misuse of prescription drugs, most of which are opiates, has not increased since 2007. • Overall property crimes, which in clude larceny, burglary and vehicle theft — the category of crime that law enforcement officials typically identify as being committed by addicts seeking money to buy drugs — have steadily declined in Vermont since 2008, according to federal statistics. The Shumlin administration referred most questions to Health Commissioner Harry Chen. While acknowledging figures that seem to contradict the assertion of a “rising tide,” Chen said his boss was right to draw attention to opiate addiction and those who cannot access treatment. “The case can be made very easily that it’s a huge problem in Vermont,” Chen said. “Most Vermonters agree that this requires focus and attention, and I applaud the governor.”
Treatment Tells
In his State of the State address and appearances afterward, Shumlin painted a grim picture of opiate addiction spreading from big cities into a peaceful state, leaving shattered lives in its wake. He pointed to the example of Dustin Machia, one of the addicts featured in The Hungry Heart, Bess O’Brien’s documentary film about drug abuse in the St. Albans area. A young man raised on a dairy farm, “Dustin started using drugs in 10th grade, during a 15-minute break between school exams,” Shumlin recounted. His addiction to OxyContin, a prescription painkiller, quickly grew from a $100-a-week to a $3,500-a-week habit, leading him to steal more than $20,000 worth of farm tools and equipment from his own parents. “‘Be careful because your addiction is waiting out in your driveway, just getting stronger, just waiting for you to slip up and take you away,’” Shumlin quoted Machia as saying. With support from his family and treatment from Franklin County pediatrician Fred Holmes, Machia beat his drug problem and has been clean for five years. Machia is just one of many Vermonters who have seen their lives — and those of
their families, friends and communities — ravaged by addiction. Shumlin cited a 770 percent jump in people receiving treatment for opiate addiction since 2000 and a long list of people waiting to enroll. But health experts acknowledge that those numbers should probably come with a disclaimer: The dramatic rise in people enrolling in opiate treatment is at least partly a product of successful initiatives to open new treatment centers and allow doctors to treat addicts in their own offices. The 770 percent is attributable not just to a surge in demand for treatment, they said in response to questions, but also to an increased supply of treatment. “We began to look at, ‘Is there a better way to put the pieces together to expand access and getting it to more people who need this treatment?’” said Barbara Cimaglio, the state health department’s deputy commissioner for alcohol and drug abuse programs. “It’s in everyone’s best interests to get people help and get them into recovery.” In 2000, the baseline year of Shumlin’s treatment statistic, there was no place to receive treatment for opiate addiction in Vermont; patients had to travel out of state.