The number of opioid-related deaths Vermont saw in 2021 will likely exceed the previous year, and Lamoille County residents account for a disproportionate number of those deaths.

In the final opioid morbidity and mortality report released last month by the Department of Health, the county saw more opioid deaths per 100,000 residents through September than any other county in the state, with 39.4 deaths per 100,000 people.

Lamoille County saw 10 opioid-related deaths in 2021, far higher than the three-year average of 3.3. Chittenden County saw 29 and Windsor County counted 18 deaths. Most of these fatal overdoses involved the synthetic opioid fentanyl.

With three months left to count, the opioid death toll in Lamoille County is already twice what it was in 2020.

The report showed a stark trend of far higher overdose deaths in Vermont that in previous years. The state reached 150 deaths in total by September, shattering the three-year average of 98 and preparing to surpass the 157 total opioid-related deaths in all of 2020.

Though Lamoille County saw an expansion of its social safety net last year and continued dedication from those that staffed them, conditions of isolation and other difficulties brought on mainly by the ongoing COVID-19 pandemic have exacerbated the challenges people with opiate addictions face.

Isolation can be extremely damaging to people in recovery, according to Shannon Carchidi, who was named executive director of Morrisville’s North Central Vermont Recovery Center in December after stepping into the role in an interim capacity in September.

“We have worked really hard through the pandemic to continue to offer all our services,” Carchidi said. “It’s very apparent that, during the pandemic, the isolation has been very challenging. We know that isolation can be very detrimental to people’s progress and recovery in the journeys that they’re on.”

In September, the center began offering in-person services again to address this isolation. With group leaders who felt safe in this environment, Carchidi said people have been responsive.

With the Omicron variant now pushing case numbers to record highs in the state, the challenge has been to ensure that hybrid remote and in-person options are still available to meet the variety of needs of people in recovery.

“If we hadn’t come together as a state to really advance harm reduction initiatives, it would have been a lot worse. A lot of the recovery centers and other community partners like Vermont Cares, and even primary care organizations, went out of their way to go meet people where they were, instead of just expecting them to come to us all the time,” former center director Daniel Franklin said.

Franklin is now vice president at the Vermont Association for Mental Health and Addiction Recovery.

Franklin and Carchidi both cited the center’s strong partnership with Jenna’s Promise and the new multi-faceted recovery center being run out of Jenna’s House in Johnson as ways the center continued to build a more holistic “recovery village” approach to treating opioid addiction.

“We’ve made great strides and efforts with our new location in Johnson, which is a part of Jenna’s House,” Carchidi said. “We have the recovery center in the lower level. This location has allowed us to offer this holistic view of health and wellness.”

Overdose prevention sites

The pressures of the pandemic and the pervasiveness of the opioid epidemic have led to the opening of the country’s first officially sanctioned overdose prevention sites, also known as safe or supervised injection sites.

New York City opened two such sites in November where trained staff provide people addicted to opioids clean needles, naloxone to reverse overdoses and options for addiction treatment in a safer environment.

“Overwhelmingly, people who pass away from substances, it’s because they were alone, and they didn’t have somebody around to help them,” Franklin said.

Franklin acknowledged that opening overdose prevention sites in Vermont was a highly controversial idea but said that such sites had long existed in a clandestine form, operated quietly and outside of legal sanction.

The Vermont Association for Mental Health and Addiction Recovery supports gathering data on the overdose prevention site’s efficacy and sees them as an important next step in overdose recovery. Franklin is also on an overdose prevention site committee in Chittenden County.

“There’s really no danger to others, no matter where these are located,” Franklin said. “There’s always been this fear that if you create one of these sites, suddenly, the location and the area around it is going to be dangerous or something like that. The evidence just doesn’t support that, it really just gives people a safe place to go.”

There’s a lack of willingness in the Legislature to help create prevention sites and law enforcement would have to buy in to allow them to operate successfully, Franklin said. Though he saw the legalization of small amounts of the overdose prevention drug buprenorphine last year as unlocking another small piece of the opioid treatment puzzle, he’s hoping legislators continue the conversation and are open to further avenues of treatment.

Everyday prevention

Carchidi said there are two main ways the average person can help prevent opioid-related deaths.

One is to carry Narcan, a brand of overdose prevention medication, and get trained on how to use it effectively. The center distributes Narcan freely, gives presentations on how to use it and partners with other institutions like libraries to distribute and educate around it.

“Being able to administer Narcan is free, and it can save someone’s life and you can have it on you,” she said, adding that community members can also help by asking other public entities to distribute it.

Becoming a recovery-friendly workplace is another way to help people battling opioid addiction.

“We’re really focused on recovery-friendly workplaces, on what it means to contribute, so that people are not isolated and they can get back to work, so that people have second chances,” Carchidi said. “I’m a part of the Working Community Challenges Initiative and we’re focused on educating employers and employees on what that means to hire and retain and support individuals and families in recovery.”

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