How Vermont is tackling an opioid and heroin addiction crisis

Vermont, a tiny border state with Canada, is known for pretty scenery and maple syrup, but it now has a reputation for high rates of painkiller and heroin addiction. Its governor calls it a crisis and wants the drug abuse treated as a public health issue, putting addicts in treatment, not jail.

Tiny border state is treating addiction as a public health issue

Raina Lowell, at her home in Montpelier, Vt., is a recovering drug addict who used painkillers, then heroin. She wants people to know that anyone can be an addict and is applauding her state's approach to treating drug abuse as a public health issue. (Yanik Dumont Baron/Radio-Canada)

Vermont is known for its quaint towns, picturesque landscapes and maple syrup, but it’s now getting national attention for far different reasons — a high rate of drug abuse and how the state is handling it.

Gov. Peter Shumlin declared in January that what began as a problem with addiction to opioid painkillers such as Oxycontin and Vicodin has grown into "a full-blown heroin crisis." The number of people seeking treatment for heroin addiction has shot up 250 per cent since 2000. Last year there were 4,000 people in state-funded treatment facilities for opioid addiction — and more sought help but were put on waiting lists. Overdoses are rising.

"In every corner of our state, heroin and opiate drug addiction threatens us," Shumlin said in his annual State of the State speech, which was entirely devoted to the drug issue.

Vermont's population is little more than 626,000 and it has the second-highest per capita rate in the U.S. for treatment admissions for opioid addictions.

Bordering on Quebec, Vermont is a microcosm of what is happening across the United States. Prescription drug abuse is considered the country’s fastest growing drug problem and heroin use has been rising, especially among young people.

People usually start off with a dependence on painkillers, then some advance to heroin because it’s cheaper and easier to get than the pills. 
Margery Keasler sits on a memorial bench dedicated to her son Brennan in Oakledge Park in Burlington, Vt. Brennan died of a drug overdose in March 2013. (Yanik Dumont Baron/Radio-Canada)

Drug overdose deaths have more than tripled since 1990 and have never been higher, according to the U.S. Centers for Disease Control and Prevention. The agency estimates 100 people die from an overdose every day in the United States.

Margery Keasler’s son Brennan is one of those statistics. At age 19, he admitted he was hooked on painkillers he first used following a snowboarding accident and over the next eight years, he was in and out of rehab, battling the addiction that eventually took his life when he overdosed on heroin.

Radio-Canada’s Yanik Dumont Baron recently travelled to Vermont and met Keasler and others who are on the front lines of the state’s drug problem. Keasler said when Brennan was alive, she was consumed with trying to help him and since his death in March 2013, the guilt and second-guessing about what she could have done differently is overwhelming.

"It's all I think about," Keasler said.

Addiction can hit anybody

"All you want to do is keep them safe.… There’s a lot of failure associated with being the parent of an addict," she said. Her pain over losing her child is so intense that she has trouble looking at photos of Brennan, who was a typical teenager who loved snowboarding and came from a caring home. 

"The face of addiction is completely different than what people think it is," Keasler said.

Raina Lowell is another one of those faces of addiction. The 38-year-old’s addiction started eight years ago with painkillers then escalated to heroin and crack cocaine.

She thought she was too smart to get addicted, that it wouldn’t happen to her, but the drugs were a coping mechanism she couldn’t resist.

"It felt really good. It was liberating," she told Radio-Canada. "I felt like a better version of myself." As her body became dependent on the pills, Lowell said, she became utterly powerless. She hated herself because she couldn’t stop. 

Nobody is more powerful than addiction. If it gets you, personality doesn't matter. Your will power doesn’t matter.- Raina Lowell, recovering addict

All of her energy, and money, went into feeding her addiction, instead of putting food on the table for her two young children, Lowell said. When she hit rock bottom, her mother took her kids for a year while Lowell went to rehab.

It is painful for her to think about that period of her life, Lowell said, but she wants to share her story.

"I want people to know this is what addiction looks like," she said. "Addiction can hit anybody at any time. Nobody is more powerful than addiction. If it gets you, personality doesn't matter. Your will power doesn’t matter."

Gov. Shumlin said in his address that Vermonters like Lowell have a chronic disease that should be treated with the same attitude as cancer or diabetes. He is trying to transform the issue of drug abuse from a criminal one to a public health one.

"We must address it as a public health crisis, providing treatment and support, rather than simply doling out punishment, claiming victory, and moving onto our next conviction," he said.

Hub and spoke model

Shumlin wants to direct more funding to treatment centres and support programs to cut the waiting lists. The state is using a "hub and spoke" model with the regional treatment centres as the hub and then a network of primary care doctors, addiction specialists, psychologists and others as the spokes to help care for recovering addicts once they’re back home.

Shumlin also wants changes to the criminal justice system so that when someone is arrested a "rapid intervention" assessment could mean they enter immediate treatment instead of facing criminal prosecution. Pilot projects in some Vermont towns are currently using this approach. About 80 per cent of those in jail in Vermont have an addiction or are behind bars because of an addiction, he said. 
Maple Leaf Farm is a residential treatment facility for drug and alcohol addiction in Underhill, Vt. Gov. Peter Shumlin wants to direct more money to centres such as this. (Yanik Dumont Baron/Radio-Canada)

It’s a wiser use of taxpayer money, the governor argued, to fund treatment programs rather than incarcerating an addict, especially when they risk committing more crimes once released because they are still struggling with an addiction. A week in prison costs $1,120; a week treating a heroin addict costs $123.

The demand for opiates and heroin is high in Vermont, which means dealers from Boston, New York City, Detroit and other cities are taking their supply to the tiny state and cashing in. A bag of heroin that sells for under $10 in New York goes for about $30 in Vermont. An estimated $2 million worth of opiates and heroin is trafficked into the state every week. Police are trying to stop the flow.

Det. Sgt. James Trieb, an officer in the narcotics unit in Burlington, Vt., told Dumont Baron that a two-pronged approach is the way to go: enforcement and treatment. Police are targeting the source providers who are setting up shop in Vermont and at the same time, he said, addicts should be treated, not punished.

"The ultimate goal here is to get those folks treatment, it’s not to lock them up in jail," he said. If more addicts get the help they need, the demand will dry up and the suppliers will leave, Trieb said.

The Vermont governor’s focus on the drug problem won praise from his fellow Democrats, and from some stakeholders, but Republicans in the legislature say there are other challenges that should be higher priorities.

Shumlin, however, says tackling drug addiction is critical to Vermont’s future and as difficult and complex as it is, he’s confident. "This is tough stuff. But this is about getting help to those who are desperately sick, and giving hope to those who wish to get better. Help and hope are what we Vermonters do best." 


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