Vermont’s efforts to deal with ever-increasing deaths from drug overdoses have gotten a little bolder.
A new addition to H.222, the House overdose prevention bill, would kick off the statewide operation of drug control sites. These are places, often co-located with needle and syringe exchanges, with staff and machinery capable of testing illicit drugs for life-threatening concentrations of chemical additives.
THE amendmentunanimously approved Friday by the Senate Health and Welfare Committee, is designed to create immunity from arrest and prosecution for those who operate the site and collect samples, as well as those who bring or offer drug samples for testing there.
Previously, the bill — unanimously approved by the House in late March — focused on programs that would improve access to harm reduction supplies, such as establishing a needle disposal program and needles and wider public distribution of the overdose drug. Narcan.
It also made significant technical changes to relax prior authorization requirements for drug treatment of opioid use disorders and to allow ongoing prescriptions via telehealth. It also requires state regulators to increase the number of places where higher doses of buprenorphine can be prescribed.
But there had been no attempt to move towards more aggressive harm reduction measures such as safe consumption sites, which are places where people can use illegal drugs under supervision so that overdoses can be reversed. quickly. The action on the bill comes after the Vermont Department of Health reported 237 drug overdose deaths in 2022, the third straight record year.
“There’s a significant frustration, I think, in this building and in the community about what we can and can’t do, and why we’re not doing more, constantly. “said President Ginny Lyons, D-Chittenden Southeast. , when the Senate Health and Welfare Committee began gathering testimony on the bill on Tuesday.
Governor Phil Scott vetoed a bill last year that would have required a feasibility study on developing overdose prevention sites in the state.
The immunity language now included in H.222 was taken directly from S.119Senate bill that largely focuses on decriminalizing quantities of illicit drugs for personal use and is not expected to advance this year.
Proponents say the adopted section is narrower than other sections of this bill, focusing only on immunity related to the operation and use of drug control sites. They frame it as a 2013 extension of the state good samaritan lawwhich provides extensive legal protection for anyone actively seeking emergency medical help for a drug overdose.
This limited type of immunity is an essential legal framework, they say, to make drug control available statewide and protect people from potentially lethal doses.
“You can’t really move forward with on-site community drug checking without immunity,” said Theresa Vezina, executive director of Vermont CARES. “Comprehensive protection for everyone is really necessary.”
Vezina’s organization is one of many providing harm reduction services to street drug users across the state. Vermont CARES has offices in Barre, Rutland and St. Johnsbury and also employs staff who use vans and cars to deliver items such as sterile syringes, fentanyl and xylazine test strips, doses of Narcan and wound care kits on request.
The approved amendment also allocates fiscal year 2023 expenditures from the Special Opioid Reduction Fund, which contains settlement funds receivable over an 18-year period following the state’s involvement in several lawsuits at the nationwide against manufacturers and distributors of opioids.
Language largely follows funding recommendations the Vermont Department of Health and the Opioid Establishment Advisory Committee. But it adds $700,000 to the department to provide grants for setting up drug control services “in a harm reduction context.” The ministry would authorize the locations, according to the bill.
The Department of Health presented drug checking to the advisory committee as one of the programs it supports, but it was not included in the final recommendations, said David Englander, the department’s senior policy analyst, to the Senate committee in testimony this week.
Senator Ruth Hardy, D-Addison, a member of the advisory board and Senate committee, said she understands the lack of immunity language in the law is the main reason drug checking hasn’t been prioritized for funding.
The only current drug control program in the state is operated by the AIDS Project of Southern Vermont, initiated as a research project based at Brandeis University. Before getting started, the organization had to reach non-prosecution agreements with state attorneys’ offices in Windham and Bennington counties, executive director Samba Diallo told the House Human Services Committee in March.
The southern Vermont program is testing small amounts of a drug on a printer-sized spectrometry device kept in a special clean room at the organization’s Brattleboro office, said Dakota Roberts, an outreach worker. who collects, records and analyzes the samples. The machine uses infrared light to identify the range of chemical compounds in each drug sample. They are then sent to a more powerful mass spectrometer to determine the concentrations, he said.
The fact that the machine can detect a wide variety of chemicals is what sets them apart from test strips, which usually focus on one type of chemical. New fillers or adulterants, some of which have lethal effects, may become part of the drug supply at any time. Proponents say these types of machines are able to alert harm reduction programs and the people they serve more quickly.
“There will always be a demand, and therefore a new chemical,” Vezina said.
People using black-market stimulants and opioids in the Bennington and Brattleboro areas have found the tests helpful, Roberts said. In its first six months, the project examined about 40 samples. About two-thirds of the samples he collects during outreach visits and another third are brought during the organization’s weekly needle exchange hours.
The results are transmitted to the person who provided the sample, either by SMS, by e-mail or in person. But they are also published on a public website and mobile app called StreetCheck, developed at Brandeis. The website shows a photo of the original packaging, if available, and where and when the sample was taken.
Roberts has already seen how this information can quickly spread through a community and change behavior, leading users to either avoid a product or take a lower dose. Supporting similar projects across the state would provide even more shareable data.
“People generally want to be as safe as possible, so this is a very effective way to mitigate overdoses,” he said.