The time has come for overdose prevention centers

Our state needs to take new steps to support survival and recovery for individuals who struggle with substance use disorder. The House has approved a bill to establish two OPCs in Vermont as a pilot project.

Michelle Bos-Lun is a second-term member of the Vermont House of Representatives, co-representing the Windham-3 district, which includes her hometown of Westminster as well as Rockingham and Brookline.

On Dec. 29, I left my house at 4:45 a.m. and headed to Harlem with two legislative colleagues, Rep. Tristan Roberts (D-Halifax) and Sen. Tanya Vyhovsky (P/D-Chittenden-Central District) for a visit to the OnPoint NYC, the only overdose prevention center in the U.S., with two locations in New York City (though multiple other locations are about to open in other states).

Dr. Ashwin Vasan, commissioner of the New York City Department of Health & Mental Hygiene, has said about the work of OnPoint: "The facts are clear - overdose prevention centers save lives. Overdose prevention centers are an evidence-based approach to harm reduction we must authorize, invest in, and expand to combat our overdose epidemic."

I did not know what I would find at OnPoint, but I wanted to learn more. I knew that a vote to establish two programs in Vermont was pending in the Legislature and that I needed more information.

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Vermont has a very high per-capita rate of death due to opioid overdoses - a rate that has quadrupled in the 10 years that has passed since our then-governor dedicated his entire State of the State speech to the opioid crisis.

For much of 2023, after the Legislature adjourned, I did social services work with individuals who lacked permanent housing. Through my work and other community experiences, I know many Vermonters who struggle with substance use.

As a legislator, I have heard from concerned family members that the state needs to do more. I believe our state needs to take new steps to support survival and recovery for individuals - including many individuals I have worked with - who struggle with substance use disorder.

Adequate resources have not been available to help people like one man I had many conversations with this summer - someone who wanted to testify about supporting individuals with opioid use disorders when the Legislature resumed. He died before we returned to Montpelier.

Vermont needs to do better for our residents who struggle with these challenges.

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Currently, Vermont has only two facilities where inpatient substance use disorder treatment is available. It usually requires a long wait to get admitted, and residential programs rarely run for longer than two weeks, after which people are returned to the streets or to the homes they lived in before treatment - which often are places where active substance use is ongoing.

"Existing treatment options are insufficient - particularly if we do not keep our friends and neighbors alive long enough to access treatment when they are ready. We urgently need to pursue additional, commonsense strategies that can save lives today," Falko Schilling, advocacy director for the ACLU, shared in a recent letter to legislators.

What is an overdose prevention center? The site I visited was a multipurpose center with a multitude of services in the same complex.

The facility had a drop-in center, which provided three meals per day, a place to bathe and get mail, psychiatric services, basic medical care, and referrals, holistic health care (acupuncture and massage), materials to test drugs, and sterile syringes and supplies.

A relatively small portion of the building was devoted to one room where individuals could use substances in a supervised setting (and, if needed, they could receive treatment if an overdose were to occur).

Many of the staff at the site are former clients at the facility. It is a place for individuals who have struggled with substances to get support to stabilize their lives and to give them time to recover and help others.

OnPoint opened its OPC in 2021 and in its first year of operation reversed 636 overdoses. In only 23 of these instances was it necessary to involve EMS or transport to the hospital.

In New York, each overdose transport costs the state over $30,000 between transport, emergency department services, and other charges. The 636 individuals whose lives were saved at OnPoint also saved New York close to $2 million in transport and ED costs.

Vermont's costs would be different, but OPCs will lighten the load of our EMS responders. The funds to support these centers will come from opioid settlement funds, not taxpayer dollars. The drug companies that contributed to creating this problem will help fund one path to survival and recovery.

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Seeing people using drugs under supervision felt uncomfortable for me, but I was grateful to know that it meant that they were not using drugs alone, on the streets or elsewhere, and that they could get help in a myriad of ways.

Painted on the wall of the room used for overdose prevention, was a message: "This site saves lives."

It does. Every day.

I believe that it is time for Vermont to follow our neighbor to the north: Canada opened North America's first overdose prevention center in Vancouver nearly 10 years ago; now, 39 of them are spread across that country.

Globally, more than 200 overdose prevention centers have opened in 14 countries since the first site in 1986 in Switzerland.

The international data is clear: OPCs save lives and lead people to recovery.

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We need to develop options to help individuals who live with substance use disorder to have their lives saved in Vermont, too.

Criminalization of mind-altering substances has not worked. Prohibition didn't work in the 1930s. The War on Drugs hasn't worked, and we've been trying it since the 1980s.

The criminalization of drugs and drug users fills our incarcerative facilities, causes long delays in our court systems, and rarely gives people the support or opportunities that enable them to recover.

We need to help and support people - not arrest them for substance use struggles.

Overdose prevention centers help people survive, connect with resources, and build skills that support their transition from active substance use disorder to recovery.

At OnPoint, we met an individual who had received harm reduction services there in the '90s. He got sober and has now worked as a staff member for over 20 years.

Many stories like his were shared with us as we toured the facility and met staff and clients.

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A bill - H.72 - to explore this model in Vermont passed the House on Jan. 10 with strong support. If passed, it will designate two pilot projects in the state.

The bill has moved on to the Senate for consideration.

It's time to try a new, globally proven route to save and transform lives here in Vermont.

This Voices Legislative Update was submitted to The Commons.

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