The share of people struggling with opioid addiction in Vermont has long been higher than the national average. The state has made addressing the epidemic a priority, and now thousands of Vermonters are in recovery.
Back in the 1990's, articles appeared in the medical literature endorsing the use of opioids for chronic non-malignant pain, with persistent low-back pain presenting a common challenge. Vermont was quick to get in on the act, especially since there was a firmly-held belief that chronic pain was under-treated.
What was not known at the time, but has since become evident, are all the down sides of using opioids for chronic pain. Even worse, many people in the state have become hopeless addicts to prescription opioids, with significant numbers of persons passing away each year due to fatal overdoses.
This is particularly the case with newer, long-acting opioids like extended release oxycodone. As a result of the spate of addictions, overdose case and fatal overdoses some practitioners have become reluctant to use opioid therapy. Nevertheless, prescriptions are still too plentiful, with a clear over-prescription situation prevalent in the state of Vermont.
Preliminary data for 2018 showed that nearly all opioid-related fatalities among Vermont residents were of accidental or undetermined intent. Three deaths were determined to be suicides (3%of all opioid-related deaths).Seven non-Vermont residents died in Vermont in 2018 due to prescription opioid related mishaps.
As of today, the Vermont Office of the Chief Medical Examiner (OCME) has one pending in-state death investigation and two cases pending for out of state deaths. In all these cases, there is a stark link to prescription opioids.
The number of opioid-related fatalities involving a prescription opioid has remained relatively consistent since the year 2015 (31 deaths in 2015, 35 in 2016, 33 in 2017 and 31 in 2018). Given that the number of overall deaths increased during this time, the proportion of deaths involving a prescription opioid has decreased considerably (from 41% in 2015 to 28% in 2018).
Over 8,000 people — or about 1.6% of the adults in the state — were being treated for opioid addiction at the end of February 2019, when Vermont Blueprint for Health's executive director, Beth Tanzan, testified in front of the U.S. Senate with regard to the evils of over-prescription in the state.
In the year 2013, when the state began its hub-and-spoke program, 5,401 people were treated for addiction. In 2017, the yearly total jumped to 7,959, an increase of 47%. Though there is no comprehensive count of how many Vermonters are in recovery, the state estimates that the average person with opioids addiction accesses treatment for about 10 months. Physicians have admitted that in many cases, the 10-month time period is insufficient and that a significant number of rehabilitated people relapse.
In 2017, Vermont providers wrote 50.5 opioid prescriptions for every 100 persons. This was among the lowest prescribing rates in the country and lower than the average U.S. rate of 58.7 prescriptions (going by information sourced from the CDC).
However, while most states have seen an increasing trend since data collection began in 2006, the opioid prescribing rate in Vermont has declined marginally, by 10%, over the last decade.
The rate of overdose deaths involving opioid prescriptions increased steadily beginning in 2014 from 4.3 deaths per 100,000 to 6.3 deaths per 100,000 persons. In the year 2017, there were about 115 drug overdose deaths involving opioids in the state of Vermont - a rate of 20.0 deaths per 100,000 persons, compared to the national rate of 14.6 deaths per 100,000 persons.
The greatest increase was among deaths involving synthetic opioids other than methadone (mainly Fentanyl) with 77 deaths in 2017. Heroin-involved deaths also rose from 10 deaths in 2012 to 41 deaths in 2017. Overall, deaths involving prescription opioids have not changed since 2013.
NAS or neonatal opioid withdrawal syndrome (NOWS) may occur when a pregnant woman uses drugs such as opioids during pregnancy. The rate of NAS/NOWS in Vermont ranged from a low of 28.3 to a high of 59.4 cases per 1,000 hospital births in 2016.
Overall, there were 107opioid-related fatalities among Vermont residents in 2017. Six of those deaths were determined to be suicides (6% of all opioid-related fatalities). Public attention has been primarily focused on opioid misuse and abuse. In the year 2017, there were 101accidental and undetermined opioid-related deaths among Vermont residents - a 5% increase from the 96 reported in 2016. This equates to a rate of 16.2 fatalities per 100,000 Vermonters.
Of the new HIV cases in 2016 linked directly to prescription medication abuse and carelessness stemming from it, 8 occurred in Vermont. Among males, 12.5% of new HIV cases were attributed to male-to-male contact and IDU. Among females, no new cases of HIV were attributed to IDU.
In 2015, an estimated 671 persons were living with a diagnosed HIV infection in Vermont — a rate of 123 cases per 100,000 persons. Of those, 19% of male cases were attributed to IDU or male-to-male contact and IDU. Among females, 32.3% were living with HIV attributed to IDU.
There were approximately 5 new cases of acute HCV (0.8 per 100,000 persons) reported in Vermont in 2016 (CDC). In Vermont, there are an estimated 3,700 persons living with Hepatitis C (2013-2016 annual average), a rate of 730 cases per 100,000 persons. Many of these cases are linked to prescription opioid abuse.
Fortunately, the state of Vermont has multiple treatment centers and modes of rehabilitation. There are many types of treatment centers such as long term addiction treatment facilities, short term drug abuse treatment, outpatient detoxification programs, outpatient substance abuse treatment services, inpatient drug abuse treatment and others.
There is a wide range of drug and alcohol rehab facilities available in Vermont. They include individual psychotherapy, dialectical behavior therapy, couple/family therapy, trauma therapy, trauma-related counseling, cognitive/behavior therapy and others, to name a few. If you need rehab in Vermont, place a call to any of the available rehab centers.
If you are addicted to alcohol or drugs, it is imperative that you look for professional help as soon as you possibly can. However, you might not know where to start or the options that are open to you. Similarly, you may have little to no idea about the differences between the different treatment facilities and the programs they have in store for their patients.
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