Editorial: Signs of Progress in Opioid Fight

Opioid addiction is a tenacious foe. The fight against it is complex and waged on many levels: personal, professional, political, cultural. The fields of battle range from the halls of power in Washington, D.C., to the country’s smallest, poorest communities. The casualties continue to mount — someone in America dies every 10 minutes from an opioid overdose — but there are some signs of progress in our corner of the world.

■ In Claremont, the School Board voted last week to permit Valley Regional Hospital to host a program that allows people who use intravenous drugs to exchange used needles for clean ones.

■ Joseph Perras, CEO of Mt. Ascutney Hospital and Health Center in Windsor, told the Green Mountain Care Board recently that his hospital has eliminated the wait for medication-assisted treatment for addiction, cut the rate of new opioid prescriptions and set up a distribution site for the overdose reversal drug naloxone.

■ And in Montpelier, Attorney General T.J. Donovan announced that Vermont is suing Connecticut-based Purdue Pharma, the multibillion-dollar company that makes and markets OxyContin, the prescription opioid painkiller that former Gov. Peter Shumlin said “lit the match that ignited America’s opiate and heroin addiction crisis.”

The vote in Claremont, which came after more than a year of sometimes-contentious debate, offers a glimpse into how complicated the issue can be. It followed the opening, and then the closing, of an earlier needle exchange program, which ran afoul of state law regarding the location of such services near schools. And it followed the closing of a drug treatment center in the city, and then the opening of The Center for Recovery Resources, under the auspices of TLC Family Resource Center, which offers recovery support to individuals and families affected by addiction. And it came only after state law was changed so local school boards could decide on allowing a needle exchange program in a drug-free school zone.

Strong support from Valley Regional President and CEO Peter Wright and Claremont Police Chief Mark Chase — including their willingness to take responsibility for making it work — were key to getting the needle exchange program going again in the city.

Chase hit the point exactly: “My belief is that it is all about harm reduction,” he said.

Not only do needle exchange programs help prevent the spread of blood-borne diseases such as HIV and hepatitis C, they also make it easier for people to learn about and access treatment services. They also cut down on both the number of discarded needles in the street and the number of police officers who suffer needle-stick injuries when responding to calls. (The Upper Valley has two other needle exchange programs, one at the Good Neighbor Health Clinic in White River Junction and another at the Springfield Health Center in Springfield, Vt.)

Perras, Mt. Ascutney Hospital’s CEO, also highlighted harm reduction in his remarks to the Green Mountain Care Board. In addition to the measures his hospital has already taken, Perras suggested starting medication-assisted treatment right in the emergency room for patients seeking opioids or in withdrawal. He’d also like to begin a needle exchange program and, at some point, possibly open a supervised injection site so people who are using intravenous drugs have a safe place to do so. Such sites are hugely controversial, but advocates say they can save lives.

“I really latched on to the saying, you know, you can’t get into recovery if you’re dead,” he told the board.

Donovan, Vermont’s attorney general, is taking a different approach to harm reduction: He’s joining attorneys general in at least 26 other states in suing a main source of the opioid addiction problem. Donovan’s 100-page complaint alleges that Purdue Pharma hid or downplayed the risks of addiction to those taking its painkillers, among other unfair and deceptive trade practices. The company denied the allegations, but it has also already paid out hundreds of millions of dollars in fines and settlements over the last decade, and several top executives pleaded guilty in 2007 to misbranding charges.

That America remains firmly in the grip of the opioid addiction crisis should come as no surprise, really, since more than one-third of American adults — nearly 92 million — have been prescribed opioids like OxyContin, according to the National Survey on Drug Use and Health. The human toll has been, and continues to be, horrific. Opioids — including legally prescribed painkillers and illicit narcotics such as heroin — accounted for nearly 70 percent of the country’s 72,000 drug overdose deaths in 2017, according to estimates by the Centers for Disease Control and Prevention.

There is no “Just Say No” solution to this complex problem. That’s why those on the front lines of the opioid addiction fight, including health care leaders like Wright and Perras and law enforcement professionals like Chase, talk less about solutions and more about trying to do whatever they can to reduce the terrible harm that is being done to thousands of Americans — parents, spouses, children, siblings, friends — who are dying opioid-related deaths every day, every hour, every 10 minutes.