Mt. Ascutney Hospital Makes Plans to Combat Opioid Crisis

Valley News Staff Writer
Friday, September 07, 2018

Windsor — Mt. Ascutney Hospital and Health Center has made progress in addressing the opioid epidemic, hospital CEO Joseph Perras told the Green Mountain Care Board during a recent budget hearing.

Such efforts have included eliminating the waitlist of patients waiting to begin medication-assisted treatment for addiction, reducing the rates of new prescriptions for opioids and benzodiazepines and establishing a location for distributing free naloxone, an overdose reversal drug sometimes known by the brand name Narcan, Perras said.

“That’s all great,” Perras said during the Aug. 29 hearing in Montpelier. “No waiting list. We’re not prescribing opioids. But we’re still failing.”

People continue to die of drug overdoses and to contract infectious diseases such as HIV and hepatitis C from drug use, he said. In 2017, 10 people in Windsor County died of drug overdoses, a rate of two people per 10,000, according to data from the Vermont Department of Health.

To address the continuing epidemic, Perras said he is going to focus on harm reduction in 2019.

“I feel like we are hitting a couple — it’s a little bit like whack-a-mole — we are hitting a few (of the issues), but if folks are still dying, we need to focus on reduction,” he said.

Not only does the epidemic affect people’s health, but it also affects the economy, Perras said. In particular, addiction prevents young people from participating in the workforce, which contributes to the hospital’s labor shortage, he said.

Harm reduction efforts could include beginning medication-assisted treatment in Mt. Ascutney’s emergency room for patients who come seeking opioids or are in opioid withdrawal, he said. In addition, he would like to begin a needle exchange program, which would provide sterile needles and information about treatment to people who use intravenous drugs. And, “down the road,” he said he’d like to see an observed injection center, also known as a supervised injection site, that would give people injecting drugs a safe place to do so.

Two needle exchange programs, run by the Lebanon-based HIV/HCV Resource Center, currently are in operation in the Upper Valley, at Good Neighbor Health Clinic in White River Junction and at the Springfield Health Center in Springfield, Vt.

And the Claremont School Board, in a 5-2 vote this week, paved the way for a third to be located at Valley Regional Hospital. The Claremont needle exchange required the school board’s approval under New Hampshire law, which bars needle exchanges from being established within 1,000 feet of school zones, unless the local board grants an exemption. Valley Regional Hospital sits next to Disnard Elementary School.

A previous version of Claremont’s needle exchange, which was located in the city’s soup kitchen, had to close last year because it was within a different school zone.

For his part, Peter Wright, CEO of Valley Regional, said Mt. Ascutney and others seeking to establish needle exchange programs need to be sure they have a strong relationship with their communities.

“In Claremont, we are in a safe school zone so we also needed to rely on our strong and long-standing relationship with the school boards,” Wright said in an email on Friday. “They need to trust us. We need to earn that. And all must be held accountable.”

Laura Byrne, the director of the HIV/HCV Resource Center, said she welcomed all three of the harm reduction ideas Perras described to the Green Mountain Care Board.

Needle exchange programs help prevent the transmission of HIV and hepatitis C by preventing people from sharing needles, she said. Such programs also help connect people to services.

Byrne, who spoke by phone from the White River Junction needle exchange at the Good Neighbor Health Clinic where she was working on Tuesday, said that a new client had come in that day and was able to get a vaccine for hepatitis A and B from providers at Good Neighbor, in addition to sterile needles.

Byrne also said that established safe injection centers in other countries, such as Canada, have been shown to prevent fatal overdoses, and the emergency room is a good place to begin providing medication assisted treatment, such as suboxone, a drug used to curb cravings for opioids, and refer people struggling with addiction to a treatment program.

Byrne’s organization has been eying Windsor as a possible location for a future needle exchange program, she said.

“We have a lot of clients from Windsor,” she said. “And they need services.”

Perras, who said via an assistant that he wanted to talk to stakeholders in Windsor before discussing his ideas with the Valley News, told the Care Board that he doesn’t expect it will be easy to get everyone on board to support these new initiatives.

“When the director of your emergency room feels like you’re substituting one opioid for another and doesn’t believe in long-term MAT ... programs, that’s a discussion that needs to happen,” Perras said. “And I met with him yesterday. And we are starting that journey together.”

As an internist, Perras said he felt the same way for a while, but the data has convinced him that such harm-reduction strategies are necessary.

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

 Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.