This commentary is by Kate O’Neill of Burlington. Her reported memoir about her family’s experience with addiction and the ongoing legacy of the drug war will be published next year by Knopf.
I used to have two sisters. The youngest, Maddie, was whip-smart and hilariously funny. She was madly in love with her curly-haired son, who adored his mama in return. Her voice when she sang was like clear lake water you wanted to both dive into and float on, buoyed by the sound. She took walks on the bike path in Burlington’s New North End. Her favorite show was “Family Guy.” She could talk to literally anyone.
Maddie also had a chronic, relapsing and sometimes fatal medical condition. Effective treatment for her illness is not widely available, and during the decade she was sick, she often had to overcome significant barriers to receive medication and services; sometimes she was unable to surmount those hurdles. Even when they can get treatment, patients with Maddie’s condition need years, on average, to achieve stable remission. So it’s crucial they’re cared for and protected when sick.
My sister’s medical condition is shared by more than 50,000 Vermonters: She had substance use disorder. I hadn’t heard of overdose prevention centers, an essential tool for protecting people with substance use disorder, when my sister was alive. OPCs are spaces where people can use drugs under supervision of trained staff who provide medical intervention if an overdose occurs. When Maddie died in 2018, there were more than a hundred centers in countries around the world, including Canada, Australia and Germany. But there were none operating openly in the U.S., even as the number of overdose deaths rose to unprecedented levels.
This is unsurprising. The U.S. has not just criminalized drug use for more than a century, it has been disgracefully slow to implement life-saving strategies to protect people who use illicit drugs.
When HIV began to proliferate in the 1980s, European countries moved quickly to implement public-health measures that reduced the spread of the virus among people who inject drugs, such as distribution of sterile syringes. The U.S. did the opposite.
In 1989, we became the only country in the world to ban federal funding of syringe services. In 1990, New York City’s health commissioner said publicly that he’d rather prevent drug use than prevent AIDS (a statement both monstrously biased and illogical: refusing people access to safe equipment doesn’t stop them from using drugs). By the mid-1990s, syringe distribution was illegal in most states. As recently as 2015, Gov. Mike Pence refused to lift an Indiana ban even as an outbreak of HIV ripped through a corner of his state and fellow Republicans begged him to act. (He finally did, but not before 235 people in a county of 4,000 had contracted the virus in a year.)
By the 1980s, there was incontrovertible evidence that providing sterile syringes to people who inject drugs prevents the spread of HIV. Decades of research since have proved that syringe services programs not only prevent disease transmission, but also increase access to addiction treatment, decrease drug use, reduce crime and save billions in healthcare costs. It’s clear that those who opposed syringe distribution were on the wrong side of history.
But history is repeating itself now with overdose prevention centers. Overdose deaths more than doubled in Vermont over between 2019 and 2022. We have among the highest per capita overdose death rates in the country. Yet Gov. Phil Scott recently vetoed a bill that would open a pilot overdose prevention center in Burlington.
Scores of studies show the benefits of OPCs: Like syringe-services programs, they prevent disease, increase treatment access, decrease drug use, save money and reduce crime. They also prevent fatal overdoses. Vancouver experienced a 25% decrease in overdose deaths in the neighborhood around a prevention center; in Barcelona, overdose mortality was cut in half. Not a single overdose death has occurred at any OPC in the world. Supported by everyone from the American Medical Association to our governor’s own health commissioner, they are an indispensable public-health initiative during Vermont’s overdose crisis.
My sister didn’t die of an overdose. Eight days before Maddie’s death, she was arrested while suffering from a treatable heart infection. At the police station, she clutched her chest and begged for medical attention; police officers didn’t provide it. After being transferred to jail, she again asked for help. “This is what you do to yourself,” correctional officers told her, ignoring her suffering because they believed it was a result of opioid withdrawal. If a police or correctional officer had gotten Maddie medical attention, she would likely be alive now — singing Taylor Swift songs to her son, hiking Mount Mansfield, making her dad breakfast on Father’s Day.
Thousands of Vermonters are asking their representatives to do what those police and correctional officers did not: Respond with compassion to the pleas from our loved ones who are at imminent risk of dying. Do what is necessary to prevent their suffering and death, in this case by overriding the governor’s veto.
Perhaps Gov. Phil Scott vetoed that bill because he’s biased against people who use illicit drugs; maybe he thought it would help him win reelection. Legislators may be considering sustaining his veto for similar reasons. Whether because of politics or prejudice, the governor and legislators who sustain his veto will not just be on the wrong side of history, people will die as a result. We are begging on behalf of our sisters and sons and cousins, fathers and aunts and neighbors: Help us.
Read the story on VTDigger here: Kate O’Neill: Prevent suffering and death, override the overdose prevention center veto.