Announces new partnerships with UVM Medical Center, Department of Health, State’s Attorney + metro area police to increase prescribing practice transparency, accelerate public reporting of county opioid deaths + better coordinate opioid-related police work
Burlington, VT – Mayor Miro Weinberger today released new principles and announced the pursuit of new initiatives to address the deepening opioid crisis in the region that has resulted in a significant 38 percent increase in opioid-related deaths in Vermont from 76 in 2015 to an estimated 105 in 2016. In Chittenden County, indicators such as retail theft and opioid-related arrests also show a growing crisis. The City is moving on numerous fronts to organize a sustained local effort to turn the crisis around, and announced today new partnerships with the University of Vermont Medical Center, the Chittenden County State’s Attorney, and metro area police departments.
“Despite the hard work of many state and local agencies and individuals that undoubtedly has saved lives, we face a deepening opioid crisis that is taking lives and ravaging our community,” said Mayor Miro Weinberger. “The City is using its new analytical and coordinating capacity to take stock of our collective efforts, create new partnerships, and launch new opioid initiatives. All of us – government officials, doctors, police, parents and patients – must take responsibility, be fully aware of the risks of opioids, and act with urgency to turn this crisis around.”
“The goal of the Burlington Police is to reduce the number of Vermonters who die from opioid overdoses,” said Burlington Police Department (BPD) Chief Brandon del Pozo. “Achieving this goal will yield many collateral community benefits, such as fewer overdoses and overall fewer fractured families and social networks. We appreciate that medical professionals, business and community leaders, and people from all government sectors will stand with our mayor on a set of guiding principles that will keep our collective work focused. The work ahead will involve the police taking novel approaches to saving lives, and we are ready to innovate. All we request is that our partners be as relentless as we will be.”
New Opioid Principles
The City of Burlington is redoubling its efforts with new initiatives on numerous fronts of the opioid crisis. The City has drafted 11 new Opioid Principles to explain its approach to the public, to encourage community debate about and engagement with these efforts, and to guide City employees and officials working on this urgent challenge (each principle is expanded upon and explained in the attached document):
- Prescription opioids can be as dangerous as heroin – and should be treated as such.
- Opioid addiction is a public health crisis with a law enforcement component.
- City governments play a unique and vital role in addressing the opioid challenge.
- People struggling with opioid addiction need access to treatment without delay.
- Police should give amnesty to users seeking help for their addictions and send them to treatment.
- Heroin dealers who knowingly destroy communities should receive the full penalties they deserve.
- The community needs the medical profession to fully embrace its role as one of the most important partners in solving the opioid crisis.
- All institutions engaged in resolving the opioid crisis should embrace data collection, data-sharing, analysis, and transparency.
- The pharmaceutical industry has a role in resolving the crisis it helped create.
- Treatment for opioid addiction should not end upon arrest.
- Naloxone must be available to the people abusing opioids, their friends and family, and their emergency service providers.
To share its approach with the public, and to gather public input through community debate and engagement, the City will hold an Opioid Town Hall meeting in Contois Auditorium on March 16 at 6 p.m. before presenting these principles to the City Council for final approval.
There will be an additional Burlington public event regarding the opioid crisis on April in Contois Auditorium at the Mayor’s Book Group discussion ofDreamland: The True Tale of America’s Opioid Epidemic. Author Sam Quinones will speak at the event and participate in a panel discussion. Dreamland reveals the origins of the nation’s opioid epidemic in the 1980s and 1990s – a narrative that is critical to understand as we seek to resolve this corrosive crisis.
New initiatives flowing from these principles
The City has taken the following steps in accordance with its principles:
- CommunityStat effort expands to include South Burlington and Winooski police departments
As of February 2017, the CommunityStat group has expanded to include representation from the South Burlington and Winooski police departments. The CommunityStat group was originally formed in November 2016 to provide coordination of data gathering and analysis efforts among the police, public health and safety professionals, and social service providers as part of the effort to more effectively reduce the impact of opioid addiction in Burlington. The South Burlington and Winooski police departments have agreed to meet with the BPD on a bi-weekly basis to discuss identified cases and concerns.
Through these conversations, the three departments will identify individuals who are engaged in risky behavior, need treatment, housing, or other social services, or may cause imminent harm to themselves or their community. The police departments will track these cases, including the time it takes to get an individual into various levels of care, and will share the data findings at the monthly CommunityStat meeting.
“The Winooski Police Department is looking forward to collaborating on this project,” said Winooski Police Department Chief Rick Hebert. “Joining data sets from our three cities will enable the team to more quickly identify and provide services to people caught in this public health epidemic.”
“The South Burlington Police Department is pleased and proud to be involved with CommunityStat,” said South Burlington Police Chief Trevor Whipple. “Individuals struggling with opioid addiction travel from community to community, making this collaborative effort even more important. This common sense approach to fighting addiction and working toward saving lives is beneficial to all our communities and those we serve. We are appreciative of Burlington taking the lead and inviting our department to join the fight against this public health crisis. We are fully committed to working together to help those in crisis.”
- First regular CommunityStat data report
One of the key Opioid Principles is a commitment to data and transparency, an effort that already has yielded valuable insights into the many effects of the crisis at the local level. Slides compiled through the City’s CommunityStat meetings (see attached) show worsening trends.
- In 2015, more children under six years old came into Department of Children and Families custody due to guardian opioid use issues than any other issue (51 percent, or 276 cases total).
- More individuals are seeking treatment for opioid substance abuse than ever before in both Chittenden County (1,390) and the State of Vermont (6,084). Statewide, in 2015 more people received treatment for opioid substance abuse than all other substances combined.
- Opioid-related overdose deaths statewide and in Chittenden County continue to rise. Chittenden County reported 20 deaths in 2015, up from 19 in 2014 and 18 in 2013.
- There is increased demand for Narcan year over year. In 2015, Safe Recovery dispensed 5,872 doses of Narcan to the public, up from 2,893 doses in 2014.
- Anecdotally, many social service agencies, including those focused on housing, economic support, and treatment, are reporting increased stress on their agencies as a result of the crisis.
- UVM Medical Center agrees to reduce opioid prescriptions and increase public transparency around opioids
In January 2017, Centers for Medicare & Medicaid Services released a national Medicare Part D Opioid Prescribing Mapping Tool based on prescription data from 2013-2014. This mapping tool suggests that of all New England states in those years, Vermont was an outlier in its prescribing practices. The BPD has completed a thorough analysis of the data provided by the map (see the BPD analysis and Executive Summary attached), which includes individual physicians’ prescribing practices, and found the following:
- At 3.2 scripts per patient, Vermont opioid prescriber’s rates in 2014 were 13 percent higher than the next highest state (Maine), and 17 percent higher than the average rate for New England not including Vermont.
- Vermont also led the region in drug supply days per beneficiary. On average, individual recipients were suppled opioids for 69 days of the year in 2014. That is 10 days longer on average than for the region not including Vermont.
- At 6.34 percent of all drugs, Vermont prescribed opioids at a 22 percent higher rate than the average for the region not including Vermont in 2014 (note: VT was not the state with the highest rate in the region).
- In 2014, doctors in Vermont wrote 11,000 more opioid scripts (82 percent of which were for the most abused opioids) to patients than the previous year – a 9 percent increase. The number of days for which doctors supplied patients with opioids increased an average of approximately one and a half days.
This analysis, along with the information already publicly available on Vermont Prescription Monitoring System (VPMS), gave the City concern that prescribing practices may remain an issue. UVM Medical Center agrees with the City that it is important to continue to focus on prescribing practices, and this is an area where continued work is needed. The UVM Medical Center has agreed to spend 90 days to create a new system in which there would greater public transparency and accountability about the hospital’s prescribing practices. The release of UVM Medical Center prescription data will allow an important public conversation about optimal prescription practices. The City and the UVM Medical Center will also work with other stakeholders to translate this progress into a new, statewide system.
“The University of Vermont Medical Center is committed to stemming the opioid addiction epidemic in Vermont,” said Stephen Leffler, MD, Chief Medical Officer, University of Vermont Medical Center. “We are engaged in both the Chittenden County Opioid Alliance and the City of Burlington’s CommStat effort. The UVM Medical Center has increased the number of providers who are prescribing Medication Assisted Treatment by nearly 50 physicians over the last year and a half, while reducing the amount of opioids we prescribe, but there is much more work to be done. Transparency is important when we are reforming complex systems, and we look forward to partnering with the City of Burlington on developing a process for reporting on our progress.”
- State agrees to release frequent reports of opioid-related deaths
As mentioned earlier, recently released Vermont Department of Health data revealed that opioid-related deaths rose from 76 in 2015 to an estimated 105 in 2016 – a 38 percent increase. At present, the Health Department releases statewide opioid death numbers quarterly, and county-level numbers annually. The Health Department soon will begin updating county-level data monthly.
“Supplying this county-level information more often may help everyone engaged in responding to the opioid crisis have a more complete picture of what’s happening on the ground,” said Vermont Health Commissioner Harry Chen, MD. “We stand with Burlington and the Chittenden County Opioid Alliance and will do whatever we can to strengthen our collective efforts.”
In addition, the City has a new agreement with the State’s Attorney’s Office regarding the weekly reporting of untimely deaths.
“I want to continue to grow and strengthen the programs the State’s Attorney’s Office currently has in place to address opioid addiction as a public health issue, and also to address public safety and reduce recidivism rates,” said Chittenden County State’s Attorney Sarah George. “My office can be helpful at an even earlier stage in the process. I have directed our deputies to track every overdose death we are called on so that I can review and analyze that data. This process will allow us to have weekly numbers on the likely number of overdose deaths in our county.”
Summary of recent, previously announced City of Burlington initiatives to address the opioid epidemic
In the fall of 2016, the City reorganized the BPD to treat the opioid epidemic as a public health crisis, hiring former social worker Jackie Corbally as the new BPD Opioid Policy Manager, and sharing the cost with the Chittenden County Opioid Alliance (CCOA) of a new Data Manager, Sam Francis-Fath, to help analyze and track opioid-related data. The BPD also has contributed significantly to the effort with its own analyst, Eric Fowler.
In November 2016, the City launched its CommunityStat effort to reverse the opioid crisis by approaching it as a public health challenge that requires collaboration and coordination of efforts among all the community stakeholders engaged in responding. Stakeholders include the Vermont Department of Health, Vermont Department of Children and Families, Vermont Department of Corrections, University of Vermont Medical Center, Community Health Centers of Burlington, the Chittenden County State’s Attorney’s Office, State Attorney General, the Community Justice Center, Howard Center, United Way, Turning Point Center, Steps to End Domestic Violence, Champlain Housing Trust, Burlington Housing Authority, King Street Center, Outright Vermont, Spectrum Youth & Family Services, and many more.
“I applaud the City of Burlington for developing a comprehensive approach to finding solutions for the opioid crisis that includes education, treatment, and law enforcement,” said St. Albans Mayor Liz Gamache, who has been facing similar opioid challenges in St. Albans. “Progress can be made by engaging both stakeholders and the community at large.”