Any room for expanded opioid treatment in the budget?

Just askin’.

It’s clear that opioid use disorder has gotten more prevalent since the pandemic began, both nationally and in Vermont. The Centers for Disease Control published a report in December that said overdose deaths rose sharply after the onset of the Covid-19 pandemic, due to “a larger supply of illegal drugs, reduced access to addiction and overdose treatment, and the lethality of synthetic fentanyl.” A study published in Population Health Management reports that, while testing for illicit drugs plummeted in the early weeks of the pandemic, positive test results for opioids went through the roof.

The American Medical Association says that “More than 40 states have reported increases in opioid-related mortality as well as ongoing concerns for those with a mental illness or substance use disorder,” and recommended action “to remove barriers to evidence-based treatment for those with a substance use disorder as well as for harm reduction services.”

Which leads me to the question posed above.

Maybe there has been an expansion of treatment, harm reduction and availability of naloxone, buprenorphine and other relevant medications. Maybe the feds’ Covid relief bills brought some funding to the states for such programs. Maybe the state acted on its own to fight this aspect of the pandemic’s impact on society.

But if they have, it’s news to me.

Maybe Gov. Phil Scott’s budget for FY2022, which takes advantage of federal relief money to boost a variety of economic development programs, increased funding for alcohol and drug use programs.

Well, I can check that, and the answer appears to be “No.” Category B.313 of Scott’s proposed budget would essentially level-fund alcohol and drug use programs. (Technically there’s a slight increase, but less than the impact of inflation and pay rises.)

And if Scott has publicly called for measures to combat the rise in substance use and opioid deaths, I haven’t heard about it. In his budget address, he boasted that “with the help of federal stimulus, includes $210 million in bold new investments to strengthen the economy, create more and better paying jobs, and address big priorities, like downtown revitalization, infrastructure, broadband and climate change.”

See the word “opioid” in there? Nope.

Ditto for legislative leadership, for whom my expectations are higher than for the governor. There is one hit when you search the Legislature’s website for opioid-related bills: H.212, which would “expand the distribution and availability of opioid antagonists.” (Hat tip to Rep. Barbara Rachelson, the lead sponsor.)

The Legislature’s list of bills wouldn’t reflect any action by House or Senate Appropriations to boost funding for alcohol and drug programs, and I’m not up on those committee’s deliberations.

But here’s what I can say. A worsening opioid epidemic, including an increase in deaths, is clearly a consequence of the pandemic. People are isolated. Many are out of work, or their work has gotten less predictable.

And as far as I can tell, nothing has yet been done by the administration or Legislature to address the issue, and there’s no sign that any action is in the offing.

If true, that’s utterly shameful. I’d be happy to learn that this is due more to my lack of knowledge than a complete failure by state leadership to respond to a deeply problematic consequence of Covid-19.

I’d be happy to learn that, because it would significantly increase my now-jaundiced view of our leaders.


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