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‘It’s still not enough’ RRMC brought local and national leaders together for roundtable discussion on opioid epidemic and substance abuse

By Ethan Weinstein/VTDigger

In what he called his “first day” as a U.S. senator, Peter Welch, D-Vt., returned to Vermont to discuss the opioid epidemic and substance use disorder at Rutland Regional Medical Center.

“This has been an area of enormous bipartisan cooperation in Congress,” Welch said at an event at Rutland Regional Medical Center, Monday, Jan. 9, praising the resources Washington has funded to support the firsthand addiction-treatment work of the clinicians on the ground. “My job is relatively easy — it’s about appropriating money to get those resources back to communities.”

In addition to Welch, Monday’s roundtable discussion included Rutland hospital staff and Rutland City Police Chief Brian Kilcullen, and Xavier Becerra, the Biden administration’s secretary of health and human services. And while all had positive things to say about current efforts to fight the opioid crisis, the message was clear:

“We’ve got work to do,” Becerra said, summing up the afternoon, and “as much as we’ve got more money now than we’ve ever had before, it’s still not enough.”

Vermont is on pace for another year of record opioid overdose deaths. The latest state data shows that from January to September, 168 Vermonters fatally overdosed — nine more than in the first nine months of last year.

Welch listened as Alison Davis, medical director of the Rutland hospital’s emergency department, described dire scenes inside the emergency room. More people are overdosing from fentanyl who believe they’re taking non-opioid drugs, Davis said, and patients are requiring more Narcan to be revived than ever before due to the strength of the drug supply. 

“Unfortunately, we’re also treating children as young as 2 years old, who have overdosed on their parents’ medications and their parents’ heroin,” Davis said. “We’re seeing more children coming in from schools into the emergency department with behavioral issues, having experienced both physical and emotional trauma in their homes related to substance use disorder.”

Unlike opioids, xylazine — an animal tranquilizer increasingly found in Vermont’s opioid supply — does not respond to the overdose-reversing drug Narcan. Mixed with fentanyl to form so-called “tranq dope,” xylazine is “becoming omnipresent here in Rutland,” Davis said.  

The potent drug combination is also causing more intense withdrawal symptoms, said Davis.

Saeed Ahmed, medical director at West Ridge Center, a medically assisted treatment location and part of the Rutland hospital, praised the “Wheels and Waves” program, which allows patients to take methadone at home using telehealth to talk with their clinician. 

The program — which Welch, as a member of Congress, helped to fund — kept 95% of patients in treatment after a year, compared to 50% in other clinics, according to Ahmed. 

“Rural areas where it’s extremely difficult to reach out to folks” need mobile methadone treatment options, Ahmed said. Mobile clinics would prevent patients from having to travel 30 or more minutes for treatment, and also allow people with suspended or revoked driver’s licenses to seek treatment, he noted. 

Mobile clinics also could serve incarcerated individuals, Ahmed said, who may avoid seeking medically assisted treatment due to the stigma of having to travel in handcuffs with law enforcement to appointments. And with a lack of sober living houses, transitioning to a new lifestyle is even more difficult for Vermonters with substance use disorder.

In Rutland, the toll of the opioid epidemic continues to grow. Property crimes have soared, as have overdoses, which rose 46% from 2021 to 117 in 2022, according to statistics provided by the Rutland City Police Department. December alone had 17 overdoses — more than any other month last year.

“The numbers are not flattering,” said Kilcullen, Rutland City’s police chief. 

Initially, property crimes went down as the city increased treatment opportunities in the years following the founding of Project VISION, a coalition of organizations, government, businesses and individuals formed in 2013 with the goal of building a better future for Rutland. But that trend has since reversed.

“We’re 10 years into this since Project VISION was created. I think Covid negatively impacted the progress we made early on,” Kilcullen said. He advocated for additional funding for inpatient treatment programs. Currently, Vermont funds a two-week program, while neighboring states fund 30-day programs and report more success.

Nontraditional police services appear to be one path toward positive change, Kilcullen said. 

Earlier this year, Matt Prouty, a former Rutland police commander and director of Project VISION, became the city’s first community resource specialist. In the role, he responds to noncriminal calls and helps connect residents with resources.

“We’re not looking to provide a police response to matters that don’t require police response,” Kilcullen said. “It’s difficult for us to hire officers; it is easier for us to hire a non-sworn officer.”

Just last week, Prouty announced that he would once again lead Project VISION, returning to his role as police commander. But the community resource specialist role has been a success, according to Kilcullen, and the city will fund a second position in the next fiscal year, and hopes to have two specialists by July. 

Thanking the “frontline folks” for their dedication to fighting the crisis, Welch vowed to return to Washington with the room’s words in mind. 

“We are going to get these ideas back to you,” he said. “I need to keep this good work going.”

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