BRANDON — There were two impressive guests at the regular Brandon Cares meeting Monday night, and they each offered some optimism and advancement in Vermont’s war on opiate addiction.
The first to speak was Theresa Vezina, the Harm Reduction Program Manager for Vermont Cares, the state’s largest AIDS service organization that administers a syringe exchange program.
Vezina explained that the goal of Vermont Cares’ mobile and walk-in needle exchange program is to help keep addicts safe from deadly disease and infection caused by using unsanitary syringes.
Vezina is based in St. Johnsbury but travels the state operating a mobile needle exchange out of her car, including the last two years in Rutland, and more recently in Middlebury. Brandon Cares co-founder Sue Gage spoke to Vezina last year about the program coming to Brandon.
“Since Brandon Cares reached out to us last year, we knew that Brandon was a place we’d like to put our focus, here in this community,” Vezina said.
The way a needle exchange works is the addict brings all their used syringes to the exchange and gets a 1:1 replacement of new, sterile syringes in return. While it may sound like a program aimed at enabling drug use, it is called harm reduction. Addicts won’t get clean until they are ready to get clean, and reusing dirty needles exposes them to diseases like AIDS and Hepatitis-C, as well as skin and septic infections that can be fatal.
“If we can help that person who is using to be healthier and in a safer space, that might be the one thing that saves them from something worse,” Vezina said.
But Vezina explained that Vermont Cares has also stayed in step with the state’s opiate crisis by becoming more than just a needle exchange, providing treatment options and counseling for clients who are in the very early stages of recognizing their addiction.
Vermont Cares also distributes Narcan, the opiate overdose antidote.
Vezina said there are a few Brandon residents who currently use the needle exchange in Rutland, and that it would be easy for her to stop in Brandon each week when she travels from Rutland to Middlebury administering the mobile exchange.
A former addict herself, Vezina was asked at what point does she refer the needle exchange clients to treatment. It is anonymous, with clients assigned numbers. No names are used.
“When they ask,” she said simply. “About 10 percent of our clients go to recovery. We believe that many of the people have left the program and gotten treatment, but I’ve also had people who have passed away.”
Brandon Cares is a community- based volunteer group that was formed in 2013 to help opiate addicts in Brandon and their families through ride sharing, education, outreach and support. The group has become an active part of Vermont’s hub and spoke model of opiate addiction treatment and recovery in Vermont. Hubs are the recovery centers in Rutland, Burlington and other larger towns, and the spokes are the local doctors and addiction counselors who treat local addicts once they get out of rehab and try to stay clean.
Brandon Cares was instrumental in supporting Dr. George Fjeld and Brandon Medical Center in becoming a Suboxone treatment office for local opiate patients last spring.
Fjeld was at Monday’s meeting and was very enthusiastic about he possibility of a mobile needle exchange starting in Brandon.
“28,000 people die of Hepatitis-C in the U.S. each year,” he said. “So, if we can get the people who are using (intravenous drugs) to survive until they get treatment, then we’re doing something positive.”
POSITIVE OUTLOOK AT HOME
A renowned addiction researcher and psychologist, Dr. Richard Rawson was also on hand at Monday’s Brandon Cares meeting to weigh in on the state of addiction in Vermont.
Rawson is the retired Co-Director of the University of California-Los Angeles Integrated Substance Abuse Programs and former Professor Emeritus at the UCLA Department of Psychiatry, in which he has been a member for more than 20 years. He has led groundbreaking research in the areas of methadone treatment for heroin addiction, cocaine and methamphetamine addiction, HIV and drug use, and one of the first studies on long-term heroin use, following addicts over 40 years from the Vietnam Era to present day.
Rawson has led addiction research and training projects for the United Nations, the World Health Organization, and the U.S. State Department. He was most recently involved in a research project studying the effects of exercise on recovering opiate addicts.
So why did Rawson retire to Sudbury? Well, he’s from here. Rawson was born in Whiting and graduated from Otter Valley Union High School in 1966. He earned his bachelor’s degree and doctorate in psychology from the University of Vermont.
“I got tired out after 40 years of all that and moved back to Vermont,” Rawson explained at Monday’s meeting. “But I also happened to run into this heroin problem.”
Rawson said UVM asked him to help out with some opiate addiction research projects, including an evaluation of Vermont’s hub and spoke treatment model. Rawson said he is impressed with how his home state has addressed the opiate epidemic.
“You should know that Vermont is about three years ahead of anywhere else on this, and you should be very proud of that,” he said. “Over the last two years, Vermont is the only New England state where overdose deaths have gone down. There is no place else in the U.S. doing this. This hub and spoke model is getting a lot of attention. You can get a lot more people into treatment a lot faster.”
Rawson said he was alerted to the opiate epidemic in Vermont on a personal level.
“I started getting calls from my OV classmates five or six years ago,” he said. “They had kids and grandkids that were in trouble and they were looking for help.”
Rawson said that in contrast to the group of heroin addicts he studied for 40 years from the early 1970s to today, the current opiate addict in the U.S. in general and Vermont in particular is quite different. He said the Vietnam-era addicts often grew up in an urban area where heroin was used for generations, often growing up in low-income households where their parents were users as well.
“This current group started with prescription opiates,” he said. “That was their first step, and then over time they moved on to heroin. They are a better-educated population and we’ve just never seen it outside an urban area like this before.”
But it is the socio-economic difference in the current crop of addicts that makes Rawson optimistic about the percentage of those he believes will seek treatment and live life in recovery.
“The prognosis will be better for this group,” he said confidently. Even more intriguing is the level of ignorance the current cohort of opiate addicts seem to have about how they acquired their disease, Rawson said.
“I have never seen a group that started on opiate prescription drugs and then moved to heroin,” he said. “And I’m just astounded by how naive they are about what they’ve gotten themselves into. They get seduced by these tablets of incredibly addictive drugs.”
But Rawson said the speed with which these addicts became addicted translates to the speed with which they seek treatment.
“I just think we may see more recovery,” he said. “The patients from Vietnam era were in and out of prison, in and out of treatment … It’s a lifetime illness for many of them.”
Rawson added that the treatment drug Suboxone did not exist 40 years ago, and that addicts overall were not treated very well due to medical and societal bias.
“One of my colleagues used to say, ‘We decided that addiction is a disease but because they’re sinners, we don’t treat them very well,’” he said.
Rawson said with the availability of opiate treatment drugs Methadone, Vivitrol and Suboxone, there are more treatment options than ever for opiate addicts, and the goal is to find the right fit.
“We need as many treatments as we can get so we can match people to the treatment that works best for them,” Rawson said.
For more information on Vermont Cares, visit the website at www.vermontcares.org.