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From YouTube: Drug Overdose Death and Harm Reduction: the Vermont Overdose Prevention Network's Position
Description
Key members of VOPN discuss Network views and policies related to preventing drug overdose death in Vermont. With guests Theresa Vezina, Mike Selick, and Joe Magee.
Mike Selick is the Associate Director of Capacity building at National Harm Reduction Coalition. He has been a community organizer and advocate for human rights focusing on police accountability, inequality, drug use, sex work, homelessness, HIV, and Hepatitis C for more than 15 years. Prior to joining the organization 7 years ago, he worked at New York City harm reduction programs, first with a focus on public policy and peer training, and then as the Director of Services at a South Bronx syringe service program. Mike earned his Masters of Social Work with a concentration in Public Policy from Columbia University. Mike is currently based out of Burlington, Vermont.
Theresa Vezina is the Executive Director at Vermont CARES, the state's largest, longest running AIDS Service Organization providing Harm Reduction services in 11 of the 14 counties in Vermont. Theresa is a leader in our state, a person with lived and living experience of drug use and a proud of it. Her journey away from a life of self-destructive use and chaos began close to 20 years ago. She has devoted her life to working with and for people who use drugs. She has been in the harm reduction field for more than a decade and comes with a deep respect and love of the work.
Joe Magee is a harm reduction advocate and person in recovery, working to breakdown stigma around addiction and mental health. He is also a Burlington City Councilor working to bring harm reduction practices into municipal policymaking.
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A
Hi
everyone
I'm
Ed
Baker,
welcome
to
the
addiction
recovery,
Channel
I'm
your
host
today
we're
honored
to
have
three
distinguished
guests
with
us.
Experts
in
harm
reduction
and
experts
in
caring
about
people
who
use
drugs
Teresa
the
Xena
is
the
executive
director
at
Vermont
cares
the
state's
largest
longest
running
age
service
organization,
providing
harm
reduction
services
in
11
of
the
14
counties
here
in
Vermont,
Teresa
is
a
leader
in
our
state,
a
person
with
lived
and
living
experience
of
drug
use
and
proud
of
it.
A
Her
journey
away
from
a
life
of
self-destructive
use
and
Chaos
began
close
to
20
years
ago.
She
has
devoted
her
life
to
working
with
and
for
people
who
use
drugs.
She
has
been
in
the
harm
reduction
field
for
more
than
a
decade
and
comes
with
a
deep
respect
and
love
of
her
work.
Thank
you,
Teresa
for
being
here
with
us.
Thank.
A
A
Thanks
for
having
me
and
Mike
Selleck
is
the
associate
director
of
capacity
building
at
National
harm
reduction
coalition.
He
has
been
a
community
organizer
and
advocate
for
human
rights,
focusing
on
police
accountability,
inequality,
drug
use,
sex
work,
homelessness,
HIV
and
hepatitis
C
for
more
than
15
years
prior
to
joining
the
organization.
A
A
A
A
A
As
of
the
latest
department
of
health
statistics
from
January
through
October
2022,
there
were
190
accidental
overdose
deaths
as
compared
to
176
for
this
same
period
in
2021.
we
are
clearly
being
overwhelmed
and
that's
what
the
show
is
about
today.
The
show
today
is
about
what
we're
not
doing
in
Vermont.
Some
would
say
we
have
a
robust
response
to
drug
overdose
death
in
Vermont
and
we
do
compared
to
other
states.
But
what
are
we
not
doing
to
that?
I'd
like
to
turn
to
my
experts.
We
have
three
experts
on
harm
reduction.
A
C
C
We
give
people
syringes
pipes
to
smoke
out
of
things,
to
keep
them
safe
from
getting
soft
tissue
infections,
transmitting
viruses,
naloxone
things
to
keep
people
alive
and
that
that's
the
general
concept
of
it
and
that
gets
adopted
by
a
lot
of
places,
but
would
be
capital
h,
capital
r,
we
think
of
it
as
a
human
rights
movement
to
respect
the
rights
of
people
who
use
drugs.
People
who
engage
in
sex
work
their
autonomy
and
to
really
be
all
about
the
principles
of
harm
reduction.
C
So
we
try
to
really
focus
on
that
spirit,
because
you
can
be
a
pharmacist
who
gives
a
syringe
to
somebody
but
you're,
not
necessarily
practicing
harm
reduction.
If
you
are
completely
mean-
and
disrespectful
that's
why
we
think
it
remain
harm
reduction
is
best
done
by
people
who
actually
care
about
people
who
use
drugs,
who
practice
harm
reduction
and
really
use
the
spirit
of
it
rather
than
just
the
simple
Public
Health
intervention
people
don't
build
trust
with
people
who
are
being
mean
to
them.
A
A
B
So
the
the
Vermont
overdose
prevention
Network,
that's
the
that's.
What
vopn
stands
for
for
folks?
That
may
not
know
what
that
acronym
means
and
back
in
2021.
You
know,
as
we
really
were,
Ed
was
saying
earlier.
You
know
that
we
were
really
seeing
the
rise
of
fatal
overdoses
really
impacting
vermonters
and
felt
that
it
was
time
to
gather
up
a
group
of
stakeholders,
community
members
from
all
sectors
to
really
address
and
look
at
the
opioid
overdose
death
rates.
And
what
can
we
do?
B
How
can
we
advocate
for
people
who
use
drugs?
How
can
we
advocate
for
better
drug
policy?
How
can
we,
as
a
as
a
group
of
of
individuals
and
both
from
the
community
and
from
within
our
sectors,
our
social
and
public
health
sectors
can
come
together
because
we
all
have
the
same
goal
and
that
was
just
to
save
lives,
and
you
know
so,
as
it
started
out
as
a
Grassroots
organization
really
looking
at.
How
can
we
help
through
the
2021
legislative
session
right
to
really
highlight
overdose
prevention
sites
and
expansion
of
syringe
service
programming?
B
Now
for
more
than
a
decade,
one
of
the
things
that
I've
noticed
and
I
think
the
vopn
is
a
really
great
example
of
is
when
I
first
started
doing
this
work
and
many
people
from
decades
ago
will
remember
when
harm
reduction
wasn't
called
harm
reduction.
It
was
not
well
accepted
and
we
were
fighting
all
of
the
time,
and
so
I
now
see
people
at
this
table
who
a
decade
two
decades
ago,
weren't
quite
there
yet.
B
And
so
it's
really
really
heartening
and
amazing
to
see
the
different
folks
that
are
at
the
table
now
who
are
genuinely
beginning
to
embrace
harm
reduction,
embrace
the
public
health
policies
that
Mike
was
just
talking
about,
but
also
really
embracing
the
philosophy
of
harm
reduction
and
understanding
that
it
is
more
than
the
public
health
interventions
and
strategies
that
it's
more
than
that,
and
it's
just
it
just
brings
me
a
lot
of
joy
and
so
we're
all
working
together
as
a
great
big
team,
because
it
takes
a
village
to
save
lives.
Really,
quite
honestly.
A
D
I
think
what
what
Teresa
said
was
exactly
right.
You
know,
and
it's
hardening
in
the
face
of
a
lot
of
suffering
and
such
a
substantial
increase
in
overdose
deaths,
to
be
working
with
a
group
of
people
that
understand
some
of
the
steps
we
need
to
take
to
begin
to
save
lives
and
to
be
have
that
space
to
share
in
the
challenges
and
the
joy
experience
in
that
work.
I
think
is
can't
be
understated
how
important
that
is.
A
Thank
you.
Thank
you.
You
know
from
from
my
perspective,
the
the
wide
range
of
representation
is
is
remarkable
city
government,
state
government,
law
enforcement,
medicine
recovery,
harm
reduction,
people
with
lived
experience,
I
mean
it
seems
to
be
very
well
represented
and
has
kind
of
a
momentum
to
it
that
that
that
that
that
that
people,
like
yourselves
are
you
know,
kind
of
fueling
and
I
do
believe
that
that
Vermont
will
will
be
changed
or
the
way
we
approach.
People
who
use
drugs
in
Vermont
will
be
changed
over
time.
A
D
This
one
uses
more
forceful
language
in
terms
of
being
explicit
in
our
endorsement
of
establishing
an
overdose
prevention
site
in
Burlington,
because
we
we've
seen
the
the
studies
that
show
that
overdose
prevention
sites
help
save
lives
in
exactly
the
sort
of
environment
that
we're
seeing
in
Burlington.
Right
now,
you
can
look
at
a
a
map
of
where
we're
seeing
the
most
overdoses
and
the
fatalities
in
Burlington
and
see
a
direct
correlation
to
studies
of
Overdose
prevention
sites
around
the
world.
D
That
show
that
that
would
be
an
effective
tool
for
us
to
implement
here
to
help
save
lives.
And
so
this
resolution
called
for
a
number
of
things.
It
called
for
the
mayor
to
begin
engaging
with
Community
Partners,
to
figure
out
what
resources
are
needed
to
stand
up
in
an
overdose
prevention
site
in
Burlington
to
make
sure
that
they
have
the
resources
that
they
would
need
to
be
successful
and
also
advocating
for
the
state,
the
a
settlement
advisory
committee
to
dedicate
resources
to
overdose
prevention
sites
as
well.
D
And
so
you
know,
I
think
this
was
a
big
endorsement
from
the
city
council.
I
think
we
need
to
see
more
action
from
the
state
legislature
to
bring
back
the
bills
that
were
vetoed
by
the
governor
last
year,
because
you
know
Burlington
can't
do
this
by
ourselves
and
so
I
think
really
having
those
State
Partners
come
to
the
table
and
recognize
that
this
is
something
that
we
need
to
do
and
we
need
to
do
now
is
very
important.
Thank.
A
You
thank
you.
You
know.
Mike
I
know
you've
done
a
lot
of
research
on
overdose
prevention.
Centers!
Do
you
do
you
care
to
comment
on?
You
know
what
exactly
happens
at
an
overdose
prevention
center?
You
know
there's
a
lot
of
misunderstanding
governor
Scott
in
his
veto
of
age,
seven
age,
seven
through
eight,
which
had
put
in
had
attempted
to
put
in
place
a
study
group
looking
at
overdose
prevention,
centers
characterized
it
as
in
an
injection
site.
A
C
For
the
most
part
that
any
other
syringe,
Exchange
program
in
the
entire
country,
when
I
was
running
a
program,
people
were
basically
injected
in
the
bathroom
and
we
called
them
an
unsupervised
injection
Center.
We
would
time
people
we
would
go
in
and
check
on
people
reverse
overdoses
in
real
time.
However,
an
overdose
can
happen
very
quickly,
especially
when
we're
talking
about
fentanyl.
It
can
happen
in
less
than
a
minute,
which
was
not
the
case
with
just
regular
heroin
and
what
we
can
do
differently
in
the
supervised
versus
unsupervises.
C
C
There
we
run
groups,
we
have
food
showers,
laundry
tons
of
different
medical
Pro
services
available,
or
referrals
and
connections
to
them,
supervised
injections
is
just
one
thing
we
are
able
to
provide
in
the
array
of
other
services.
However,
it
is
the
one
that
we
can
tell
you
in
over
200
facilities
in
14
countries
for
decades
across
the
world.
No
one
has
died,
not
a
single
person
has
died
in
one
of
these
facilities.
It
is
not
the
Magic
Bullet
that
ends
overdose
across
the
whole
state.
C
It
isn't
even
the
Magic
Bullets
that
would
end
overdose
in
Burlington,
but
it
would
have
a
significant
impact
specifically
in
the
area
surrounding
it,
which
is
where,
in
our
case
of
Burlington,
most
of
the
problems
are
happening
is
in
the
general
downtown
area.
It's
a
small
enough
downtown
that
one
Center
can
probably
serve
that
entire
area
and
people
can
walk
10
blocks
to
get
to
it.
C
So
we
don't
need
more
research
to
show
this,
because
we
know
it
doesn't
increase
crime.
We
know
that
it
reduces
the
amount
of
times
people
are
injecting
a
day
we
know
nobody's
going
to
die.
You
know
they're
going
to
get
connected
to
treatment,
to
detox
and
other
services
that
they
need
to
stabilize
their
life
and
stay
alive.
C
Basically,
when
somebody
says
they
oppose,
this
I
would
like
to
hear
them
always
say
and
that's
why
I
want
to
see
this
person
overdose
and
die
in
a
public
bathroom
on
Church
Street,
because
that's
what
they're
essentially
saying
when
they're
against
this
they're,
not
saying
that
this
doesn't
enable
anything,
there's
no
negative
consequences.
The
consequences
are,
people
aren't
dying
at
that
moment,
so
they
have
an
opportunity
to
do
something
different
tomorrow,
whether
that
be
engaging
Health
Care
get
onto
buprenorphine
or
you
know,
keep
working
towards
trying
to
get
housing.
A
I
I
couldn't
agree
more
with
you
and
I.
Think
about
that.
A
lot
I
think
it's
interesting
that
you
put
it
that
way,
because
sometimes
I
think
about
crimes
of
omission
and
crimes
of
commission
and-
and
it
seems
to
be
that
the
mentality
is
as
long
as
we
don't
do
something
to
harm
people
who
are
dying
of
drug
overdose,
we're
safe,
but
it
should
be.
If
we
refuse
to
do
something
that
can
save
people
dying
from
drug
overdose,
then
we're
responsible.
A
It's
like
a
crime
of
a
blatant
crime
of
omission
that
the
Administration
in
Vermont
and
the
health
department
in
Vermont
are
not
actively
seeking
and
pursuing
ways
to
open
an
overdose
prevention
center
in
schinden
County,
where
there's
a
death
a
week,
a
death
a
week
that-
and
many
of
them
can
be
prevented.
As
Joe
has
said,
there's
a
heat
map
showing
the
concentration
of
death
there's
on
superimposed
under
that
Heat
Map
There's,
a
public
transportation
system,
there's
a
location,
that's
ideal.
We
know
everything
we
know
and
and
I
want
you
to
comment
on
this.
A
C
Yeah
I
mean
we
know
overdose
Prevention
Services
save
lives.
It
also
saves
money,
prevents
people
from
needing
to
call
the
police
on
public,
injecting
prevents
people
from
needing
to
go
to
the
hospital
as
much.
But
the
thing
is
I.
Don't
blame
people
for
getting
this
one
wrong.
Everything
we've
learned
about
drugs
was
incorrect.
I
didn't
know
any
of
this
stuff
before
I
started.
Working
in
this.
C
Didn't
know
any
of
this
stuff
to
be
be
true.
We
have
this
weird
idea
about
Rock
Bottom,
Rock
Bottom
is
dead.
On
the
streets
we
aren't,
making
drugs
more
harmful
is
not
making
anybody
recover
faster.
It's
like
the
idea
that,
if
somebody's
going
to
be
drinking
and
don't
give
them
a
glass
to
drink
out
of
they're
going
to
stop
drinking,
that
is
a
ridiculous
comment.
People
are
going.
C
Broken
whiskey
bottle,
if
that's
all
they
have
available,
so
we
give
them
syringes
that
they're,
not
injecting
with
you
syringes.
All
of
a
sudden.
The
HIV
rates
go
from
huge
among
people
injecting
drugs
down
to
basically
nothing.
It's
the
same
thing
here.
People
think
we're
enabling
drugs.
These
all-enabling
is
people
to
not
die
on
the
street
and
it's
what
most
people
in
the
community
who
are
complaining
about
truly
wants.
They
say
they
would
like
to
not
see
people
injecting
in
public.
They
say
they
don't
want
to
have
to
deal
or
see
these
overdoses.
C
This
service
gets
people
behind
closed
doors
where
they
can
get
support
and
where
nobody
in
the
community
has
anything
to
complain
about
anymore.
So
it's
literally
a
win-win
for
everybody,
and
we
see
this
in
places
where
they've
been
opened.
It
takes
a
few
years.
We
still
see
some
opposition
happening
in
New
York
to
what's
happening
in
that
neighborhood
same
thing
was
happening
in
Vancouver
when
that
place
first
opened
wait
a
few
years.
It
was
almost
10
years
later,
when
the
Federal
Government
tried
to
shut
down
Insight
in
Vancouver
the
police,
the
neighborhood,
the
community.
C
The
mayor
all
came
out
in
support
of
it.
People
see
how
this
helps
their
Community.
It
just
takes
time
for
it
to
really
work.
You
can't
decide
tomorrow
we're
going
to
open
the
center
magically.
Everyone
is
going
to
start
using
it
every
single
time
it
needs
to
be
available
for
everyone.
As
far
as
the
money
goes,
there's
plenty
of
money,
I
know,
Vermont
doesn't
have
the
biggest
budget
in
the
country.
We're
also
one
of
the
smallest
states
in
the
country.
C
C
They
end
up
coming
out,
overdosing
and
dying.
The
learning
programs
that
are
supportive
for
people,
overdose,
Prevention,
Services,
syringe
access
programs,
harm
reduction,
increases
people,
engagement
in
accidents-based
treatment,
and
it
makes
them
more
likely
to
stay
in
it,
and
it
also
lets
them
know
that
when
they
exit
this,
if
they're
going
to
use
again
we're
not
mad
at
them,
they
should
come
back
and
talk
to
us,
get
in
the
lock
Zone
and
be
safe.
A
D
C
A
A
B
The
the
overdose
prevention
site
and
just
to
kind
of
the
way
that
the
way
that
I
kind
of
look
at
overdose
prevention
site
is
it's
just
the
natural
progression
of
what
our
existing
syringe
service
program
network
is.
Anyway,
it's
kind
of
like
the
the
natural
next
step
to
the
work
that
we're
always
already
doing
and
have
been
doing
for
decades
and
doing
you
know
the
best
we
could
with
what
we
had
and
and
following
best
practices
and
so
I,
just
really
like
what
Mike
was
saying
like
it's.
B
A
Right,
no,
no
and
that's
exactly
that's
exactly
where
I
was
going,
because
I
wanted
to
ask
you
about
expanding
access
to
Safe
syringes,
lower
barriers
to
buprenorphine
and
the
measures
of
that
nature,
which
are
also
priorities
for
BOP
and
then
I
think
you're
already
involved
in
what
is
it?
What
is
it
about
providing
of
safe
syringes
to
people?
I
mean
what
what
what?
What?
What
is
it
about
that
that
Fosters
Health,
that
that
helps
to
prevent
overdose
death.
B
Everything
just
leads
to
different
Pathways
to
health
and
wellness
and
keeping
people
alive,
and
it's
really
determined
by
that
person
and
what
else
they're
coming
in
for
they
they
may
be
coming
in
to
say
they
need
a
syringe.
But
after
you
sit
down
and
chat
for
you
know,
20
30
minutes
you
find
out
that,
in
addition,
you
know
they.
They
also
need
several
other
of
the
things
that
we're
offering
and
and
I
think
that
is,
is
also
what
an
overdose
prevention
site
could
be
like
by
expanding
what
we
offer.
B
B
It
is
we
serve
in
11
of
the
14
counties
and
we
have
a
very
small
staff
to
do
to
to
reach
all
11
of
those
counties
and,
as
you
know,
it
takes
at
least
20
minutes
to
get
anywhere
when
you're
in
Vermont
so
having
little
other
spots
with
scattered
throughout
the
state
where
these
services
are
available,
is
critical
and
absolutely
can
go
a
long
way
towards
not
only
saving
lives
but
just
being
there
for
more
people.
Yeah.
B
A
Want
to
talk
about
that,
a
little
bit
like
this
population,
that's
been
persecuted,
prosecuted,
incarcerated,
judged
punished
historically
for
decades.
Well,
what
what
is
it?
What
is
it
like
when,
when,
when
they
come
and
they're
met
with
Compassion
or
love
or
a
sense
of
dignity
and
respect?
What's
what's
their
response
to
that.
D
B
You
know
other
people
are
just
like
really
bubbly
and
really
excited
and
I've
received.
So
many
hugs
we
were
just
talking
recently
with
a
community
partner,
but
when
we
opened
the
mobile
program
in
Rutland
and
that
Community
had
been
unserved
for
the
whole
for
all
the
years,
that
Vermont
cares
was
in
all
the
syringe
service
programs.
There
was
no
syringe
service
program
in
Rutland,
County
and
Vermont
care
said
well,
let's
start
a
pilot.
B
This
is
back
in
about
2014
2015
and
the
very
first
people
that
I
saw
when
I
went
to
Rutland
literally
came
up
to
me
in
tears.
They
were
just
hugging
me
so
hard
and
saying
oh,
my
God.
We
can't
believe
someone's.
Finally,
here
we
we've
been
standing
six
or
seven
people
deep,
taking
turns
sharing
the
same
syringe
for
months,
there's
no
more
numbers
on
the
syringe
and-
and
these
people
were
just
so
genuinely
grateful,
but
I
also
saw
the
the
distress
in
them
that
they
had
been
living.
B
This
way
when
Services
were
available
two
hours
away,
they
didn't
have
services
in
their
Community
and
and
it
really
it
makes
you
it
makes
you
really
stop
and
think.
When
you
have
get
to
have
opportunities
to
really
connect
with
people
in
that
way
and
see
what
they
really
needed
and
be
able
to
bring
that
to
them,
I
think
everything
that
we're
talking
about
on
this
platform,
with
the
vopn
supports
all
of
those
types
of
of
things
and
and
really
meeting
the
needs
of
people.
C
Same
if
doctors
and
nurses
were
willing
to
go
out
to
tent
cities
under
bridges
at
two
in
the
morning
to
provide
Public
Health
Services,
we
wouldn't
exist.
We've
invested
a
Internet
Health
System,
run
by
people
who
use
drugs
and
people
who
love
people
who
use
drugs
because
the
medical
system
and
our
society
is
not
set
up
to
help.
People
like
that,
and
you
see
this
like
I
I
I'm
from
starting
people
being
brought
to
Tears
by
getting
their
first
dimensional
program.
My
personal
experience
has
been
very
different
a
lot
of
times.
C
C
I'm,
like
your
grandma's,
totally
diabetic
and
give
them
whatever
they
need,
and
then
they
walk
away.
My
co-worker
goes:
why
do
you
give
them
needles
if
their
Grandma's
diabetic
I'm,
like
first
of
all,
we're
in
a
poor
neighborhood?
If
poor
people
of
color
need
diabetic
supplies,
they
can't
can't
afford
I'm
happy
to
give
them
to
them.
C
More
importantly,
though,
that
guy
took
cookers
and
ties,
there's
no
way
that
guy's
Grandma's
diabetic
and
he's
not
ready
to
talk
to
me
about
the
fact
that
he's
shooting
drugs
but
I'm
going
to
tell
I
told
him
I'll
be
here
next
week,
and
we
can
talk
next
week.
Sometimes
it
takes
a
month
or
more
for
someone
to
finally
go
hey,
so
I
have.
C
Know
what
to
do
about
me?
Let's
talk
about
my
drug
use
and
that's
fine,
so
I'm
sure
there
are
people
who,
like
this
is
a
totally
eye-opening
moment
for
them.
I
personally,
just
haven't
experienced
it
I've
seen
way
more
people
who
are
unwilling
to
admit
that
they're
using
drums
or
I'm
willing
to
talk
about
it
asking
people.
C
Oh,
how
often
are
you
injecting
was
one
of
the
first
questions
we
asked
when
you
come
to
the
program
if
they
say
20
times
and
then
ask
me
for
one
syringe:
I'm,
like
you
see
the
math
there
isn't
working
out,
can
I
give
you
more.
The
numbers
thing
that
Teresa
mentioned:
that's
still
real
ever
seen,
so
many
people
oppose
something
just
have
their
stocks
with
no
numbers
on
it
and
they're
like
it's
fine,
it's
fine
I'm,
still
using
it.
Every
time
you
inject
the
needle
gets
less
and
less
sharp.
C
People
are
still
too
scared
to
talk
about
their
drug
use
until
they
really
worked
through
it
and
really
develop
trust
with
people.
So
I
would
often
tell
our
Outreach
team
look
if
somebody
wants
to
come
by
and
talk
to
you
for
baseball
about
10
minutes,
10
minutes
after
you
give
them
the
needles.
That's
the
conversation,
that's
going
to
make
them
say:
hey
I'm,
having
this
medical
problem,
I'm
too
scared
to
ask
anybody
about
I've
been
treated
Slowly
by
doctors.
My
whole
life.
Do
you
know
any
doctors
who
will
be
nice
to
me?
C
A
So
so
we've
discussed
overdose
prevention,
centers
we've
discussed,
increasing
access
to
safe
syringes
and
the
common
theme
seems
to
be
connecting
and
engaging
people
who
use
drugs
in
a
way
that
communicates
compassion-
and
you
know
and
I
think
that's
going
to
be
a
theme
in
every
every
topic
we
discuss.
Let's,
let's
move
on
to
making
buprenorphine
more
available
by
eliminating
prior
authorization
from
Medicaid.
What
about
that,
making
buprenorphine
more
available
to
people?
Why
and
making
buprenorphine
decriminalization
permanent?
Why
is
that
important?
C
Sure
it's
a
partial,
Agonist
opioid,
so
it
puts
some
influence
on
The
receptors,
but
it
has
a
ceiling
effect.
That's
just
kind
of
technical
Neuroscience,
but
the
idea
here
is
it's
very,
very
difficult
to
overdose
on
people
or
something
making
it
incredibly
safe.
If
there's
just
a
new
study,
I
believe
out
of
Indiana,
where
they
were
looking
at
all
the
drugs
people
had
on
board
when
they
overdose
and
I'm
pretty
sure.
In
five
to
ten
years
there
was
2.5
percent
of
the
overdoses
had
buprenorphine
at
all.
That
isn't
saying
it
caused
the
overdose.
C
That's
saying:
if
you're
on
buprenorphine
you're,
probably
not
going
to
overdose,
it
is
less
regulated
than
methadone
and
slightly
safer
than
methadone
because
of
the
ceiling
effect.
So
essentially
it's
the
best
easiest
to
administer
medication
we
have
available
to
us.
Methadone
should
be
more
easily
available
in
people,
but
unfortunately
they're
pretty
serious
Federal
rules
to
how
you
can
dispense
it
as
far
as
buprenorphine.
It's
actually
just
reduced
the
rules.
They
X
the
X
waiver
from
the
federal
government,
which
means
now
anyone
who
is
got
a
training
from
the
DEA
to
dispense.
C
Medication
can
also
dispense
buprenorphine.
They
got
rid
of
the
patient
caps,
so
one
doctor
can
now
prescribe
to
as
many
people
as
they
need
and
we
need
to
make
buprenorphine
easier
to
get
the
entire
winter
fentanyl
on
the
street.
We
need
to
People
Want
it.
It
works
well
for
them
and
they
should
be
able
to
access
it
when
we
decriminalize
buprenorphine.
We
did
this
because
we
found
most
people
who
were
giving
buprenorphine
weren't
selling
it
to
make
money.
C
They
were
giving
some
of
their
personal
usage
to
their
friends
so
that
they
could
try
to
avoid
withdrawal
and
protect
themselves
when
they
couldn't
find
drugs.
People
make
risky
decisions
about
sharing
syringes
about,
potentially
overdosing
run
their
own
withdrawal
and
their
risk.
Calculus
has
changed,
you're,
not
feeling
well,
and
you
want
to
do
anything
you
can
to
feel
better
and
that's
when
you're
more
likely
to
make
a
mistake
and
do
something
that
you
might
not
normally
think
is
safe.
Deeper
nursing
helps
interrupt.
That
cycle
gives
you
time
and
you
can
go
use
that
later.
C
Unfortunately,
Vermont
has
structured
a
deal
with
a
big
Pharma
company
in
order
to
get
one
formulation
cheap
for
Medicaid,
which
is
always
a
good
idea,
but
has
made
them
unwilling
to
give
affordable
buprenorphine
to
people
who
use
different
formulations
of
it
and
that's
what
this
whole
prior
authorization
is
about.
For
private
insurance.
You
don't
have
to
do
a
prior
authorization
or
choose
a
doctor,
tells
you
need
it.
They
send
the
prescription
to
the
pharmacy.
It's
there.
You
pick
it
up.
C
Prior
authorization
is
another
step,
that
is
for
insurance
companies
to
throttle
back
care
to
save
money
and
try
to
say.
Oh,
you
don't
need
this
medication,
or
maybe
you
need
it,
but
you
should
wait
a
week
or
you
need
it,
but
I
want
you
to
take
a
different
kind
of
it
and
we've
already
eliminated
that
for
private
insurers.
But
when
we
try
to
eliminate
it
for
public
Insurance,
the
governor
vetoed
it,
which
is
essentially
him
saying
it's
not
worth
the
money
to
make
sure
we
keep
people
safe
and
Alive.
C
We
need
to
solve
that
problem.
I
will
commend
the
legislature
of
Vermont.
We
have
passed
a
supervised
consumption
bill
in
this
state.
We
have
passed
a
buprenorphic
decrim,
which
is
on
its
verge
of
sun
setting.
We
have
passed
the
parodies
to
make
sure
there's
no
prior
authorization
for
buprenorphine.
Our
problem
is
the
governor
who
is
consistently
vetoed
these
bills
and
the
deaths
are
at
his
door.
It's
his
fault
that
people
are
overdosing
when
they
don't
have
access
to
Butte
or
a
safe
place
to
use
drugs
so
that
they
don't
overdose.
A
C
B
C
Was
going
to
die,
but
there
is
literally
no
intervention
that
we
have,
that
is
better
than
buprenorphine
or
methadone.
They
are
the
thing
that
works,
the
best
that
are
FDA
available.
There
are
other
full
opioid
agonists
that
people
have
used
around
the
world
and
even
in
the
US
that
are
super
successful,
but
the
two
treatments
we
have
that
are
FDA
approved
at
this
point
in
time
are
method
of
buprenorphine
and
they
are
the
most
effective
treatment
available
for
people.
It
should
be
the
first
thing
we
offer
them
before
counseling.
C
Before
anything
else,
I
mean
we
should
offer
them
syringes
and
stuff.
But
when
we
talk
about
drug
treatment,
low
threshold
buprenorphine,
which
is
happening
at
the
syringe
programs
and
will
continue
to
be
happening
if
we
open
an
overdose
prevention
center
is
the
first
line
treatment.
It
is
the
best
thing
we
should
be
offering
people
and
there
should
be
zero
barriers
to
it.
So
when
we
create
artificial
barriers,
we're
making
people
more
likely
to
be
dead
and
less
likely
to
be
in
treatment.
A
Thank
you.
Thank
you.
Mike
I
think,
I'm
glad
that
you
mentioned
the
governor's
veto,
because
that
was
an
overdose.
A
bill
focused
on
overdose
responses
and
clearly
the
legislature
was
was
United
about
it,
expressing
the
will
of
the
population
of
the
will
of
the
people
and
the
governor
veteran
it.
We
had.
It
would
address
safe,
syringe
programs,
prior
authorization,
guidelines
for
medication
for
opioid
use,
disorder,
mobile
medication,
assisted
treatment,
which
I
think
Teresa
was
alluding
to
a
little
bit
earlier.
A
Substance,
use
support
for
justice
involved,
vermonters
and
other
overdose
emergency
responses,
and
the
bill
was
just
the
will
of
the
people
was
negated
with
that
veto.
Maybe
we
could
we
could
move
into
this
substance.
Use
support
for
justice
involved
of
vermonters.
To
do
I
mean
it's
my
understanding
that
people
who
are
incarcerated
and
released
from
incarceration
have
like
a
an
incredibly
a
high
rate
of
drug
overdose
death.
Is
that
correct.
C
Anybody
who
is
forced
in
or
has
decided
to
have
a
short
period
of
abstinence,
whether
that
be
from
prison
jail,
a
treatment
center.
A
detox
bed
has
a
significantly
higher
rate
of
Overdose
jail
in
prison
is
pretty
high
on
that
list,
although
Vermont
is
better
than
some
places
with
connecting
people
to
community-based
treatments
and
initiating
treatment
while
they
are
incarcerated,
there's
still
definitely
a
huge
link
between
coming
out
of
any
apps
and
space
requirements
based
into
the
regular
world.
A
And
that's
one
of
the
one
of
the
platforms
that
we
need
to
be
looking
at
is
you
know
advocating
for
for
more
services
for
people
who
are
incarcerated
or
or
released
from
prison?
It's
one
more
way
to
save
lives.
Teresa
I
think
that
you
began
to
talk
a
little
bit
about
decriminalizing
possession
of
all
harm
reduction.
B
I
you
know,
I
will
elaborate
on
that.
I
think
that
the
general
consensus
has
been
that
the
interventions
that
that
we
use
supplies
that
we're
giving
out
are
constantly
changing
because
we're
we're
going
with
the
flow
of
like
current
drug
Trends.
Also
what
what
the
folks
that
we're
serving
are
needing
and
so
right
now
the
paraphernalia
law
only
covers
syringes.
B
This
paraphernalia
law
well
all
were
great
and
has
been
in
place
for
many.
Many
many
many
years
just
needs
some
updating.
It
just
needs
a
little
little
addition
to
it,
and
that
is
just
to
include
all
harm
reduction
supplies
this
way,
whatever
the
supply
is
that
people
are
needing
harm
reduction
is
is,
for
us,
anyway,
is
led
by
the
by
by
participants
by
people
who
use
drugs.
So
people
are
coming
and
say:
gosh.
We
really
need
acts.
B
You
know
to
to
stay
safer,
we're
going
to
do
all
we
can
to
make
sure
that
that
Supply
is
available
to
them
and
and
so
I
think,
there's
very
purposely
to
keep
it
Broad
and
open
and
to
trust
that
the
harm
reduction
providers
in
Vermont
are
providing
the
supplies
that
people
need
right.
Now,
today,
no
matter
what
that
day
is
to
help
to
keep
them
safer,
whether
that
be
you
know,
to
reduce
infection
or
reduce
overdose,
or
you
know
whatever.
That
might
be
that,
where
that
we're
there
to
provide
that.
B
B
A
So
so
so,
basically
it
looks
like
you
know.
What
we're
trying
to
do
is
keep
people
alive.
It's
what
we're
saying
to
the
public
who
uses
drugs,
it's
more
important
for
you
to
stay
alive
than
it
is
for
you
to
stop
using
drugs.
We'll
meet
you
where
you
are
we'll
help
you
use
drugs
safely,
we'll
help
you
to
stay
alive
will
protect
you
from
from
using
an
unregulated
drug
Supply,
that's
contaminated
with
poison,
and
while
we're
doing
that,
we'll
engage
you
will
let
you
know,
we
love
you,
we
care
about
you.
A
We
understand
you
we're
studying
addiction
science,
so
we
can
better
meet
your
needs
because
you
deserve
it.
You're
worth
it
and
in
the
meantime,
if
we
can
help
you
with
something
else,
we'll
do
our
best
to
do
that
too.
Do
you
need
transportation,
you
know,
do
you
need
a
place
to
live?
Do
you
need
clothes?
Do
you
need
health
care?
Do
you
need
help
navigating
a
system?
That's
very
complex.
A
Do
you
need
help?
You
know
feeding
your
dog
or
your
cat?
Do
you
need
a
shower?
Do
you
need
a
haircut?
Do
you
need
somebody
to
talk
to?
Do
you
need
any
any
basic
human
need
met
while
we're
meeting
you
where
you
are?
If
there's
something
that
you
decide
you
want
help
with,
will
be
there
for
you
and
that's
the
beginning
of
a
path
that
could
lead
anywhere.
A
A
Is
I,
understand
it,
but
it's
unacceptable
and
it's
it's
beyond
me
and
I'd
like
to
go
into
the
last
part
of
the
show
talking
a
little
bit
about
the
decriminalization
of
drug
possession,
because
I
think
this
is
one
of
the
major
factors
that
drives
people
into
the
Shadows
where
they
die
because
they've
been
criminalized,
they're
afraid
to
come
out
for
help
because
they
fear,
rightly
so
they
may
be,
arrested
and
thrown
in
jail.
So
let's
talk
a
little
bit
about
that
who
wants
to
start
on
that
decrease
the
decriminalization
of
drug
possession.
C
And
we
talked
about
earlier
jails
in
prison,
lead
to
overdose
deaths,
so
avoiding
them
is
preferable,
I
believe
in
bodily
autonomy.
We
could
have
conversations
about
how
we
feel
about
like
drug
trafficking,
but
that's
not
who
we're
arresting
for
drugs
ever
we're
arresting
either
people
who
are
using
them,
which
means
they're
people
who
are
making
their
own
choices
about
what
they
do
with
their
bodies
and
I.
Personally,
think
that
is
none
of
our
legislative
business
or
we're
arresting
people
who
sell
drugs,
which
are
mostly
just
people
who
use
drugs.
Who
drugs
are
expensive.
C
You
want
to
help
people
who
have
no
money,
afford
them
without
stealing
stuff,
they
sell
drugs
to
their
friends,
and
then
they
keep
the
extra
for
themselves
so
that
they
can
get
what
they
need.
When
we
criminalize
this
people
are
less
likely
to
get
the
support
they
need
in
the
future.
You
become
ineligible
for
federal
grants
for
college
lots
of
housing
becomes
unavailable
to
you.
Lots
of
benefits
become
unavailable
to
you.
C
You
get
background
searches
when
you're
looking
for
simple
jobs,
they're,
basically
telling
people
we
want
you
to
change
your
entire
life
and
we're
going
to
make
it
as
absolutely
challenging
as
physically
possible
for
you,
because
guess
what
most
jobs
are
going
to
do
background
checks
and
not
hire
you
because
you
got
picked
up
on
heroin
possession.
While
you
were
unhoused
and
using
drugs
in
public,
it
doesn't
really
seem
like
a
solution
to
anything
to
me
and
as
you're
kind
of
alluding
to
and
that's
the
wrong
message.
C
It
says:
you're
a
criminal
for
using
drugs
as
opposed
to
you're,
a
human
being
who
is
using
drugs
as
a
you
know,
probably
now
adapted
but
coping
mechanism,
drug
uses,
rational
choice
in
a
society
that
leaves
people
out,
you're,
homeless
and
hungry.
You
have
ten
dollars
in
your
pocket
and
you're
cold
Aaron
will
solve
those
problems
for
tonight.
No
other
ten
dollars
is
getting.
You
housed,
fed,
warm
and
feeling
safe
and
getting
some
sleep.
C
D
What
if
we
I
think
as
a
policy
maker?
What
I'm
the
question
that
I'm
called
to
ask
is
what,
if
we've
dedicated
those
resources
towards
community
care
towards
investing
in
treatment,
investing
in
harm
reduction
and
helping
folks
get
the
support
they
need
to
deal
with
the
trauma
that
they've
experienced
in
their
life.
D
I
think
you
know
when
we
start
to
reframe
issues
of
drug
uses,
Public
Health
crises
rather
than
criminalizing
possession
and
use
that's
when
we
start
to
really
get
at
addressing
the
root
causes
that
we're
seeing
and
investing
in
housing
for
folks
investing
in
mental
health
support,
making
sure
folks
have
access
to
health
care.
So
I
think
everything
that
we've
talked
about
here
today
is
is
working
towards
that
goal
of
expanding
access
to
just
basic
health
support
that
folks
need
that
our
current
system
does
not
provide
good
point.
A
B
B
I
think
about
my
kids
they're
in
their
early
20s
and
mid-20s,
and,
thank
goodness
you
know,
I
was
able
to
have
open
conversations
with
them,
but
I've
also
talked
to
many
families.
You
know
their
kids,
it's
still,
it
still
is
illegal
and
when
you
grow
up
with
something
criminalized,
you
know
for
I'm
thinking
also
for
our
next
Generations
I
have
a
grandbaby
coming.
You
know
it's
like
like.
How
do
we
want?
B
How
do
we
want
our
current
members
of
society
to
be
treated
and
how
them
to
feel,
but
also
what
do
we
want
for
the
generations
to
come
and
I
think
this
could
have
far-reaching
effects
on
in
on
so
many
levels,
and
so
the
the?
What
we
learned
from
our
study
was
that
more
people
would
feel
comfortable
from
a
Public
Health
Point
to
talk
to
their
medical
providers
if
it,
if,
if
it
were
decriminalized,
hopefully
then
fending
off
any
particular
life-threatening
issues
sooner.
A
A
B
Gosh
Ed,
what
would
I
say
to
people
using
drugs
like
I
I'm,
a
person
that
uses
drugs,
so
those
are
what
would
I
say
to
myself.
You
know
I,
just
think
it's
just
be
yourself.
You
know
it's,
it's
actually
just
okay,
because
we
are
so
much
more
than
people
who
use
drugs
like
I.
Don't
even
know
that
I
even
like
that
label
anymore
right.
It's
like
we're.
B
Guess
that's
what
I
would
say,
we're
all
people
first
and
the
activities
we
engage
in
the
behaviors
that
we
take
part
in
all
that
stuff
is
a
piece
of
who
we
are,
but
it's
just
a
piece
and
we
have
the
choice
every
single
day,
every
single
moment
to
choose
something
different
I
I
personally,
have
always
you
know
been
an
everyday
glass
of
wine.
Drinker
I've
I've
a
few
months
ago,
saw
that
hey.
You
know
what
I'm
gonna
choose:
I'm,
not
going
to
be
drinking
wine
every
day.
D
B
Doesn't
mean
anything
particular
just
means
that
I
chose
something
different
and
I
think
you
know
we
just
all
have
the
opportunity,
Edward
all
people
and
we're
all
people
that
deserve
to
have
our
own.
Our
own
choice
like
not
to
have
that
our
choices
taken
away
from
us
also
as
a
woman
with
everything
that
just
happened
like
like
our
bodies,
are
our
bodies
and
what
we
choose
to
do
with
them
and
put
into
them.
It
should
always
be
our
choices,
and
we
should
never
be
judged
for
those
choices.
C
About
10
years
ago,
when
I
still
worked
in
Services
I
made
a
series
of
pamphlets
that
we
gave
out
of
our
program
safer
sex
work,
safer
drug
use,
overdose
prevention,
they
all
said
different
things
on
the
front,
but
every
single
one
of
them
said
you
matter
so
I
want
that
to
be
the
message
that
people
who
use
drugs
always
hear
from
us.
The
whole
world
tries
to
tell
people
they
don't
matter,
people
internalize
that
stigma
and
start
to
feel
like
they're
worthless.
That
makes
people
use
drugs
more.
C
If
you
think,
you're
worthless,
you
don't
feel
like
doing
anything
different
you're
just
going
to
keep
using
drugs,
so
I
hope
everybody
who
uses
drugs
knows
you
matter.
There
are
people
in
the
state
who
care
about
you.
There
are
programs
here
who
can
treat
you
with
that
kind
of
respect
and
dignity
and
help.
You
understand
that
you're
not
a
bad
person
just
because
of
your
drug
use-
and
you
know
that's
that's
what
we
all
need
to
do
is
to
stop
making
people
feel
bad
about
themselves.
The
more
we
do.
C
D
Well,
Mike
and
Teresa
I
think
it
said
most
of
what
I
I
would
say,
I
think
I'll,
just
close
it
out
by
saying
simply
you
know
you
are
loved
you're
valued
to
our
community
and
your
story
matters
as
a
policy
maker
social
lived
experience.
Sharing
stories
about
how
our
systems
have
failed
is
how
we
begin
to
make
them
work
better
for
folks,
and
so
I
would
just
encourage
folks
if
they
feel
comfortable,
if
they're,
if
they're
able
to
share
their
story
and
myself
or
find
a
way
to.
C
A
A
We
need
to
research
people
running
for
state
senate
research,
people
running
for
the
House
of
Representatives
research,
people
running
for
local
positions,
people
running
for
the
governor,
the
gubernatorial
position.
We
need
to
research
that
and
we
need
to
vote
for
people
that
are
in
line
with
our
values
and
if
we
care
about
people
and
we
care
about
people
who
use
drugs,
we
can
find
out
what
people
running
for
positions
of
power
think
along
those
lines
and
vote
for
the
ones
that
we
identify
with.
A
A
We
could
be
more
vocal
about
this
I
know
everyone
is
overwhelmed
with
life
life
itself,
we're
all
struggling
to
meet
the
demands
we
meet
every
day,
but
each
one
of
us
each
one
of
us-
can
make
a
little
bit
of
a
difference
and
that
can
make
a
very
big
difference
and
we
need
to
make
a
very
big
difference
in
what
is
happening
in
Vermont.
So
so
thank
you
and
I
look
forward
to
seeing
you
next
time.