Advancing a public health approach to substance use

Our communities are grappling with the devastating impacts of Vermont’s growing opioid crisis, a record-breaking number of overdose deaths, and the abject failure of the decades-long “war on drugs.” We need a new approach to this worsening public health crisis—one that centers the dignity and humanity of our loved ones and neighbors, expands harm reduction infrastructure, decriminalizes drug use, and fosters meaningful investments in people and communities instead of policing and prisons.

Vermont must continue advancing a public health approach to substance use—a framework that the U.S. Surgeon General urged communities to adopt in its 2016 Report on Alcohol, Drugs, and Health

Respond to people who use drugs with support and compassion, not handcuffs

Criminalization is an ineffective—and even counterproductive—strategy for addressing the complex neurobiological and social factors that contribute to substance use. Becoming involved in the justice system triggers a cascade of negative impacts on the lives of people who are arrested and their loved ones. By extension, the criminalization of personal drug use has been a driver of overincarceration and the damaging ripple effects it has on our communities.

The war on drugs has fueled mass incarceration for generations. This has been especially harmful for people of color. Between 2014 and 2019, Black people in Vermont were over 14 times more likely to be a defendant in a felony drug case compared to white people—despite the fact that Black and white people use and sell drugs at similar rates.  

Furthermore, the criminalization of drug use increases stigmatization and drives substance use underground—making it less likely for people to seek or receive the care that they need and more likely to engage in unsafe practices that can lead to disease and death.

In addition to the human toll that criminalization and incarceration take on our communities, it is extraordinarily expensive to lock people in prison. The annual costs of incarcerating someone in Vermont is $95,000. By decriminalizing personal drug use, we can reduce our overreliance on incarceration and reinvest those savings into programs that actually serve our communities. This is why we hope the legislature will take up legislation to decriminalize the personal possession of drugs in Vermont.

Expand critical harm reduction infrastructure

Vermont has adopted an evidence-driven model to help people recover from substance use disorder through its hub-and-spoke program, but far more must be done to ensure that people who are struggling have access to the life-saving resources they need, especially with the increase in fentanyl and xylazine in Vermont's drug supply.

In addition to bolstering the existing substance use disorder treatment model, policymakers can and should ensure that people in every corner of our state have easy access to the overdose reversal medication naloxone, drug checking services and supplies, sterile safe injection devices and disposal boxes, transportation to treatment and support services, and mobile treatment solutions. 

Implement overdose prevention centers

Overdose prevention centers are medicalized facilities where people can use opioids in a safe, non-judgmental space that offers on-site medical care. These facilities not only save lives—they also make our communities healthier, result in fewer discarded needles in public spaces, and reduce the transmission of HIV, Hepatitis C, and other blood-borne pathogens by giving people access to clean needles and disposal boxes.

In creating a space where people who use drugs can interact with professionals, overdose prevention centers provide another low-barrier avenue for people to connect with long-term recovery programs. H.72 was passed into law in 2024 thanks to a legislative override of Governor Scott's veto, and it is imperative that lawmakers hold the administration accountable for its full implementation in the year ahead.

Learn more about overdose prevention centers