WHITE RIVER JUNCTION — As the COVID-19 pandemic took lives and diminished livelihoods in the Upper Valley, the opioid epidemic that has afflicted the Twin States for several years raged on in 2020, seemingly fueled by some of the efforts required to mitigate the spread of the novel coronavirus.
Windsor County logged 21 opioid overdose deaths from January through October of 2020, the most of any county in Vermont. The town of Hartford alone saw six in that time period and another four since then, Police Chief Phil Kasten said on Thursday, an indication that the county had at least 25 overdose deaths for the entire year.
The overdose deaths are well above the 13 Windsor County logged in 2019 and the most in any one year in the county over the past decade. Both Vermont and New Hampshire marked decreases in drug overdose deaths in 2019.
In fact, more people appear to have died of overdoses in Windsor County in 2020 than died from COVID-19 in the entire Upper Valley. The pandemic as of Dec. 30 had killed 18 people in the four counties that comprise the Upper Valley — nine in Grafton, five in Sullivan, three in Windsor and one in Orange.
“All of a sudden we’re ahead of Burlington, and that’s crazy,” said Sheila Young, the executive director of the Second Wind Foundation, which operates Upper Valley Turning Point community center for people in recovery from addiction in White River Junction.
Young and others in the Upper Valley’s recovery community said the spike this year is likely due to a collection of factors, including the isolation required of the pandemic that has left people with fewer ways to connect with support systems.
“I would say we have a tenth of the amount of people that we used to have,” Young said of the meetings hosted by the center, which are limited in size due to COVID-19 restrictions.
Some people are attending meetings online, while others who lack a smartphone or computer, internet access or a taste for technology may simply be skipping them.
There’s “sort of an invisible population that we don’t know where they went,” she said. “We’ve had some suicides. A lot of people will say to me, ‘I just can’t Zoom.’ It’s not the same as the in person face-to-face contact that you have with others.”
Windsor County, which has less than 9% of Vermont’s population, tallied 17% of the 123 overdose deaths in Vermont through October, more than any other county. Orange County, just to the north, had six, up from zero in 2019. Chittenden County, the most populous in the state, had 20.
On the New Hampshire side of the Upper Valley through Dec. 18, Grafton County had 20 drug overdose deaths, or 2.19 deaths per 10,000 people, which was down from 24 in 2019, according to preliminary numbers. Sullivan County had six fatal overdoses, or 1.36 per 10,000, down from seven in 2019, according to preliminary data.
New Hampshire’s preliminary numbers, a total of 390 for the year which is the lowest since 2014, seemed off to Dan Wargo, who manages the Recovery Center in Claremont.
“I’m a little skeptical,” he said. “Vermont offers a substantial amount of services. You’d think it will be the opposite.”
He suggested there may be a lag in the data collection. He said he knows of people dying of fentanyl overdoses and also that the relapse rate has risen amid the pandemic and associated isolation and boredom.
“It’s always hard to figure out why” the numbers of overdoses change, said Laura Byrne, executive director of the Lebanon’s HIV/HCV Resource Center. “I do know that obviously COVID is really just wreaking havoc on everyone.”
Byrne said the mobile syringe exchange program her organization operates has been working hard to get the overdose reversal drug naloxone, also known as Narcan, out to people on both sides of the Connecticut River. However, due to the isolation required to mitigate COVID-19, some people are using alone and may not have someone else there to administer the naloxone when they overdose, she said.
Other contributing factors to the increase in overdose deaths likely include the shift away from in-person treatment and support services to online or phone services, as well as people’s routines being upended and a sense of despair that has developed for some, she said. The region’s location at the crossroads of Interstates 91 and 89, less than two hours from big cities in Massachusetts, also may be a factor, she said.
“One thing that hasn’t changed since COVID is the drug supply,” Byrne said. “…We already had the problems we had before COVID; now we just have more.”
Kasten, Hartford’s police chief, said his department has worked during the pandemic both to assist in providing resources to people struggling with addiction and to hold those responsible for bringing drugs into the community to account. Nearly 30% of the deaths in Windsor County through October were in Hartford, Kasten said. In the past two months, four more such deaths have occurred in Hartford, including a fatal overdose on Wednesday.
The challenge of keeping the drug supply in check has grown as “cartels” have adapted to the pandemic and as law enforcement agencies and courts have changed their procedures as well, Kasten said.
“It’s provided an opportunity in a number of ways for business to flourish as agencies that might normally keep an eye on those sorts of things … run at a different level of operations,” he said.
Some people who use drugs may have switched to a new and less-trusted source during the pandemic, said Cynthia Seivwright, who directs the Vermont Alcohol and Drug Abuse Program for the state Department of Health. Though addiction treatment providers and recovery centers were quick to set up services via phone and internet, Seivwright said there may have been an interruption early on in the pandemic.
She noted that some people in recovery overdosed after receiving the federal stimulus checks in the spring. A trigger that those in the recovery community are keeping an eye out for now is the $600 most adults are likely to get from the COVID relief package President Donald Trump signed into law late last month, she said. Rutland County, Vt., saw a spike of seven overdose deaths in April, and Grafton County saw five in May after the spring stimulus checks went out.
Some of the overdose deaths across the state have occurred in motels where people without homes have been staying under a state voucher program, Seivwright said. White River Junction is home to a couple of lodging establishments that have participated in the program.
Kasten said three of Hartford’s 10 fatal overdoses in 2020 were at hotels, and he said that the voucher program presents a challenge because, in some cases, it has brought together groups of people struggling with addiction. But he also said it’s an opportunity to connect people who may be new to the area to resources they may need.
“This is the time when we should be building bridges,” he said.
The department is working with community organizations such as the Upper Valley Haven and the Turning Point Recovery Center to get naloxone and information about recovery services to people who are using drugs, such as those who have recently had a non-fatal overdose, he said.
That outreach “could certainly position us to come out of the pandemic even better than we were going into it,” he said.
Young said the outreach, which includes providing naloxone, fentanyl test strips and information about recovery, is not necessarily aimed at getting people into treatment. Instead, she said the group’s aim is to “let people know that we’re there and that it’s OK. It’s really more about stigma. People feel like they don’t deserve to have help.”
A group of community organizations is working together on an anti-stigma campaign, said Jill Lord, director of community health for Mt. Ascutney Hospital and Health Center in Windsor. The group also aims to alert community members to Good Samaritan laws that protect people from being cited for drug possession when they call 911 or otherwise seek medical care for someone experiencing an overdose.
Mt. Ascutney last year began offering to begin medication-assisted treatment in the emergency room for people struggling with addiction and then to connect them with outpatient treatment elsewhere. Mt. Ascutney providers also connect patients in the emergency department to recovery coaches through the Turning Point Recovery Center in Springfield, Vt. The hospital also hands out naloxone for free, said Lord.
“We have to save a life before we get people into treatment,” she said.
Windsor County saw highs of four deaths each in the months of January, pre-pandemic, and July. The county had no opioid overdoses in October. Official numbers through the end of the year statewide aren’t available yet.
Lord said she hopes that the end of the pandemic, now in sight due to the beginning of the vaccine rollout, also brings the numbers of overdose deaths down. If not, she and others in the community will continue their work to reach people still struggling with addiction.
“We’re in it for the long haul regardless,” she said.
Mike Johnson, who directs the Springfield Turning Point Center, said he’d like to see Windsor County get a detox center where people could go after they leave the hospital following an overdose but before they can get in for inpatient treatment. He’d also like to see “step down” beds for when people are coming out of treatment. He said connecting people to outpatient treatment is one thing, but it doesn’t address the challenges people might face in their living situation or from the people around them.
“Life is every day,” Johnson said. “Recovery is about changing; learning to live without.”
Information about recovery resources in Vermont can be found online at vthelplink.org and in New Hampshire at thedoorway.nh.gov, or by calling 211 in either state.
Nora Doyle-Burr can be reached at ndoyleburr@vnews.com or 603-727-3213.
