Addiction Recovery Channel: Overdose Prevention Centers and Decriminalization

Hi everyone, welcome to the Addiction Recovery Channel. I'm Ed Baker, and I'm your host. The Addiction Recovery Channel was born out of the devotion to contribute to the elimination of stigma, and the way we planned on doing that was by having guests on the show who were based in science, based in data, based in compassion. By bringing you accurate information, we would help you to unlearn stigma and unleash compassion. The ultimate goal that we would together save lives.

having guests on the show who were based in science based in data based in compassion and by bringing you accurate information we would help you to unlearn stigma and unleash compassion the ultimate goal that we would together save lives

We're very privileged today to have two people with us who have spent a considerable amount of their time, treasure, and talent doing exactly that. It's my pleasure to introduce Greg Gardner and David Mickenburg. Greg Gardner is a senior policy counsel for the Drug Policy Alliance, which is a leading organization in the United States working to end the drug war, repair its harms, and build a non-punitive, equitable, and regulated drug market. Prior to his work for DPA, he practiced law as a public defender for over a decade and served as legislative staff for several members of Congress in Washington, D.C. The Drug Policy Alliance partners with a number of Vermont-based and national organizations working to shift Vermont's approach to drugs and people who use drugs away from a punitive approach to one focused on individual and public health. Thank you, Greg, for being on the show.

policy Alliance which is a leading organization in the United States working to end the drug war repair its harms and build a non-punitive Equitable and regulated drug Market prior to his work for DPA he practiced law as a public defender for over a

Thanks for having me. David Mickenburg is a partner at the Burlington law firm Mickenburg Dunn and Smith and has been actively involved in drug policy reforms since 1997. He started his career at the Drug Policy Alliance, where he worked on political efforts to reduce the harms associated with the war on drugs, including a multi-year effort to allow Vermonters to access methadone treatment. He currently works in a variety of public policy campaigns, including an effort to decriminalize drugs in favor of a public health approach. Thank you, David, for being on the show.

away from a punitive approach to one focused on individual and Public Health thank you gray for being on the show thanks for having me David mickenburg is a partner at the Burlington Law Firm mickenburg Dunn and Smith and has been actively involved in drug

Thanks, great to be here. Jordan, if you could put on that slide, please, the Centers for Disease Control slide. I'd like to just paint a context for the viewing audience. If you look at this slide, this is from the Centers for Disease Control. This tracks the velocity and the increase in overdose death in Vermont from 2015 to early 2023. If we had a graph that went back to 2010, you would see the drug overdose deaths told more than quintupling over 14 years. In 2021 in Vermont, there were 217 deaths. In 2022, it appears when the numbers are finalized, there will be over 240 deaths. And in 2023, it appears from data collected to date that the numbers will eclipse 2022. What's happening in Vermont is every year we set a record. Every year is worse than the previous year with everything we're doing now.

he currently Works in a variety of public policy campaigns including an effort to decriminalize drugs in favor of a public health approach thank you David for being on the on the show thanks great to be here Jordan if you could put on that slide

Greg, you wrote a commentary, to be exact, published in the Vermont Digger on April 6, 2023, a recent commentary, and you titled it "Vermont Keeps Kicking Important Drug Reforms Down the Road." And, you know, it was a scholarly article. I would recommend it to all my viewers, and I'd like to begin there. You know, what are we doing in Vermont? How are we dragging our feet in Vermont? What are we not doing to end the war on drugs? I know that the Drug Policy Alliance, that's one of your major focuses. What are we doing in Vermont to perpetuate the war on drugs?

increase in overdose death in Vermont from 2015 to early 2023 if we had a graph that went back to 2010 you would see the drug overdose deaths told more than quintupling over 14 years in 2021 in Vermont there were 217 deaths

Well, thanks, Ed. Thanks for highlighting the overdose curve, not only in the United States but in Vermont. We are in a crisis, and that's what that article was about, that we're in a public health crisis. Instead of completely overhauling what we're doing, instead of completely focusing all available resources on public health solutions to a public health crisis, we continue to have a haphazard approach. We continue to criminalize drug use. We continue to prohibit the use of drugs in a way that pushes people into worse situations, that pushes people into more dangerous situations. We continue to fail to invest in solutions like you've promoted and talked about extensively here on your program. Overdose prevention centers, Vermont has been slow to adopt evidence-based solutions like overdose prevention centers that have been shown to be effective and safer around the world, are in use in hundreds of places around the world. We've been slow to adopt other solutions as well, although I'm very encouraged that we've started to adopt, that we've gone heavier into working on drug checking over this past year. I think there's been a greater understanding in the legislature, and we're going to talk about that. I hope that we need to help give people tools for identifying contaminated substances and give people better information that allows them to change their use in ways that may keep them safer.

worse than the previous year with everything we're doing now gray you wrote a uh a commentary to be exact was published in the Vermont Digger in April 6 2023 a recent commentary and you titled it Vermont keeps kicking

But yeah, the point of that article, I think, was just to highlight that we really need to be focusing all of our resources on evidence-based solutions and to stop creating more harm, which we've been doing not only in Vermont but throughout the country in rejecting drug decriminalization and continuing to think that it's some sort of radical solution when it is a very pragmatic solution to reducing harm in people's lives. You know, we're going to dedicate a substantial amount of time toward decriminalization. I'd like you first, though, to just dig a little bit deeper into this idea of the war on drugs. You know, for my viewing audience, what do we mean when we say that? What is the war on drugs? How did it start? How did we all get inundated into it? What is going on in our culture?

dragging our feet in Vermont what are we not doing to um end the war on drugs I know that the drug policy Alliance that's one of your major focuses what are we doing in Vermont to perpetuate the War on Drugs

You know, the drug war goes back beyond its more modern inception 50 years ago. There have been policies throughout over a century in the United States that have criminalized people for what they put into their bodies. And those drugs, those laws have come about largely for racial targeting, for purposes that have been used, have been intended to marginalize people, to marginalize specific groups of people. Over the past 50 years, we've ramped that up significantly. I think everybody at this point understands how much money and how much of our resources, how much more personnel have been put into arresting people, into criminalizing people, and incarcerating people for what they put into their bodies.

completely overhauling uh what we're doing instead of completely focusing all available resources on Public Health Solutions to a Public Health crisis we continue to have a haphazard approach we continue to criminalize drug use we continue to prohibit the use of drugs in

You know, but when we talk about the drug war, we're not just talking about mass incarceration. I think when people think about the drug war, they think mass incarceration, and certainly mass incarceration is a huge problem. We've incarcerated, you know, we have now about 2.3 million people incarcerated in the United States, and one in five of those are in prison for a drug-related offense. We imprison more people than any other nation in the world. Women are one of the fastest growing segments of the prison population in the U.S., largely because of draconian drug laws. Nearly, I think it's 45 percent of women in federal prison and 25 percent in state and local prisons are incarcerated for drug offenses, and over half of those have minor children. So we're perpetuating harm in the cascading effects of this.

to adopt uh evidence-based Solutions like overdose prevention centers that have been shown to be effective and safer around the world are in use and in hundreds of places around the around the world we've been slow to adopt other Solutions

But when we talk about the drug war, we're not just talking about mass incarceration. We're talking about all the other components that exacerbate poverty, discrimination, unemployment, poor health, and instability in general. We've created these systems within civil systems that create punishments for people in housing systems so that you're subject to removal from housing if you're alleged to have used drugs. There are a number of different penalties that we've built in, from driver's licensing to professional licensing to background screening that keep marginalizing people, keep segmenting people, and isolating them from systems that provide more stability. And that's all part of the drug war. In many ways, that's been done by intent, with the intent to marginalize certain seg—

about that I hope that that we need to help give people tools for identifying uh contaminated substances and give people better information that allows them to to change their use in ways that um that may keep them safer

but yeah the point of that article I think was just to highlight that we really need to be focusing all of our resources on evidence-based Solutions and to stop creating more harm which we've been doing not only in Vermont but

throughout the country in rejecting drug decimalization and continuing to think that it's some sort of radical solution when it is a very uh pragmatic solution to reducing harm in people's eyes you know we're we're going to dedicate a

substantial amount of time toward decriminalization I'd like you first though to to just dig a little bit deeper into this idea of the War on Drugs you know for my viewing audience what what do we mean when we say that what is

the War on Drugs how did it start how did we all get inundated into it what what is what is going on in our culture you know and um the the drug war goes back Beyond uh it's it's more modern Inception 50 years

ago uh there have been policies throughout over a century in the United States that have criminalized people for what they put into their bodies um and those drugs have those laws have come about largely for uh racial targeting for uh purposes that are

have been used have been intended to to marginalize people to marginalize specific groups of people over the past 50 years we've ramped that up significantly um I think everybody at this point understands how much uh money and how

much how much of our resources how much more Personnel have been put into arresting people into criminalizing people and incarcerating people for what they put into their bodies um you know but when we talk about the drug war we're not just talking about

mass incarceration I think when people think about the drug war they think mass incarceration and certainly mass incarceration is a huge problem we've incarcerated you know we have now about 2.3 million people incarcerated in the United States and one in five of

those are in prison for a drug-related offense we imprisoned more people than any other nation in the world women are one of the fastest growing segments of the prison population in the U.S you know largely because of draconian drug

laws nearly I think it's 45 percent of women in federal prison and 25 percent in state and local prisons are in jails and state prisons are incarcerated for drug offenses and over half of those have minor children so we're perpetuating

harm uh in their cascading effects of this but when we talk about the drug war we're not just talking about mass incarceration we're talking about all the other components that exacerbate poverty discrimination unemployment core health and instability in general

um we've we've created these systems within civil systems that create punishments for people in housing systems so that you're subject to removal from housing if you're alleged to have used drugs um your uh there are a number of

different penalties that we've built in from driver's licensing to Professional Licensing to um you know background screening that keep marginalizing people keep segmenting people and isolating them from systems that provide more stability and that's all part of the drug war in

many ways that's that's been done by intent with the intent to marginalize certain segments of of our communities it's had a racially disparate impact people who are people of color and white people use drugs at the same rates they

sell drugs at the same rates and yet black and brown people tend to be criminalized they are criminalized prosecuted incarcerated at higher rates than white people so these are the the drug war is extensive and and it is not subsiding in

a substantial way it continues to be perpetuated throughout the country and and even in Vermont through arbitrary enforcement you know I think it's I think it's interesting and I want you to jump in whenever you whenever you feel you you

you should uh David I think it's interesting when you you dig down into this concept of War on Drugs how profound it becomes you know we've all heard of critical race Theory I for one think somebody should begin to study critical stigma

Theory and see how stigma against people who use drugs has infiltrated every level of American American society we've been we've been taught it for at least 50 years as policy as public policy as political policy and to me it's one of the main things that

keeps people from from embracing like Humane efforts to help people with with drug use issues do you care to comment on on stigma or or what we're talking anything absolutely thank you um so it was interesting I was

reflecting as gray was talking about what Vermont is doing now and what Vermont's not doing now we we've been here before when DPA and myself started working on drug policy issues in Vermont in the early 2000s Vermont was one of

six states that didn't have methadone treatment we didn't have needle exchange we didn't have a hub and spoke model all these things we talk about in naloxone treatment buprenorphine we didn't have any of that and we were stuck in this

drug War mentality that that the folks that use consumed drugs don't deserve our love compassion and don't deserve the same level of humanity that other people do now what's hopeful for me about this time now which was reflected

by the history of what happened then is that Vermont did take affirmative steps we were leaders in the country we not only got methadone treatment but we just developed a broad system of buprenorphine distribution we were the first state in the country to allow for

naloxone to be sold over the counter we work to pass one of the most in fact the most far-reaching Good Samaritan law meaning people who were overdosing could call 9-1-1 without fear of prosecution and it was it was by far a model for the

rest of the country and the way that we accomplished all that was by having folks voices impact did folks folks that normally live in a world of stigma come forward and say we deserve these same rights we deserve the same protections

that everyone else had and it had a powerful impact and I see that sort of energy forming again it's been a while since we've worked to push the envelope we did some of that this year we've done had some of those conversations last

year in the legislature but I I'm encouraged by our history even though we have more to do now and and more to do around stigma around the policies that we Implement we've been here before and we've stepped up and so

I I feel uh enlivened by the opportunity to again bring back the voice of people that are impacted and the people that are impacted aren't just people consuming drugs it's the families it's employers it's all of the people that

are impacted the children of people the Ripple effects throughout society that happens when we don't give somebody their full Humanity yeah I mean that that is an excellent point coincidentally this morning I was at a webinar with Dr Yao Gallo he's the

equivalent of the health commissioner in um in in Portugal and he spoke about exactly what you're speaking about the facilitator asked him what it was about Portugal that got them to enact you know Progressive Humane approaches to people who use drugs mainly

decriminalization of drugs and decriminalization of using drugs and he emphasized that what happened in Portugal in the late 70s and 80s was there was an explosion of drug use and by the 90s the early 90s there was no

one in Portugal who could say you know drug overdose is occurring within marginalized populations it's those people who it's happening to it was happening to everyone and that caused the momentum to form in the culture that enables these the decriminalization of drugs and

the Humane approach to people who use drugs and and I I know you see it I know you see it in America today that's what's happening everyone is involved in this if it's not oh his son died you know

it's you know my nephew died his son you know it's you know we're all involved in this and I can feel the momentum developing that you're pointing out there's great resistance to it we all know that maybe would you would you continue a

little bit because I know you spend a lot of time in the legislature sure would you continue a little bit with some of the advances that were made specifically this year last year we had the veto of 728 the governor vetoed a

bill that was designed to study over those prevention centers but this year The Advocates came back do you care to elucidate that a little bit what were some of the the measures that were passed sure yeah um this year

um many of the provisions that were included in the bill that the governor vetoed resurfaced in a bill h.222 which was a real harm reduction focused Bill there was a lot of really good elements of harm reduction making it easier to

access treatment doing things like decriminalizing drug paraphernalia or harm reduction harm reduction tools so people can access safe harm reduction tools there was you know a variety of Provisions to strengthen our harm reduction laws and that was exciting and we also eliminated

the sunset on the decriminalization of buprenorphine Vermont was the first state in the country to decriminalize buprenorphine in certain amounts had a sunset on it the governor when became law said we wanted to study it to see what the impacts would be and lo and

behold the impacts all the negative impacts that people had talked about didn't materialize and so we eliminated the sunset on that made that a permanent piece of legislation as the bill made it through the process we really made I think a a tremendous

step forward in line with the type of work that we were doing decades ago in Vermont and gray had mentioned this around drug checking and I found it interesting I saw an article today a that the Biden Administration is now

launching a new policy and I haven't seen the details gray may know more about it related to xylazine and Fentanyl and for those that know xylazine is a animal tranquilizer that's added to fentanyl to stretch out the length of the effects of fentanyl with

very potentially dangerous impacts on people that consume it so the but part of what the national uh platform that the Biden administration had come forward with was increased access to testing and generally the form that that's taken is testing strips so

fentanyl testing strips or xylazine testing strips to see whether or not there are those substances in the drugs they're consuming what we did in Vermont modeled under a pilot program that was being done in southern Vermont was we passed a law that was included in

h.22 to provide not just access to drug checking Services where you can bring your drugs to get tested by machines that will give you everything that's in um in the drugs for your own protection not just the authorization of that but

we provided criminal immunity for people to bring their drugs in we said we value your life more than arresting you for having a small amount of drugs on your possession we provided criminal immunity for the people testing the drugs similar

to what we would be talking about for overdose prevention centers and we also in the provisional law allowed for the dissemination of information to the community to say that in an anonymous way that we can say if we find drugs

that are contaminated we're going to let you know so you can be safe and we're also going to put out information in the community and the best part of it for me is that we took money from the opioid

settlement funds and used that money to pay for this so that we can have these machines throughout the throughout the state and to me that's a really major accomplishment uh that the and major step forward that the legislature took

and the Coalition which I think we can talk about was sort of instrumental in making that happen and so very exciting yeah absolutely you know can I jump in on that real quick I think yes go ahead one of the things about this drug

checking provision that I think is so significant is exactly what David said I mean it really prioritizes the health and safety of the individual as well as the community safety getting information out to the community like we would do in

in a TV outbreak or in you know covet racing you know we try to get information that helps us identify where the threat is and um and try and help people make choices that are better for them that help them live in a safer way

but that that premise of trying to focus on the health and safety of the person is Central to harm reduction it is Central to shifting toward a public health model that gets away from as you put it you know stigma focusing on

stigmatizing people focusing on you know criminal sanctions the threat of criminal sanctions um that that that cause people to use in in more uh dangerous ways and and perpetuate the overdose crisis so I think it's a really important step

and I think there's there's similar Provisions that that need to be incorporated into some of the other uh harm reduction measures like overdose prevention sites the legislation would have similar uh Provisions to to ensure that people are not going to be

criminalized that we're we're emphasizing open doors we're encouraging people to come in to harm reduction sites by saying you're safe here you're not going to be arrested if you come in here and by shifting that focus in in

this specific way with drug checking I think we make a step in the right direction in terms of reducing stigma um I would like to go back to your question about stigma if that's okay oh yes of course absolutely

you know you asked about stigma and and how things are progressing in in Vermont and I think that there is a greater understanding in Vermont and throughout the country um of addiction as of the nature of addiction as a medical condition of

substance use disorder as a medical condition as a chronic medical disease um that that is involving the brain circuitry you know I think there's a better understanding of that there's an understanding by the health department and I think their messaging is very

clear in Vermont that stigma is a problem I think it's actually somewhat perplexing the the Department of Health has a major campaign they have a proactive effort to destigmatize drug use they have an entire section of their website dedicated to ending addiction

stigma um I think it says on there together we can end addiction stigma um to me one of the most significant forms of stigma is caused by the criminal legal system by arresting people by publicly shaming them labeling

them with a criminal record that goes on for years that can last a lifetime and um you had Noah volkov the director of the National Institute of drug abuse on your show director volkov has written extensively about the impacts of of stigma on

people's lives and about criminalization and the effect of criminalization on people's health if I can read one of her quotes I think it's just very uh poignant it's that punitive policies around drugs Mark people who use them as criminals and so it

contributes to the overwhelming stigma against people contending with an often debilitating and sometimes fatal disorder and even against Medical Treatments that effectively address it and stigma has major negative impacts on health and well-being which explains why only 18 of people with drug use

disorders receive treatment for their addiction I think that kind of sums up why decriminalization we're moving uh criminal penalties is just so important and there are so many other impacts of the harms of criminalization that that we can get into but but in terms of the

stigma I think we just need to get over the hump of realizing that that the criminalization the prohibition in general of saying that you know you are uh your reprehensible you are to be labeled as you know with a Criminal penalty if you

if you use a substance in an illicit way until we start to realize the damage that that's doing you know we can't truly address all the harms that are occurring you know that's um eloquently put and and accurate and we we we couldn't be

more on point addressing this on the show today well just to reiterate norovalkov in another article she tells the vignette of a gentleman in Puerto Rico um with a xylazine sores sores soft tissue infection caused by the injection

of xylazine which you mentioned earlier earlier and the the man is in in danger of having to have his leg amputated and she's with him and she's trying to get him to come into the Medical Center for Medical Care and he refuses Medical

Care and the reason he refuses Medical Care is to avoid the indignity of stigma and this is what we have in America we have an entire population of people who are literally about to die with very severe drug use disorder injecting

lethal unregulated drugs who are alienated from our systems because our systems have searched them handcuffed them incarcerated them and stigmatized them for decades this is the population when you both mention harm reduction my heart jumps for Joy because this is the

population that harm reduction is it's just so uniquely set up to embrace non-judgmental unconditional safety come to us as you are we'll meet you where are you are we're not going to make any demands on you and I agree with you I think what I

think America is funny we're making progress in different levels in different places it's kind of haphazard but basically the next logical step is decriminalization so gray I wanted to ask you I know that you're involved on a national level

what are you seeing nationally in other states is there any state that we should be looking at that's saying well this is what they've done we should try to replicate that as closely as possible well I think there's a movement

toward reducing the harms of criminalization throughout the country I think there is a movement uh that people realize I mean the national polls show that 66 percent uh people agree that we shouldn't be criminalizing people for for substance use

the numbers are way higher here in in Vermont you know it's 84 of people think that uh drug use should not be criminalized possession of low-level amounts of drugs should not be criminalized um it's astounding and it's a bipartisan

um it's a bipartisan agreement on the issue um in many ways so I so yeah I think that um there is a movement around the country to to really change the way we're doing things um Oregon is the best example of course

um the GPA had worked with Partners allies in in 2000 to work toward uh the implementation the the passage and implementation of a ballot measure in Oregon that would decriminalize low-level possession of all substances um that passed by a strong majority in

2000 almost 60 percent of Oregon voters supported it and the measure itself not only eliminated low-level criminal penalties but it also provided for shifting significant funds into uh woefully under-resourced treatment and harm reduction systems they made available in the first two years over

300 million dollars to invest in expanding behavioral health networks throughout the state and they also recaptured upwards of in the in the first period they've they've assessed they recaptured uh over 40 million in uh funding that was going to law enforcement that was

freed up by the ballot measure so Oregon is the best example of of trying to make uh resources available in a better way and to get remove the barriers of criminalization that prevent people from getting connected with Services

since that passed in 2000 we saw uh in 2020 we saw significant efforts around the country to try and do similar things we've seen legislation throughout New England through Massachusetts Rhode Island New York Maine there are states throughout the rest of the country as

well Washington State Kansas Kentucky Texas I mean you see decline bills all over the country and there's serious consideration of of these measures in a lot of different places um but up north you know in Canada I think

is one of the best examples Canada as you know um just well Vancouver um in the in January of this year implemented um by waiver from the National Health Authority uh an emergency measure to decriminalize the levels of all

substances and also to invest heavily in harm reduction and treatment Addiction Services so they have done what what other states should be looking toward is addressing this as a public health emergency as an emergency that affects all of us when you see uh

fatality rates like you showed at the beginning of this program I think all policy makers should start to realize that the number one priority should be to stop causing the harm and to get resources to addicting Services treatment as quickly

yeah thank you thank you can I can I just add one thing of course yeah I mean it's just I think about as Gray's talking as you're talking I would think about imagine uh another uh one of the most deadly drugs in the

country um nicotine and imagine that instead of doing what we've done which said let's educate to try to bring rates of nicotine youth youth rates down which has been effective here in Vermont let's talk to people about harm reduction

let's offer alternatives to smoking cessation and things like that instead of doing that imagine we said we're going to put people in prison for smoking cigarettes we're going to put people in prison for drinking alcohol I mean when we're talking about drugs it's

good to put it in the context I don't see any legislation around the country to make alcohol illegal cigarettes illegal there are harms associated with both of them serious harms but the harms associated with the illegality and the

criminalization are so significant that um that that wouldn't be contemplated and so I think just sort of piggybacking on what gray was saying looking at these policies within the framework of is what we're doing doing causing more harm and

I think the evidence shows that it clearly is um so absolutely and thank you for for that perspective I think that harm reduction perspective is absolutely essential crucial I wanted to just note that both of you have alluded to sort of

strands of decriminalization in Vermont residual drugs at drug testing um there was uh um of the Good Samaritan laws you know so so it looks like we have the beginning we have some budding ideas some budding acceptance of

decriminalization I think maybe it's time to talk a little bit about Coalition building in Vermont what you've been doing in Vermont and what your sense is of the momentum in Vermont toward eventual decriminalization well that's great yeah and in fact gray had

been mentioning bills all over the country Vermont um has decriminalization uh legislation that was put in there's two bills h-423 who's in the House s 119 in the Senate we had 47 sponsors of the house bill which is I think probably the most in

the country a number of legislators from all over the the state with different perspectives coming together to say that the current system has failed we need to move towards a public health model it was really inspiring in the Senate we

had 11 over a third of the Senate said that this policy that we currently have is no longer working so we're seeing a lot of growing conversations and growing support for this effort and a lot of that is due to the growing Coalition

gray and IU and others have been working together over the last two or three years to bring a variety of different groups together we have our harm reduction groups we have criminal justice reforms groups we have women's groups we have the you know the

Burlington FC Soccer FC green soccer club you know a lot of different types of folks seeing that it's an organization called decriminalize Vermont and folks seeing that the current uh the the current policy has failed this this it's not really an

organization this group of this collaboration of folks coming together started with just a handful full of groups and now has grown to over two dozen groups and growing and so for instance when we were talking about the drug checking piece that wasn't included

in the House pass version for a variety of reasons we held a press conference with this Coalition of groups and brought really poignant stories uh to the Forefront people were saying we can no longer accept that um we are going to have to go blindly and

tell people that they just get what they get and you know whether they die it doesn't matter to us and that Coalition came together and forcefully said that we need change and that change happened so it was really encouraging and I think

this is going to be a growing movement because as you said it's based on data science it's based on compassion and love and it and it touches everyone absolutely and I think that's the key yeah is it touches everyone I mean not

only do a majority of people have some connection to this issue they know somebody who's overdosed they know somebody who suffers from substance use disorder but also I think people from different political backgrounds and different uh ideologies I mean have a a

coherent interest in this particular issue the harms of criminalization affect us in so many ways not only from you know the the overdose issue but to The Compassion toward other people that providing assistance to other people the civil liberties

I think there are a lot of people who who are starting to realize that the harms of criminalization are so broad that it's just not worth it anymore it never was effective it never affected the rates of substance use it never

affected uh the price it never reduced the supply it hasn't been affected for over for 50 years and people are starting to realize that as well as seeing how much harm is created and I think that overdose issue

is particularly Salient I mean when uh it is uh it is the third leading cause of death in custody you know when you put somebody in a jail who is suffering some from substance use disorder they are at greater risk uh

than outside of the jail in many ways uh one study found that naloxone was administered in only 20 percent of fentanyl related overdoses uh in jails and prisons that were studied and about 40 percent of of deaths occur within the

first seven days of someone's admission into a jail so even if you think that hey people aren't getting significant amounts of time you know they're just being uh put into a jail until you know they can go see a judge or something

like that you're still putting people in danger um but beyond the overdose uh risk the increase of Overdose risk both in jails and outside of jails you know in the first two weeks of release from from uh Prison from incarceration individuals

are almost 13 times more likely to die than the the general population I think that should alarm people um it should alarm people that what we're doing with the criminal justice system is just not helping connect people with treatment it's not helping

people connect with services that they really need to help stabilize their life are so vast uh when you talk about housing when you talk about employment impacts when you talk about social impacts mental health impacts um an arrest is just an arrest not a

conviction that's associated with a 12 to 14 decline in mental health so you have increases in PTSD and depression uh and suicidal ideology um there are a number of impacts on individuals and on people within the community that are heavily policed as

well um there there's so many different things that I think I don't know if we showed the the graphic um of all the various forms of criminalization uh from you know the erosion of our constitutional rights our fourth amendment rights uh to the

increase in militarized policing that that have accompanied uh criminalization to the housing impacts there are so many different aspects of this that I think should alarm people and should grow this Coalition uh in in different ways but a

much broader movement for for reform is growing you know I wanted did you want to see that did you want that graph up that would be great yeah uh Jordan can you put that wrap up which was it on the

effects of uh criminalization was that it yes I think that's it I think that just gives people a sense of the many different ways that that people are impacted um that our communities are impacted that that that harm is great being created by

our policies and to no beneficial effect you know what elaborate elaborate on it now have Jordan uh you know put it up when she puts the show together but you can elaborate on it now sure um yeah I think

people tend to think that criminalized for drug use anymore um but I think the numbers don't bear that out I think that there are still many many people who are criminalized for drugs in in Vermont and Beyond um

initial data that we have shows that 15 of arrests in 2021 were for drug-related offenses um that number that percentage has held fairly consistent it's been around 14 15 percent uh for the past uh four or five years that's still a huge investment not

only in terms of uh police resources but financial resources on strain on the court system it is uh it is a huge waste and it is a huge impact on the community that is just unjustifiable um the racial disparities we haven't even

talked much about the racial disparities here but the impacts you know have been tracked in in Vermont people of color are far more likely 18 more likely to get a sentence of incarceration in Vermont than similarly situated white

people um and uh more likely to be criminalized in the first place so there are there's still a significant amount of criminalization that goes on and I can tell you many different ways that the system was failing certainly in

my practice when I was working in in the District of Columbia I saw an extensive amount of wasteful and harmful prosecutions of these types of cases and I I believe it still continues once again bringing information like this to the General Public

who are fired by inundated with false information supporting stigma is absolutely essential I think to what we're doing so I want to I want to thank you for that and gray I want to I want to underline a term that you used you

used the term alarmed we should be alarmed and it's this kind of information when people hear it they are alarmed and instead of being soothed by this rhetoric about how great we're doing they feel the sense of urgency

people coming out of jail are 10 times more likely to overdose than people who are not incarcerated what is that about what can we do about that how can we're putting so many people in jail just for using drugs

people begin to ask themselves those kinds of questions and then in my experience if you can connect with them they begin to ask you you know what can I do if you would ask me about the population in Vermont the regular citizen ring in

Vermont I think everyone is either aware or unaware but either they're aware or unaware but what they're feeling is a tremendous sense of grief and a tremendous sense of responsibility everyone has been watching death in Vermont accelerate in velocity over the past 15

years and nobody knows what to do with the two about it so people people like you leaders in our state who are out here engaging people giving us a place to go where we have someone to follow that we can trust in you know I just

want to express my gratitude to you I wanna I wanna tell the viewing audience that if you have a pencil or a pen jot down drug policy.org so drugpolicy.org that's the site for the drug policy Alliance now I went on to the site

and I was you know messing around going to this place in that place and on the site there's one area that says do something now this is a this to me is incredible when you tap do something and you get to

that part it has a box for people in Vermont to join an advocacy push towards red decriminalization you you put in your identifying information and hit submit and a letter gets sent to all your representatives relative to this

particular issue I did it and within within a half day I had received two responses from state senators thanking me for my input so this to me is is just I want everybody in Vermont to know about it because people in

Vermont we want to do something and regular people don't know what to do so along those lines what's in what are the coalitions are the coalitions reaching out I know that we're having um just for the viewing audience again

we will be having a demonstration on the State House lawn on August 31st which is international overdose Awareness Day from five to seven in montpelia on the State House lawn with guest speakers on issues letting you know what's going on

what can be done there will be members of the Coalition that you can join there so I think it's time really the time is ours we have to really see it as a moment yeah I agree I think

doing things like contacting your legislators telling them that whether it's a specific piece of legislation or just generally the need to do more I think that's essential talking to local leaders your local Council people and others in your community talking to law

enforcement officials engaging in dialogue with law enforcement whether it's our attorney general or your local police and saying well do you think this system is working now is it working for you as a law enforcement official is it

working has it worked for the last 52 years of the War on Drugs why don't we start a conversation about that I think in Vermont we're lucky enough to be small so small enough to be able to have

those conversations throughout communities and that's how we're going to help change policy I mean right now you talked about legislation age 72 is a bill related to overdose prevention centers which you and others have been very involved in that bill came out of

its first committee and its second committee it's in its third Committee in the Appropriations Committee waiting for Action I mean that is an immediate step that can be taken to save lives if we were able to get that through the house

and the Senate next year we have communities Burlington and other places willing to step up and set one of these up this is being done around the world it's being done in New York City right now with on point there's lots of

stories about it over a thousand people almost a thousand people probably more than that lives have been saved since they've opened those doors people who are father fathers mothers sisters brothers grandparents who are now living to you know continue their lives and to

work towards uh stabilization that wouldn't have happened if they didn't have that opportunity so there's a lot that can be done immediately and we can continue to voice to our leaders the need to make change I mean I I couldn't

agree with you both more and to hear you you know speaking about advocacy with the enthusiasm that you have there seems to be a critical mass being developed in Vermont now we're kind of at a Tipping Point I I watched it at the opioid

um abatement funds committee that that committee as a result of advocacy both inside the committee and I know gray that you wrote a very um poignant letter to the um Commissioner of Health on that committee advocating for overdose prevention centers I watched

Advocates on that committee fight for six to seven months and as a result 100 percent of opioid funds was allocated to harm reduction now they dragged their feet a little bit on overdose prevention centers but the health commissioner put

in writing that he would be looking at overdose prevention centers during this phase of the process they've already had one person come and testify Brandon Marshall who is a national expert from Rhode Island a researcher he came and

testified they're going to have Kalin C who is the senior project director at on point come and testify this committee now you know with the help of outside Advocates needs to put pressure on leadership to support opioid abatement funds moving into

supporting overdose prevention centers it's happened in Rhode Island has done it there's a precedent it can be done this is one of the areas that we really need to focus attention I think if we had folks pushing the Department of Health

and the Department of Health would actually have an honest conversation about the science associated with overdose prevention centers harm reduction centers and the Department of Health would be supportive of this we would get this legislation passed without a without a lot of problems I

agree yeah I agree you know we're going to be close we're going to be closing soon okay and I was just going to add we are engaging a lot of different groups on these issues and I think we're

having conversations like we're having today with people in different constituencies different backgrounds who represent different groups of people and and also people just from different backgrounds to to learn more about why these issues are so important to to

learn more about the specifics of of how criminalizing is negatively impacting uh the overdose crisis and and impacting our lives in general and to learn how some of these Solutions have been effective throughout the world particularly overdose prevention centers

DPA Works in a lot of different states throughout the country and we are seeing a lot of energy throughout the country for building networks of harm reduction centers similar to what was what was done in New York where the focus is really on the

individual's health and safety and helping connect people to services in a voluntary way when they're ready and as they build trust instead of creating less trust and less and more difficulties more barriers in people's lives so I think we are engaging a lot

of different groups uh I think one example is is the health communities David mentioned the health department but I think people should be aware that in other parts of the country even the the like the medical uh the Minnesota

Medical Association just passed a resolution in support of decriminalization there are many other professional associations now that have stepped out and said you know we should end uh criminalization of substance use because it's ineffective and is farming the people that we care about and

particularly with health professionals who are devoted to doing no harm this seems to be something that we should start to think about more seriously thank you thank you and uh you know more and more um it becomes really a matter of

professional ethics for people in various fields to step up and adhere to ethics and support what's based in compassion and support what's based in in science and data I want I want to thank you gray I want to thank

you David I want to thank you thank you for being on the show and and really kind of like pushing the ball forward where you pushed it Forward today and I want to thank you from the bottom of my

heart I want to um I just like to uh kind of rope you into another show um closer to the legislative session on decriminalization over an overdose prevention centers maybe with a uh like a choice panel to join two or three

other significant others in Vermont that can address this closer to the legislative session I want to I want to just um I want to thank my guests for tuning in I want to remind people drug policy.org that's the drug policy

Alliance Workshop go there it's like a diamond mine and there's all kinds of things there's ways to learn and ways to participate in closing also the event International overdose Awareness Day gathering on the State House law on August 31st from 5 to 7 where

uh joining a team parenting Vermont which is a group of parents who have tragically lost children to overdose death so come there and stand in solidarity with us and demonstrate demonstrate your concern we want to show we want to show the governor the health

commissioner we want to show everyone that we're concerned about what's happening we're alarmed about what's happening we want more being done so thank you thank you Ed for bringing us on the show and doing everything that you're doing to to raise awareness of

these issues I would just add the one other resources the decrim vermont.org website which has a tremendous amount of additional resources as well and information about many of the efforts that we're doing the poll that we discussed today

um and and many other aspects of the legislation that have been uh put forward so thank you thank you so much thank you for remembering that thank you