John S. Searles and Mike Yantachka
Overdose prevention sites don’t work
As the author of the overdose prevention sites (also called safe injection facilities) literature review for the governor’s Opioid Coordination Council Report published in October 2018, I take great exception to the enthusiastic endorsement by Diaz and Baker published in The Charlotte News recently. Their uncritical approach lacks scientific rigor and misstates several important aspects of these sites. Since space issues constrain my response, I would refer readers to the full report by Googling the Governors Opioid Coordination Council and accessing the “reports, testimony and comments” section and clicking on the Safe Injection Facilities report link.
In brief, almost all the benefits listed by Jay Diaz and Ed Baker (e.g., reduction in HIV, hepatitis C and other blood-borne diseases) are attributable to syringe exchange services at a significantly reduced financial investment (overdose prevention sites are very expensive to establish and maintain — Canada’s first facility called InSite in Vancouver is supported by $3,000,000 a year in taxpayer funds.). The vast majority of data about overdose prevention sites has been derived from InSite and a lot of it is misinterpreted, incorrect, or both. For example, the large reduction in the overdose death rate in the neighborhood surrounding InSite immediately after its opening in 2003 was due to a dramatically increased police presence in the area operating 24 hours a day, seven days per week. This had the effect of displacing the drug market surrounding InSite from the area which also resulted in a reduction in crime in the immediate InSite area. Not a surprise.
I’ll mention three more salient points. First, injections at InSite accounted for less than six percent of all injection drug use in their service area. Second, there are very little data demonstrating that individuals accessing overdose prevention sites avail themselves of enrolling in treatment programs — one of the main selling points of their establishment. Finally, opioid overdose deaths in the Vancouver area (where Insite is located) are at their highest level in history and show no signs of declining. 2021 saw a 23 percent increase in opioid overdose deaths there, so the ameliorating function of overdose prevention sites is highly questionable.
Everyone in public health wants to see the reduction and eventual elimination of preventable opioid overdose deaths. However, we should seek methods that are aligned with science that provide the biggest “bang for the buck.” Overdose prevention sites do not fulfill that promise.
John S. Searles
(Searles is a retired doctor who worked in substance abuse research and programs for the Vermont Department of Health.)
Yantachka running for re-election as representative
To the Editor:
It has been my privilege to serve as the Charlotte-Hinesburg State Representative for the past 12 years. I am taking this opportunity to announce that I will be running for re-election this year for another term.
During my time in office, my priority has always been to support policies that benefit Vermonters and make Vermont, and our community in particular, a better place to live and work. I believe in a strong democracy in which all citizens can participate through their right to vote. I have advocated for a livable minimum wage, for mental health benefits for first responders, and for sustainable pension funds for our hard-working teachers and state employees, as well as many other policies to support working families. During the worst days of the pandemic, I helped many employees, small business owners and self-employed persons in Charlotte access state and federal economic assistance programs. Through my work on energy and environmental policy, Vermont has taken significant steps to address climate change. However, much more needs to be done to further reduce our greenhouse gas emissions while helping folks save money on their heating bills and adapt to the changing weather patterns.
One of my most important responsibilities is keeping you informed through my bi-weekly Legislative Reports in our local newspapers and occasional Front Porch Forum posts. You can access those reports at my website, for a look at what I’ve been working on throughout my legislative career.
With your support I will continue working to support policies that will benefit the social fabric, the economic vitality, and the natural and lived environment of Vermont. Thank you for the opportunity to serve.
Rep. Mike Yantachka
(Yantachka is the Charlotte-Hinesburg (Chittenden 5) District representative and a member of the House Energy & Technology Committee.)