27 March 2024 •Dr. White
Committee looks to invest Vt. opioid settlement funds in stimulant treatment program
MONTPELIER, Vt. (WCAX) - A rise in overdose deaths from cocaine and other stimulants has the state looking to invest opioid settlement funds into a stimulant treatment program pioneered in Vermont.
Some 41% of Vermonters who died of an overdose in 2021 had a combination of fentanyl and cocaine in their toxicology screenings.
“There’s a huge crisis right now and we’re in kind of the fourth wave,” said Dr. Suzan White, a psychiatrist. “It started with pills that then was replaced by heroin, was then replaced by fentanyl, and now we’re in this wave of stimulants.”
It’s a rising trend that advocates and the Vermont Department of Health have signaled to the Opiate Settlement Fund Advisory Committee.
Committee member Sen. Ruth Hardy has listened to hours of testimony on how to spend the allocated money.
Committee member Sen. Ruth Hardy has listened to hours of testimony on how to spend the allocated money.
“A lot of times people don’t know that their stimulants have fentanyl or xylazine or some other opiate mixed with the stimulant,” said Hardy, D-Addison County.
Hardy says the committee’s first priority is harm reduction, and then supporting recovery services and increasing drug use prevention.
One way the committee members hope to achieve their goals is by investing $800,000 in contingency management, one of the only known clinical treatments for stimulant use disorder.
“Contingency management basically says, ‘Let’s shape behaviors, let’s help people stop using by giving them a reward,’” White explained.
The treatment was invented by University of Vermont Professor Stephen Higgins. A common model has patients with stimulant use disorder attend weekly meetings. Every time they show up and connect with the recovery industry, they receive a gift card. If they have a drug-free urine sample, they receive two gift cards.
“There’s a part of the brain that lights up to a financial or a fiscal reward, and it’s the same part of the brain that lights up when people use cocaine,” White said.
Studies show contingency management can increase abstinence rates for people who use stimulants. One experiment found those in a contingency management program were four times more likely to stop using stimulants than those who weren’t.
But the programs aren’t foolproof. White says a common problem these programs face is a lack of trained professionals and funding, which in turn forces them to be short and less effective.
Statistics also show stimulants are one of the hardest types of drugs to quit because of withdrawal symptoms and the way they rewire the brain.
Still, medical experts believe contingency management is the best way to tackle the problem.
“If you can manage the stimulant use with the contingency management and, if necessary, support people with the opioid use, then you’re going to end up with fewer overdoses,” White said.
The final decision on how to use the opiate settlement fund will be decided at the end of the session with the passing of the budget.