The stories surfacing in Vermont over the past several months have been heart-wrenching: small towns plagued with heroin abuse, families destroyed.
Fusion’s own investigative unit traveled to the state and visited a family dealing with a range of addiction issues, including heroin. The New York Times, Rolling Stone — and many other news outlets — are calling Vermont’s heroin problem an “epidemic.”
The numbers paint a different picture, however.
Heroin usage in Vermont isn’t all that different than in other parts of the country, meaning it’s a tiny group of people. Here are some figures that put Vermont’s heroin problem in perspective.
Few people are dying from overdoses
The number of overdose deaths related to heroin usage in Vermont doubled from 2012 to 2013. That’s seems startling, but not when you consider the scale.
In 2012, nine people died from overdoses involving heroin. A year later, that figure rose to 21 people.
That means the state had 3.4 fatal overdoses per 100,000 residents.
Compare that with the rate of overdoses in New York City and it seems like a success story. In NYC, 5.3 per 100,000 died from overdoses involving heroin in 2012 — 35 percent more than in Vermont.
This isn’t just a question of city versus small town, either. Per 100,000 people in nearby New Hampshire, 5.2 died of heroin-related overdoses in 2013.
And keep in mind — these deaths aren’t exclusively from heroin usage. They could be from heroin in conjunction with other drugs.
Pills are still a much bigger problem
The number of people being treated for heroin abuse has risen in Vermont over the past several years. But that increase is nowhere near the dramatic spike in treatment for prescription pill abuse over the past decade.
Credit: Vermont Department of Health. Data source: Vermont Substance Abuse Treatment Information System
The rise in heroin abuse in Vermont follows a national trend. Like what’s happening on the national level, however, the abuse of prescription painkillers like oxycodone are a far bigger concern.
There’s another important distinction here: the rise in treatment for opioids — both pills and heroin — is largely due to better availability of medical services, according to the Vermont Department of Health.
Here’s what the department said in a fact sheet:
While Vermont has seen large increases in the number of people treated for opioid addiction due to greatly expanded access to treatment and increased awareness of the problem, three separate nationally funded statewide surveys show that the prevalence of opioid abuse in the general population has remained stable for all age groups.
Prescription painkiller and heroin abuse in Vermont is similar to what you find in the rest of the country.
Combined data from 2011 and 2012 show that roughly 4.6 percent of Vermonters ages 12 and older reported having taken a prescription pain reliever for non-medical reasons in the past year, according to a survey by the Substance Abuse and Mental Health Services Administration. That’s comparable to the national average.
Surveys looking at data from 2002 to 2009 found that hardly anyone in Vermont — roughly 3,200 people — reported having used heroin in the past year.
Limited access to treatment
While the Vermont health department says treatment for opioid abuse, both pills and heroin, has expanded, getting help can still be a challenge.
Fusion’s investigation found that hundreds, if not thousands, of people are stuck on waiting lists for opioid-abuse treatment in Vermont because of a federal law that limits the number of patients who can be seen by a single doctor. The law was meant to rein in the illicit sale of prescription medications like methadone, but has resulted in long lines for help in Vermont.
According to federal data, Vermont residents are slightly more likely to say they aren’t getting drug treatment compared with people in the rest of the country.
The political landscape in Vermont
One big reason that so many media outlets have flocked to Vermont in recent months is Gov. Peter Shumlin. He devoted his entire “state of the state” address this January to heroin abuse.
“What started as an Oxycontin and prescription drug addiction problem in Vermont,” he said, “has now grown into a full-blown heroin crisis.”
Major outlets took the speech at face value and nearly 100 news article have been written about the “heroin epidemic” in Vermont since the start of 2014.
But focusing on heroin was a politically advantageous move for Shumlin; it took the spotlight away from Obamacare, a more contentious health issue in the state.
How bad was the healthcare launch in Vermont? The rollout was ugly enough to prompt the governor to create an independent commission to evaluate what went wrong. And due to technical problems with the website for the state’s new Obamacare-related program, the Vermont Health Connect, there are still roughly 8,000 households floating in insurance limbo.
After Shumlin’s speech about the heroin problem, however, Obamacare faded into the background.
“It was a great way to deflect attention from the Vermont Health Connect debacle,” said Anne Galloway, the editor and founder of VTDigger.org, a non-profit news website. “There was a lot of scrutiny that was going to be brought to bear on that.”
Now, she says “people aren’t as apt to hold him accountable.”
In another state, Shumlin might have received blowback for playing up the heroin crisis while the state’s health insurance program sat in shambles. But Galloway said the Democrat-dominated Vermont Legislature wasn’t likely to criticize the governor, who is also a Democrat.
The governor’s office rejects the idea that the speech was a way to deflect criticism away from policy failures.
“This has been a difficult conversation here, and the Governor has faced some criticism for his vocal stance about tackling this serious problem,” said Deputy Chief of Staff Susan Allen, in an email to Fusion. “Shame on your source, or anyone, who would try to play politics with the issue of opiate and heroin addiction and its devastating impact on families and communities.”
The takeaway: As in the rest of the country, heroin usage in Vermont is on the rise and addicts deserve access to treatment. But anecdotal media accounts lack important context, namely that heroin users are still a small group of people.
Ted Hesson was formerly the immigration editor at Fusion, covering the issue from Washington, D.C. He also writes about drug laws and (occasionally) baseball. On the side: guitars, urban biking, and fiction.