Vermont Advances Safe Consumption Site Bill, But Cuts Second Location

April 23, 2024

Lawmakers in Vermont have formally adopted changes to narrow the scope of a House-passed safe consumption site (SCS) bill, which in its amended form would create and fund a facility in Burlington where people could use currently prohibited substances—part of a pilot program aimed at quelling the ongoing overdose crisis.

After approving a panel amendment April 18, the Senate Health and Welfare Committee voted 3–2 to advance the bill, H.72. On April 19, the Finance Committee also voted 4–2 to approve the bill and send it to the Senate floor for consideration. As of April 23, it had received favorable reports from two Senate committees.

“H.72 is one we’ve worked on quite a bit,” Sen. Virginia “Ginny” Lyons (D), who chairs the Senate Committee on Health and Welfare, noted at a hearing ahead of her panel’s vote.

As passed by the House in January, the legislation would have created two SCS in undeclared parts of the state, with $2 million set aside in funding for the facilities, plus another $300,000 to study the impact of the pilot project.

In its amended form, $1.1 million would go toward the single-site Burlington project, though the full $300,000 would be retained to study the program.

 

 

The Department of Health would need to establish operating guidelines for the new program, which would include staffing levels and qualifications, by September 15.

Many of the new provisions in the Health and Welfare Committee’s striking amendment came at the request of various stakeholders, including Burlington’s mayor and fire department and the Vermont Medical Society, as well as Lyons, whose district lies south of Burlington.

After discussing the bill at past hearings, the panel went over final changes before the vote, which included restoring a clarification in the House version that SCS could be either fixed or mobile services, adding a requirement that grant applications receive approval from the city council as well more minor, technical amendments.

Panel revisions broadly restructured the bill’s language to separate its SCS provisions into one section and provisions around the bill’s proposed syringe service program (SSP) expansion into another.

As for the SSP section, that would provide $1.45 million to fund programs for HIV and harm reduction services through grants by September 1. That money would come from the state’s Opioid Settlement Fund. The latest committee draft also removed an additional $400,000 that would have come from the state’s general despite pushback from senators Ruth Hardy (D) and Martine Larocque Gulick (D). Lyons, the chair, said that money could still be set aside during the state’s budget process.

 

 

“I don’t feel comfortable abdicating those decisions to down the hall, because this committee has done the work, and I in particular have done a ton of work on this issue, and I don’t have confidence in the decisions made down the hall, frankly,” Hardy said.

“We’ll see what happens,” replied Lyons. “Everybody’s trying to do the best they can.”

At Lyons’ request they discussed provision of on-site drug-checking services for participants. A revision added at the request of the Burlington Fire Department, meanwhile, requires on-site experts trained in CPR, overdose interventions, first aid and wound care, as well as performing medical assessments to determine the need for further care.

 

 

At a hearing in early April, Lyons pointed out that the amendment lacked language conceiving of more SCS in the future.

“In a way we’re limiting it to one site in Burlington,” she said. “Going forward…there’s nothing in here that allows for expansion, should there be funds available.”

As the Health and Welfare Committee returned to the bill on April 12, however, Lyons also noted that the new language “doesn’t preclude” other SCS from being authorized later on.

The revised bill also includes adjusted language on legal immunity for SCS staff, property holders and others, to ensure they aren’t subject to arrest or prosecution as the result of good-faith overdose prevention efforts.

 

 

If the bill becomes law, Vermont would join Rhode Island and Minnesota as the third state to authorize SCS.

Sponsored by Rep. Taylor Small (P/D) and 28 House colleagues, the bill is another attempt by lawmakers to allow SCS following Gov. Phil Scott’s (R) veto of a 2022 measure that would have established a task force to create a plan to open the sites.

Even if the legislation passes the Senate this session it still faces a possible veto from the governor.

“I just don’t think that a government entity should be in the business of enabling those who are addicted to these drugs that are illegal,” the governor said of the current measure at the time it passed the House earlier in 2024.

Scott wrote in his 2022 veto message on the previous legislation that “it seems counterintuitive to divert resources from proven harm reduction strategies to plan injection sites without clear data on the effectiveness of this approach.”

Ahead of the Senate committee vote, members took testimony and received written comments from a number of officials and organizations over the course of multiple hearings.

At one of the more recent meetings, the new mayor of Burlington, Emma Mulvaney-Stanak, who took office earlier in April, said that—like outgoing mayor, Miro Weinberger—”I also strongly support H. 72 and the pathway it provides our city of Burlington to pilot an overdose prevention center in our community.”

“They cannot prevent all risky drug use or related harms. However, evidence demonstrates that they can be remarkably effective.”

Weinberger, who himself addressed the panel at an earlier hearing, said addressing the overdose crisis has been a top priority in the city since 2015.

“I have long supported overdose prevention sites as a strategy,” he said. “I have become increasingly focused and increasingly believe that this is something that we urgently need to pursue.”

The proposal has support from advocacy groups such as the Drug Policy Alliance, Law Enforcement Action Partnership, National Harm Reduction Coalition, the American Diabetes Association, Planned Parenthood of Northern New England, Johnson Health Center, Broken No More, Recovery Vermont, the Vermont Association for Mental Health Addiction and Recovery as well as various individual public commenters.

The National Harm Reduction Center, for example, called SCS “a vital part of a comprehensive public health approach to reducing the harms of drug use.”

“They cannot prevent all risky drug use or related harms,” the group said in its testimony. “However, evidence demonstrates that they can be remarkably effective and cost-saving and improve the lives of people who use drugs and the safety and health of our communities.”

Prior to the amendments, some state officials told the committee that SCS aren’t the right fit for Vermont’s rural areas.

“My position is that while I acknowledge [SCS] can have many potential benefits and be part of a multi-pronged approach to the opioid epidemic, they ultimately may not represent the best option for a state such as Vermont at this time,” Mark Levine, commissioner of the Vermont Department of Health, said in submitted testimony ahead of the committee changes, arguing that the facilities work best “where people who need these centers can access them easily and quickly—typically these tend to be larger-population areas, neighborhoods where injection drug use is more prevalent.”

New York City, he pointed out, has located its two SCS in areas that fit that description.

“Half-measures avail us nothing.”

Rep. Eric Maguire (R), who also opposed the bill, argued at the earlier hearing that while SCS might be an acceptable option for Vermont in the future, the state currently lacks the infrastructure to make the project worthwhile. He also emphasized that the sites could violate federal law.

“Currently at this time, the state of Vermont does not have the infrastructure or continuum of care to support this harm reduction model,” he told the panel. “It’s not sanctioned by SAMHSA… It’s against the law under the Controlled Substances Act.”

“There may come a time when they are sanctioned by our national health organizations and sanctioned within the harm-reduction model laws,” he added, “and then we can look at crossing that bridge.”

Weinberger, the former Burlington mayor, told panel members that not only do SCS prevent overdose deaths, they also connect drug users with treatment and other services, often reaching individuals who are missed by other outreach.

“One often under-appreciated in the discussion is that studies are showing that these facilities reduce—not only do they not increase, they reduce—crime and disorder in the area immediately around the facilities,” he said. “I think that surprises many people.”

Weinberger acknowledged that the sites may not work in every part of Vermont, especially more rural areas, but said that wasn’t a reason to deny facilities in denser areas such as Burlington.

Scott Pavek, meanwhile—a substance use policy analyst for the city of Burlington and a member of the state’s Opioid Settlement Advisory Committee and Substance Misuse Prevention Council—urged lawmakers not to be complacent about the ongoing overdose crisis.

“Recently, this committee heard testimony that suggested the state’s overdose deaths have plateaued,” he said, warning against the “eagerness to point to a still unacceptable number of Vermonters lost to preventable overdose deaths as proof that our harm reduction and treatment strategies are sufficient.”

A saying he often heard during his own recovery, Pavek added, is that “half-measures avail us nothing.”

Though Rhode Island and Minnesota have authorized SCS, New York City became the first US jurisdiction to open them.

Separately in April, Vermont’s Senate passed a measure that would establish a working group to study whether and how to allow therapeutic access to psychedelics in the state. If the bill is enacted, a report from the working group would be due to the legislature in November with recommendations on how to regulate the substances. As originally introduced, that bill would have also legalized use and possession of psilocybin, but lawmakers on the Senate Health and Welfare Committee nixed that section to focus instead on the working group.

Though Rhode Island and Minnesota have state laws on the books allowing SCS, New York City became the first US jurisdiction to open them in November 2021, and officials have reported positive results saving lives.

The American Medical Association has found that the facilities have decreased overdose and public drug use, provided various ancillary health services to participants and have led to a decrease in arrests without an increase in “crime.”

Meanwhile the federal government has fought an effort to open an SCS Philadelphia. Earlier in April, the court in that case granted the Justice Department’s motion to dismiss a challenge from organizers.

The Supreme Court rejected a request to that hear that case in October 2021.

DOJ first blocked the Philadelphia nonprofit from opening the SCS under the Trump administration. Supporters hoped the department would cede the issue under President Joe Biden, who has supported some harm reduction policies, but the parties could not reach an agreement to allow the facility to open despite months of “good faith” negotiations.

Congressional researchers have highlighted the “uncertainty” of the federal government’s position on such facilities, pointing out in November 2023 that lawmakers could temporarily resolve the issue by advancing an amendment modeled after the one that has allowed medical marijuana laws to be implemented without DOJ interference.

Meanwhile, National Institute on Drug Abuse Director Nora Volkow has tacitly endorsed the idea of authorizing SCS, arguing that evidence has effectively demonstrated that the facilities can prevent overdose deaths.

Volkow declined to say specifically what she believes should happen with the ongoing lawsuit, but she said research has shown SCS have “saved a significant [percentage of] patients from overdosing.”

 


 

Photograph by Photo Claude TRUONG-NGOC via Wikimedia Commons/Creative Commons 3.0

This story was originally published by Marijuana Moment, which tracks the politics and policy of cannabis and drugs. Follow Marijuana Moment on Twitter and Facebook, and sign up for its newsletter.

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Ben Adlin

Ben is a writer and editor covering cannabis since 2011, including as a senior news editor for Leafly. He is currently senior editor at Marijuana Moment. He lives in Seattle.