Fatal fentanyl overdoses surged in 2017 in Vt.

Overdose deaths, a majority that included fentanyl, hit an all-time high in 2021. Vermont and other states reached a settlement with former opiate maker Endo this week. 

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BENNINGTON — Coming on the heels of a year of record-breaking overdose deaths, the state of Vermont announced Wednesday a national $450 million “agreement in principle” settlement with Endo International, an Irish drug-maker with U.S. headquarters in Pennsylvania.

“Every Vermonter has been touched in some way by the opioid crisis,” said Attorney General Susanne Young in a statement announcing the settlement. “No settlement amount will ever be enough. The Attorney General’s Office will continue to do everything in its power to hold the bad actors who promoted and profited from this crisis accountable.”

The Endo agreement marks the third such agreement the Attorney General’s Office has reached with opioid makers since July, when it announced agreements in principle with Teva and Allergan. To date, the office has negotiated more than $100 million in opioid settlements for Vermont, the office reported.

Previously, settlements also were reached with companies including McKinsey & Co., and the Sackler family’s Purdue Pharma.

News of the latest settlement was welcome, but those on the frontline of the fight against opioid addiction and its ravages on people and communities are waiting to see how the money is used.

Margae Diamond, executive director of the Turning Point Center of Bennington recovery program, worries the money will be divvied out in tiny amounts — providing little impact — annually into the future.

“That would be sad,” Diamond said. She said the system needs a significant cash infusion for what she called “infrastructure” — trained, experienced and compensated personnel. “We’ve got to have staff. This is a constant struggle.”

Diamond said creating more programming is great, but who — she asked — will staff those programs? She noted that frontline workers are poorly paid, and most — including herself — lack health insurance.

Diamond added, “Yay, it’s great that there’s some reparation happening. But the distribution to service organizations is a little up in the air yet.”

Those decisions will be made by the state with annual input from the newly created Opioid Settlement Advisory Committee — headed by Health Commissioner Mark Levine, “a member from the state Senate and House; health care providers; two people who lived through the experience of opioid use disorder; an assistant judge; and representatives from municipalities.”

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Bennington Rep. Dane Whitman is co-chairman of the panel. He said the terms of the settlements dictate the longer-term dispersal of the funds. He expects the committee to look for the “highest impacts” for the money. He agreed with Diamond that compensated, trained staffing for quality programs is a key piece. But the money will also be used for continuum of services — treatment, recovery, harm reduction (such as sterile needle programs) and prevention.

Whitman noted that lawmakers appropriated $9 million in state money to tackle this crisis, earmarking it for prevention, residential treatment, recovery centers and more.

He said the settlements dictate at least $3 million annually come to Vermont, adding, “These dollars will never be able to fully reverse the harm that has been done, but $3 million is significant, and it can have an impact on programs and recovery.”

The number of overdose deaths in Vermont hit a record-high 210 in 2021, according to the Vermont Health Department. That marked a 33 percent increase over the previous year.

“These people are our neighbors, our friends and our loved ones,” Whitman said.

Anyone seeking help with substance abuse can contact vthelplink.org or call 802-565-5465 (LINK) for nonjudgmental assistance.

Endo made generic and branded opioids, including Percocet and Endocet, before being pulled from the market in 2017, the Attorney General’s Office said. The settlement will require Endo and its lenders to pay up to $450 million to participating states and local governments, and turn over for publication millions of documents related to its role in the opioid crisis.

Endo is also banned from marketing opioids forever.

The company filed for Chapter 11 bankruptcy protection Tuesday night in the Southern District of New York. The settlement “resolves allegations that Endo boosted opioid sales using deceptive marketing that downplayed the risk of addiction,” the Attorney General’s Office said. The resolution is contingent on final documentation and Bankruptcy Court approval.

Among the other states working with Vermont on this settlement are Maine, Massachusetts and New Hampshire.