Vermont’s opioid overdose deaths fell for the second year in a row in 2024, hitting their lowest annual tally in four years, according to the latest opioid annual report from the Vermont Department of Health.
The department reported 183 Vermonters died of opioid-related overdoses in 2024, compared with 236 deaths in 2023. The drop was paralleled by falling deaths at a national level, according to data from the U.S. Centers for Disease Control and Prevention.
Deputy Health Commissioner Kelly Dougherty said her team was happy to see the decline in deaths, but noted they remain high — higher than pre-Covid-19 pandemic levels and higher than in 2015 when then-Gov. Peter Shumlin raised alarms about a rising rate of overdoses in the state.
Health officials had been encouraged by a drop in overdoses in 2019, only for the trend to reverse during the pandemic, when Vermonters saw their lives upended in a variety of ways. Recent years have also seen a continued rise in potent opioids like fentanyl and xylazine, often in combination with non-opioid drugs like cocaine.
The Vermont Health Department and substance use organizations across Vermont have fought back by aggressively expanding access to naloxone, a medication that can reverse opioid overdoses and prevent them from becoming fatal. Dougherty said the department has distributed naloxone throughout the state, making it available online, in schools, at job sites and even in a few vending machines.
The department has also widely distributed fentanyl and xylazine test strips and co-created the VT Help Link, a “one-stop shop” to access services and treatment.
Dougherty said these initiatives are reflective of a shift toward seeing opioid use and substance use disorder as a medical condition that can be targeted with harm reduction strategies.
Vermont has a handful of community organizations that distribute clean syringes. The state legalized safe injection sites in 2024, but the first site in Burlington is still in the planning stage.
There are limitations to the overdose data. Dougherty said deaths are falling, but little is known about whether fewer Vermonters are using opioids or have substance use disorders.
Tracie Hauck, executive director of the drug recovery group Turning Point Center of Rutland, said focusing on death data alone could be misleading.
“From what I see in our community, things aren’t any better,” she said. “Crime is picking up again. You’re seeing people that are struggling health wise and have no place to live and are using substances.”
Hauck said a lack of supportive transitional housing for Vermonters in recovery is a gap that can make it hard for people to stay sober.
“A lot of people we’ve sent to rehab are homeless to begin with,” she said. “So if they don’t go to a transitional living program after they complete rehab, they’re back out on the street and there’s no housing for them.”
People without stable housing often find themselves in “survival mode,” leading them back toward substance use, Hauck said.
“People don’t have phones. They don’t have reliable transportation. They don’t have stable housing, so they’re just in survival mode continuously,” she said. “And that doesn’t lead to real, good, solid recovery because their stress level continues to be so high.”
Hauck said a more holistic approach to substance use disorder is needed that incorporates a person’s mental and physical health, housing, and interactions with the criminal justice system.
Dougherty echoed the need for more transitional housing along with “step-down” facilities that can help rehabilitate people after their initial medical withdrawal.
Both urged Vermonters to look past their assumptions and judgements about drug use and consider the human beings affected by the opioid crisis.
“These are people — 183 people who were somebody’s loved one, somebody’s friend, somebody’s family member,” Dougherty said.
Hauck said despite her reservations about focusing solely on deaths, she still favors harm reduction measures like naloxone that offer people more chances to seek help.
“I am not anybody’s higher power to decide whether they should live or die, and I don’t think any other human being is, but I just know sometimes it takes a lot for someone to go through before they make that decision to get involved in recovery,” she said.
Hauck said she has seen people on Facebook complain about the distribution of naloxone without considering the full implications of not having it available. Anyone can risk opioid overdose when drugs like cocaine are so frequently contaminated with them.
“They’re not pausing and thinking about how tainted our supply is and how far that reaches, and to who that reaches to,” she said. “It’s not just people with substance use issues. It’s people that use recreationally.”
Dougherty said she was concerned about potential changes to the health care system being discussed at the federal level. Congress and President Donald Trump are working on legislation that could lead to Medicaid cuts. The Trump administration has proposed cuts to the U.S. Substance Abuse and Mental Health Services Administration.
None of the Vermont Department of Health’s harm reduction services rely on federal funding, Dougherty said. But Medicaid pays for many substance use services in Vermont, so the department is worried about cuts overall, she said.
“We’re just bracing generally at the health department, beyond substance use, because it’s like a full-out attack on public health,” she said.
