In Vermont as elsewhere, OD deaths involving MAT opioids buprenorphine and methadone have increased after experts pushed through changes to make them easier to get.

by Clark Miller

Published June 3, 2024

Vermont is among a majority of states that adopted federal loosening of take-home doses and other standards for methadone dispensing, and was granted less restrictive safety standards as were all states for buprenorphine prescribing and training requirements for prescribers.

How have opioid trends played out over the period of relaxed safety standards beginning in 2020? Here are the data for select years, from this report – 

For methadone-involved opioid overdose deaths: 

2015  2016 2017  2018  2019      2020  2021  2022  2023

   7        14      12       11       9             18       17      29       19

One could construct a line graph, but I don’t think that’s necessary. 

And for buprenorphine-involved OD deaths: 

2015  2016 2017  2018  2019      2020  2021  2022  2023

   2         1       0         6       3               2         2        5         14


Those apparent trends and changes associated with more reckless prescribing and dispensing of America’s gold standard opioid treatment medications are not anomalous, are instead predicted and consistent with outcomes in other locales. 

From JAMA, an illustration that Vermont is one of a minority or few states that increased methadone provision over past years by relaxing longstanding safety standards. 

As fully explored in this recent post, additional states or regions illustrating the same lethal, predictable outcomes include:




Washington DC, and 

Ontario, Canada

In Vermont as in other locations, those increases in MAT opioid-involved deaths occurred despite concurrent increases over the time period in use of naloxone to reverse potentially lethal overdoses. 

And while the Narcan moderating effect appeared to slow overdose deaths for other, non-MAT opioids – 

a pattern seen in Ohio as well – 

That should tell us something. 

Why A Critical Discourse?

Because an uncontrolled epidemic of desperate and deadly use of pain-numbing opioid drugs is just the most visible of America’s lethal crises of drug misuse, suicide, depression, of obesity and sickness, of social illness. Because the matrix of health experts and institutions constructed and identified by mass media as trusted authorities – publicly funded and entrusted to protect public health – instead collude to fabricate false assurances like those that created an opioid crisis, while promising medical cures that never come and can never come, while epidemics worsen. Because the “journalists” responsible for protecting public well-being have failed to fight for truth, traded that duty away for their careers, their abdication and cowardice rewarded daily in corporate news offices, attempts to expose that failure and their fabrications punished.

Open, critical examination, exposure, and deconstruction of their lethal matrix of fabrications is a matter of survival, is cure for mass illness and crisis, demands of us a critical discourse.

Crisis is a necessary condition for a questioning of doxa, but is not in itself a sufficient condition for the production of a critical discourse.

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