BRATTLEBORO — Of the counties in the state, Windham County may be bearing the brunt of the opioid crisis, which is getting new attention at the state level with a second lawsuit filed in recent days against the manufacturer of pharmaceutical opiates.
According to statistics released in January by the Vermont State Department of Health, 24 individuals in the county died last year because of opioid-related overdoses, more than 20 percent of all deaths from that cause in the state.
That's a rate of 59 deaths per 100,000, more than double that of every other county in Vermont except Windsor, which had about 32 deaths per 100,000.
“It's not clear to me why our rate of overdose death is higher than other counties,” said Daniel Quipp, a newly elected member of the Brattleboro Selectboard.
According to the Centers for Disease Control and Prevention, the national rate of overdose was 21.7 per 100,000, a statistic that in itself has increased by almost 10 percent.
Vermont is well above that national average, but according to statistics from the Kaiser Family Foundation, 14 other states have higher statewide rates of death by opiate overdose.
But Windham County's death rate exceeds the overall rate in the state at the top of that list - West Virginia, at 49.6 per 100,000.
Statistics can be misleading or skewed when the numbers are small, but if both the nation and the state are facing a crisis, Windham County and Brattleboro have become a local hub.
Money for treatment and education?
The origins of the state's drug epidemic are complex, as they are across the United States, but one thing seems certain to many people: the current crisis has its roots in the way Purdue Pharma pushed out an opiate-based prescription painkiller, OxyContin, in the 1990s and early 2000s.
In September, Vermont became one of at least 28 states to file suit against Purdue Pharma, alleging that deceptive marketing practices by the drug company had created a foundation for the epidemic of opioid addiction.
Last week, the state's attorney general's office stepped up its game to a new level by filing suit against two distributors of opiates, Cardinal Health Inc. and McKesson Corporation.
Quipp and Elizabeth McLoughlin, another new Brattleboro Selectboard member, see some local promise from the path of litigation against drug manufacturers that, the state contends, pitched its drugs as safe and non-addictive products for pain relief and marketed them aggressively.
“I strongly support this effort by the state's attorney general,” said McLoughlin. “Money should go to treatment and education. Perdue Pharma did tremendous harm.”
Quipp echoed these statements.
“I would hope that if Vermont wins a major settlement, those funds could be used to benefit those parts of the state most affected by the crisis,” he said. “Any money awarded from such a suit ought to go to healing our communities and those directly affected.”
'They kept on selling'
The suit against Cardinal Health and McKesson alleges that the two companies “committed unfair and deceptive acts” that violated the Vermont Consumer Protection Act, and alleges claims of negligence and public nuisance. It also asserts that the two firms concealed their illegal conduct.
According to a press release, the state alleges that the two companies pushed prescription opiates into the state while failing to take steps to prevent their diversion into illicit channels.
Vermont accuses the two companies of focusing on market share rather than helping to monitor and control the sales of their drugs.
“Cardinal and McKesson sold out their duty to the public in exchange for the bottom line,” Attorney General T.J. Donovan said, according to the press release. “They ignored the fact that opioid sales in Vermont were far outpacing legitimate need. These distributors were obligated to identify and report the problem. Instead, they kept on selling.”
Vermont's suit against Perdue Pharma, which is owned by a branch of the Sackler family, was allowed to continue by a recent decision in Chittenden Country Court. The court case is sealed so the question of damages is unclear.
A lawsuit filed against Perdue Pharma in Oklahoma was recently settled in that state for $270 million, according to news reports.
A court victory or a similar settlement for Vermont could come with a significant infusions of resources to address the addiction crisis in the state, including in Windham County.
“Perhaps this might look like better access and support for treatment and recovery,” Quipp said, “but it could also include more support for schools, affordable housing, jobs that pay a living wage and greater investment in public spaces and services.”
As drug companies are being held to account for the social and economic costs of opioids, some are also shining a spotlight on who has gained from the enormous profits that the drug companies generated from a volume of prescription-drug sales that far outstripped legitimate demand.
In the case of Perdue Pharma, the branch of the Sackler family that is behind the company is one of the largest donors in the museum and art world.
Sackler family foundations have made significant bequests to museums from the Louvre in Paris to the Guggenheim Museum in New York City.
Also in New York is the Metropolitan Museum of Art, where the Sackler Wing houses the Temple of Dendur, one of the museum's most visited exhibits.
The family's role in charitable giving to the arts, according to reports, has caused recipients of donations to re-examine their relationships with the family's foundations. That giving also prompted recent public protests at the Guggenheim and the Met.
In 2017, the Brattleboro Museum & Art Center (BMAC) received a gift from the Arthur M. Sackler Foundation of more than 300 ancient and historical artifacts from Sackler's private collection to aid in promoting arts education for young people and to provide inspiration for mature artists to use in their work.
BMAC was referred to in a recent post on the Green Mountain Daily website as one of the organizations that scored profits from opioid prescription medications.
But the BMAC's inclusion in the post was based on a fundamental misunderstanding, according to Danny Lichtenfeld, the museum's executive director.
Arthur M. Sackler, who helped to found the first phase of the company, had stepped away before it became Perdue Pharma. He died nine years before OxyContin was released.
The bequest to BMAC came through a foundation supported by Sackler's children: his son, Arthur F. Sackler, and his daughter, Elizabeth Sackler, who spent time as a student at Windham College in Putney.
Lichtenfeld, explaining the value of the artifacts to BMAC's educational programs, said that he regretted that anyone would confuse this bequest's donors with relatives who, with their family company, are facing public scrutiny and state lawsuits.
“The art we received did not represent any ill-gotten gains,” Lichtenfeld said.
'All hands on deck'
The question of how the state's lawsuits will play out is still open. Some national reports suggest that Perdue Pharma may seek bankruptcy rather than face its liabilities in court.
New money from achieving the kind of settlement that Oklahoma recently did would certainly help the town, but multiple people emphasized to The Commons that the burden is on ourselves and the systems we are putting into place.
In the meantime, in her new role as Selectboard chair, Brandie E. Starr has already made clear that the addiction issue will be a priority in the coming year.
“The statistics are indeed alarming,” she said, “and in themselves they are only a snapshot of the systemic opiate crisis that Brattleboro and hundreds of other towns and cities are facing nationwide.”
“This is a community issue, and it will take all hands on deck,” Starr said. “It will take an openness to harm-reduction based services, and community-wide collaboration from all of us.”