Indifference is Impossible: The Impact of the Opioid Crisis on a Vermont Community

The story of one county where the sweeping effects of the national opioid epidemic have infiltrated the entire community.
by Samantha Pearl                                                                  

It was 1997 when 13-year-old Jesse Brooks sat anxiously beside her brother in the office of Mt. Abraham Union School in Bristol, Vermont. Their aunt arrived to pick them up, bearing the news that their mother had overdosed on heroin again. This time was worse. This time, Jesse and her brother were being taken to the hospital to say goodbye. “We were told that it was inevitable that she was going to die,” Jesse recalled. The teenage siblings, who shared little more than a last name, walked into the emergency room. In a sterile cubicle curtained off from other beds, their mother lay unconscious and barely breathing. “I was only with her for a few moments before being told to sit in the waiting room.” Jesse returned to school the very next day.

“My mom had a pretty textbook journey of abusing opiates and opioids,” Jesse recounted. Her mother had always struggled with her mental health and with substance abuse. A back surgery leading to an opioid prescription turned into an opioid addiction. She fed her addiction by self-prescribing through a stolen prescription pad from the doctor. When this ran out, she turned to heroin. Despite the dismal outlook that day at the hospital, Jesse’s mom ultimately survived that episode and many more like it during her long journey with addiction.

This was 1997: twenty years before President Donald Trump declared the opioid crisis a national public health emergency in Oct. 2017. “An overdose was a big deal back then,” Jesse recalled. “Paramedics were just starting to learn what this looks like, how to revive people.” Trump’s declaration was set to expire on Jan. 23 but has since been extended an additional 90 days, which means a sustained allocation of emergency funds and resources. The deadly rhythm of prescription opioids to street opioids to heroin, one that came so close to stealing Jesse’s mom time and time again, has echoes throughout the country.

In the midst of everything from the Olympics to the worst high school shooting in U.S. history, the New York Times, in the month of February alone, published over sixty articles related to the opioid epidemic. Topics vary widely: an analysis of President Trump’s policies and plans for addressing the opioid crisis, a personal story from a doctor on the struggles of working with an opioid-addicted patient, a prescription opioid lawsuit in Ohio that is backed by the U.S. Department of Justice. Referred to as the worst drug crisis in American history, the opioid epidemic has hit an artery of the nation. There is unprecedented national sympathy for this crisis–– a crisis which, notably, has had a disproportionate impact on white suburbanites and rural areas. Yet despite the injustice of unequal, racialized attention and compassion that should not be new, the fact that 116 Americans now die every day from an opioid overdose, a killer that has surpassed even cars in its death toll fury, warrants attention. Prescription opioids and heroin are now responsible for 66 percent of deadly overdoses in a country that, despite containing only 4.4 percent of the world’s population, accounts for over 30 percent of the world’s opioids.

opioids-infographic

Vermont has not managed to hide from the grasp of the epidemic, as it rips through the Green mountains and spills over Lake Dunmore. Perhaps that is unsurprising, given the leading crisis demographics, in a state that is 93 percent white and overwhelmingly rural. Former Gov. Peter Shumlin devoted almost the entirety of his 2014 State of the State address to Vermont’s “full-blown heroin crisis.” Current Gov. Phil Scott recognized the opioid epidemic as “a public health and public safety crisis in Vermont” in his inauguration address. Despite the recognition and resulting attempts at remediation, in 2016, a record number of overdose deaths occurred in the state. And, in Addison County, a 37,000 person, 800 square-mile county tucked in central-west Vermont, the number of people treated for heroin or other opiate addiction has more than tripled in the last decade, data that are consistent with the rest of the state.

Jesse left Addison County’s only hospital, Porter Medical Center, that day with her mom’s boyfriend who asked to take her out to lunch. Jesse uses the term boyfriend loosely, citing the 15 guys that came into her life from ages 13-17 as dealers and traffickers, as various “pieces of a puzzle to get drugs.” To her mom, this one was a drug dealer. To the town, he was a painter or contractor of sorts. Jesse sat beside him in the front seat of his white utility van, slowly recognizing that they were not, in fact, headed to lunch. “He kept saying, ‘You gotta tell them [the police and doctors] I didn’t help her get the drugs, you gotta tell them, your mom has a problem, you know she has a problem.’” Jesse remembers nodding silently next to him. “I didn’t know what his intention was to have me in that van, I was in survival mode, and I was scared.” They drove down the streets of Middlebury, frozen images largely unchanged in the past twenty years. On these streets, where, today, children walk home from school, sometimes to homes like Jesse’s, consumed by substance use disorders. Past neighborhood grocery stores, where families shop, where drive-by drug deals frequent parking lots. Over the bridge that crosses Otter Creek where, farther upstream, children swim, where empty needles land. “It involves everybody,” says Jesse. “Everybody is part of it whether they think it or not.” In one small county in Vermont, nobody remains unaffected while the crisis flares. When you strike an artery of a nation, of a county, blood drains from every limb.

I.
I’m more costly than diamonds, more precious than gold, The sorrow I bring is a sight to behold.

It’s 9 p.m. on a bitterly cold Wednesday and Vermont State Police Sergeant Matt Daley sits across from me in full uniform at one of Middlebury’s only late night dining options: McDonald’s. Over sounds of French fry orders and a temperamental soda fountain incessantly spewing ice cubes, he reenacts the gurgling, gasping sound of the suffocation of an opioid overdose. Only hours before, I had heard the very same sounds from Jesse’s throat– vivid images burning at the forefront of their minds, seemingly eager to escape. “It’s not a glamorous thing,” Daley says, bluntly and firmly. “You’re basically suffocating is what you’re doing.”

Narcan, a drug that can reverse the effects of an opioid overdose, is now sold over the counter at most major U.S. pharmacies in 41 states. “Now, everyone carries Narcan. 12-year-olds know how to use Narcan,” says Jesse. Although lifesaving, Narcan is also not pretty. A Middlebury College student and advanced EMT who has responded to countless overdose calls throughout Addison County notes that people are often extremely agitated having received Narcan because it almost immediately kills the high that is their state of normalcy. “You give someone Narcan, stand back,” he says. “It’s the opposite of a high.”

Perhaps more gruesome than even the sounds of an overdose or image of Narcan is the picture Daley paints of withdrawal, or, as he calls it, “detox.” He recalls one kid, arrested around 3pm one afternoon, who was addicted to OxyContin. By 6 p.m., in the holding cell, he was shaking and sweating, he was vomiting and having diarrhea, “but he was able to stand up, turn around, and vomit in the toilet. By the end he was laying on the bench, he was defecating in his pants. Not because he wanted to but because he hurt so bad he couldn’t get up, and then he’s heaving the bile that comes out of your stomach when you have nothing left to throw up.” This is the horrific reality of someone typically sustained by opioids, forced suddenly to detox. “It’s gruesome, but that’s the end game right there, that’s what awaits you if you do these things.”

These are sights that sear, from the outside in, the minds of Sergeant Daley and Jesse. For Trish Lafayette, a 37-year-old who recently relocated from Middlebury to Brandon, Vermont, the images burn from the inside looking out. She is a portrait of Vermont-mother-grocery-shopping-next-to-you, average height and build with light skin and short blonde hair. She is also four years in recovery from a heroin addiction.

Trish grew up in a stable, loving, household without any exposure to substance abuse. She got her GED in 11th grade, started working, and created a successful restaurant delivery business. Yet the beginning of Trish’s addiction strongly resembles that of Jesse’s mother. Gastric bypass surgery in her late 20s led to a prescription for liquid Percocet, a drug containing the opioid pain medication oxycodone. As a mother of two young children in an abusive relationship, Trish began using the drug to cope with more than the pain of surgery. She admitted she was abusing to her family doctor. She weaned herself off, but within a month, she found the absence unbearable, and, “within twenty minutes of deciding to buy, I had a dealer.” Trish continued buying Percocet on the streets for a few years until, one day, her dealer told her that she would not be able to get more until the end of the week and convinced her to try heroin instead. Though initially reluctant, “it was that or nothing, and I took that. I never went back [to Percocet].”

By the time she realized she needed help, four years ago now, Trish was in too much physical pain to even function without opioids. “I couldn’t get out of bed without having a massive dose of drugs first. I’d take what was on my nightstand and then I’d be ready to go. I’d get the kids off to school, childcare, preschool, and go to work for that day.” Every day became a difficult and vicious cycle for Trish. “My biggest struggles were the 5 o’clock hour. I had to come home to my abusive boyfriend, put dinner on a plate for him, make sure he was happy, get the kids fed and happy.” To cope with this, “I’d do most of the drugs in the 5 o’clock hour.” She would then see everybody off to bed, wake up the next morning, and repeat. “I struggled with the 5 o’clock hour for three years into my recovery.”  

According to Daley, “The majority of people we see addicted to opiates now are not doing it to get high. They’re doing it to maintain.” For Trish, opioids had reduced her once vibrant life to a cycle of maintenance, tolerance, an increased need, and continued maintenance. Even those closest to her were unaware that she was struggling so profoundly, that she was sustained by opioids. Drive-by drug exchanges would happen right outside the kitchen window, unbeknownst to Trish’s mother. Trish took care of her family and held a job at Gregg’s Meat Market. Throughout the addiction, Trish was able to maintain her image of  normalcy.

This inconspicuous existence of someone so deeply struggling behind closed doors is precisely how the crisis has so silently snaked through the county. Andrea Grimm, director of Addison County’s Department of Children and Families, notes that “there’s no poster child for the opioid crisis.” Sergeant Daley agrees, vehemently shaking his head when asked if there is a typical profile he sees of someone struggling with addiction. “It reaches everybody. It doesn’t matter whether you’re rich or poor, black or white, whatever. The idea that it’s a low-income problem is false.” According to the National Survey on Drug Use and Health and the National Institute on Drug Abuse, there are correlations between race and socioeconomic status and opioid abuse, especially prescription opioid abuse, yet Daley’s point stands that is is not exclusive to any group. 

Trish wants to help people understand the power, wrath, and fury of heroin and addiction not only to prevent others from ever trying it, but also to help people look towards those struggling with substance use disorders with a greater sense of compassion. So, with a table, two coffee mugs, and some of the greatest human pain imaginable between us, I push harder to try to understand. Trish, struggling to find her own words to color the experience, pulls out her phone and leans over the table. Her voice, still soft, carries a sudden intensity that mutes the clinking mugs and chattering hums of the diner around us, as she begins reading a poem.

“I destroy homes, I tear families apart,

I take your children, and that’s just the start.

I’m more costly than diamonds, more precious than gold,

The sorrow I bring is a sight to behold.

If you need me, remember I’m easily found,

I live all around you – in schools and in towns

I live with the rich, I live with the poor,

I live down the street, and maybe next door…”

The poem was originally written about methamphetamines by Samantha Reynolds in 2000, but it was reposted to a heroin support blog where Trish first encountered it. She continued reading for three more verses then leaned back. “That’s it. It’s true, it’s all really true.”

II.
I destroy homes, I tear families apart, I take your children, and that’s just the start.

“I didn’t have a lot of basic things that a girl should have.” Jesse recounted story after story of growing up under a single mother profoundly struggling with substance use disorder. “I didn’t always have clean clothes. I didn’t always have shampoo or conditioner.” But these material absences are not what stand out most to Jesse, now an adult and a mother of three. Most impactful were the feelings of guilt, self-doubt, and inadequacy. “I did not ever think in that big chunk of time that it was my parents failing me––I really thought I was failing them. So when my mom did overdose or would overdose, and she did multiple times in my teenage years, I really thought that it was because I wasn’t there to help her, I wasn’t there to prevent it.”

These feelings and mindset followed Jesse through every aspect of her life as she learned to fake normalcy by watching the other girls at school. “I knew not to let anyone know about [my home life]. So I would present myself as very bubbly, loud, animated. I knew not to show people how awful I felt inside, how bad I thought of myself.” All day, she would keep up this image. At night, she often returned to an empty home. “She’d be gone for days; she’d be gone for weeks. Sometimes she would leave money, sometimes she wouldn’t… I was worried about her, but it was also kind of a relief.” The weight of responsibility for her mother’s tenuous safety, a daunting role reversal for a young teen, was, in those absences, lifted.

The profound difficulties of growing up in a home scarred by substance abuse and opioids color the lives of far too many kids throughout Addison County today. Perhaps it is the scene of a home neglected: a cloud of flies circling dishes in the sink, trash piled up in one corner, dirty laundry heaps in another. Perhaps it is the moments of immense responsibility held by hands far too small: Jesse, fighting that month’s boyfriend to get to her overdosed mother and save her life yet again; an 11-year-old in Monkton figuring out how to drive a car to get enough cell phone reception to call an ambulance for his overdosed father; two kids around 7 years old left in the back seat of a stranger’s car while mom goes off to do a deal.

The consuming nature of substance use disorders often presents great challenges to individuals who are using and are also parents. The Department of Children and Families has seen the direct impact of the opioid crisis on this phenomenon. In 2016, Vermont’s DCF Child Protection line received a record number of calls, and substance abuse was reportedly a factor in almost one-third of those calls. The 30% increase in calls over the past five years is attributed to the rise in opioid abuse and developing epidemic during this time frame. The Vermont Opioid Coordination Council says that more than half of the 266 young children in state custody are there due to opioid abuse issues. While there are limited data from other states about specifically opioid abuse, estimates from demographically comparable states such as Maine attribute up to 60% of DCF custody cases to substance abuse of some form. There are not enough foster families to meet this current need, especially given the shortage of child care in Addison County, which puts great strain on potential foster parents who also work full-time jobs.

Cheryl Huntley, co-director of the Counseling Services of Addison County (CSAC), and Grimm of DCF both note that parents in these situations almost always desperately want to do a good job and love their children more than anything. Some recognize they cannot be the parent they want to be for their child at that moment and voluntarily involve themselves with DCF while they work to get clean. This is especially significant given that the potential long-term implications on the mental health and life trajectories of children with a parent with substance use disorder are becoming more well understood. Dr. Jody Brakeley, a developmental–behavioral pediatrician in Addison County, has worked tirelessly to raise awareness of adverse childhood experiences (ACEs), and some of the profound impacts that having a parent with substance use disorder can create even in infants.

While many parents affected by substance use disorder face difficulties in parenting during that time, there are other homes that are able to remain a healthy environment for the children. Grimm of DCF notes that “just because someone is struggling with substance use, doesn’t mean that they necessarily cannot also parent their kids.” In some cases, such as Trish’s, DCF or other close relatives are able to work with families to help support maintaining custody during their recovery process. Trish likes to make the students she speaks to laugh by admitting that, up until recently, she thought she was one of the few cases of opioid addiction where her children weren’t affected. Unlike Jesse, Trish’s kids had the basic necessities: they were clothed and fed, they were not neglected or abused. But the not-so-little-little-things were missing. “They were well taken care of, but they didn’t have me present in their lives at the time.” In Trish’s lowest moments, when she had to stop nursing her infant because she couldn’t stay sober, when she couldn’t leave her bed without opioids, her children motivated her to seek help. “If I didn’t have such a loving and supportive family, I could have lost my kids. That was my biggest fear. Losing my kids.”

“My biggest fear in that time was just losing my mom,” says Jesse. “As a kid your life is your parents. That’s your way of survival.” And with this strikingly paralleled fear of loss between a mother and a child came a sense of compassion for her mother’s profound struggles. Jesse normally saw her mother as a victim. But there were moments in which circumstances pushed Jesse beyond this realm of compassion.

She described one such moment that still stands out as the Christmas when she was 13 or 14 years old. In an infuriating veneer of normalcy, wrapped presents lined the base of the ornamented tree. Jesse’s mom sat in a chair, out of it, ‘on the nod.’ This head-nodding straddle between consciousness and unconsciousness is a telltale sign of opioid abuse. Her mother, a character in the chair, seemed out of place in what could, upon image alone, be a scene from a modest take on It’s a Wonderful Life. A mature and self-sufficient teenager, Jesse was reduced to, as she describes it, a tantrum. “I got pissed, I got really mad, and I took all the Christmas presents under the tree and I started throwing them away. I just put them in the garbage. I was like, ‘I’m done with this I don’t even want anything from her.”’

This Christmas and in episodes like it, Jesse always left feeling overwhelming guilt and fear. At the time, the fear was losing her mother, the guilt was that she could not help her more. Only in the past two years has she begun to process these stories and, in them, has found the pain, the loss, the fear of a childhood lived beneath a roof that was consistently crumbling under the weight of opioid addiction. “Oftentimes I look back and I’m like, how in the hell did I survive?”

III.
If you need me, remember I’m easily found, I live all around you – in schools and in towns.

How did this small Vermont county that hugs the shores of Lake Champlain and stakes a claim to much of the Green Mountains, the namesake of the state, reach this point? These small idyllic towns are, in fact, exactly where the opioid crisis happens. Jesse refers to Addison County as “our Dreamland,” referencing Sam Quinones’s 2015 book Dreamland: The True Tale of America’s Opiate Epidemic, which examined how one small town in Ohio exemplifies the rise of opiates. Quinones detailed the transformation of a beloved town pool from a thriving community hub to a cold concrete drug dealing ground. While much of this tale resonates in Vermont, Addison County’s story is not as tangibly tracked as Portsmouth, Ohio, the town where Dreamland takes place. One cannot build the story of Addison County from a blossoming town pool. So where does the story begin?

A potential entry point is through one default finger point of the national conversation: opioid prescribers. Dr. Ben Rosenberg, an orthopedic surgeon in Middlebury, describes a child—10 or 11 years old—who needed to have traction pulled on his femur with a traction pin. There is no prerequisite understanding of the mechanics of this procedure to imagine the agony it would entail. This is an operation for which not treating pain is, as he describes, truly inhumane. In situations like this, opioids serve an important function–– they are narcotics, which block feelings of pain. A few years back, there was a huge push in the medical community to “treat pain as the 5th vital sign.” Thus, many doctors, eager to minimize pain and having no great alternatives, turned to more opioids.

Dr. Rosenberg in his role typically treats acute short term pain, for which there are some, but not enough, alternatives to opioids. The awareness of the dangers of opioid drugs is increasing not only among doctors but among patients. “Many people don’t even want to get opioid prescriptions anymore,” says Rosenberg. Yet not all doctors in the area are quite as conscious about the issue. One Addison County resident shared a story from the past year where her husband had knee surgery and was prescribed Percocet to cope with the pain. “I said we wanted 5 pills. She prescribed me thirty. I asked again for only five, and she was genuinely frustrated at having to change the prescription.”

CDC Guideline for Prescribing Opioids for Chronic Pain

While debates flair about the role and considerations of prescribers–– are they asking the right questions? What alternatives are there? What’s more dangerous: temporary pain or the risk of addiction? Do we have to choose? If prescription abuse decreases will heroin abuse just increase? –– many mental health experts emphasize that the problem is not isolated in the pills themselves. Dr. Brakeley noted that addiction often begins as a coping mechanism for other mental health issues. Trish affirmed that the worst part of her treatment was facing up to the mental health issues behind the problem, which Huntly of CSAC acknowledges as commonplace for those in recovery. Grimm frames it as the “chicken and the egg” situation of trauma and substance use.

Regardless of the questions surrounding how, why, or who is to blame for the rapid and violent spread of the crisis, the reality is that it has infiltrated and impacted every avenue of our country and our county. Sergeant Daley notes, “It’s far-reaching. It’s not just the drug users and stuff like that. It’s a drain, basically, on society. It’s really going in to every avenue that we have.”

Daley is right. DCF hotline is experiencing an increase in calls. There is a shortage of foster families. CSAC is increasing group treatment in order to be able to maximize their resources. Recovery centers have long waitlists, EMTs are busy responding to overdose calls. Lake Champlain is experiencing pollution from improper needle and prescription disposal. Even hikers are subject to the crisis’s wrath as car break-ins near the trailhead of mountains such as Snake have spiked, according to Daley. “Guys or girls break in, looking for some spare change or a cell phone. The majority of people that you catch, [opioids] of some form they’re into or on.”

Trish echoed this caution almost identically, widespread impact and an ensuing call to action. “It does affect you. It affects you in a lot of ways. Addicts are gonna break into your house and steal your stuff. Or you have family members that are using that you don’t even know are. So you have to do your part in the community. Step up. Go looking for it. Do your part to help because it does affect everybody.”

Although the crisis has deeply impacted a variety of communities, some residents are reluctant to devote tax dollars to address the crisis. According to Trish, “the biggest thing I’ll see and I’ll fight with on social media is ‘Why should we be paying all these tax dollars for Narcan to save these junkies’ lives?’ I say to them, ‘What about me? I’m a mom, I’m a good person in this community, I’m giving back to this community. Yes, I had addiction trouble, but given all that I do for this community, what if I had had a bad batch of dope and died because nobody gave me Narcan? Is that fair? No it’s not.”

Public policy solutions involve not only spending tax dollars on Narcan, but also the willingness to spend money on treatment and prevention. Putting money into housing, daycares, and food stability all represent pieces of the puzzle that communities must grapple with. While there are resources, they are not always enough. Far too many people slip through cracks that are expanding under the weight of a growing epidemic.

Trish now works as a recovery coach through the Turning Point Center, to help others struggling with substance use disorders. One man she coaches was once married with a child, and his wife had to leave him to keep the child when his addiction became debilitating. He is homeless, currently located in Marble Works.  “He’s using and struggling and wanting to be better but he just cannot get off his two feet because we don’t have housing in this area, we don’t have enough mental health stuff for him, he lost everything.”

And, to people like Jesse, this is not how our community needs to function, nor how the crisis will end. “These small communities, these are where it’s at. Our neighbors are where it’s at.” Jesse again draws parallels to the small town in Ohio. “And it doesn’t matter how big our community grows or how small it is, we absolutely need to protect and preserve the Dreamland that we have here.”

IV.
You could have said no, and just walked away, If you could live that day over, now what would you say?

Trish, Jesse, and Matt Daley, among a handful of other speakers, take turns speaking week by week in front of classrooms in Vergennes High School, Mt. Abraham High School, and Hannaford Career Center, among others. Honest and gruesome, beautiful and tragic, stories spill out one-by-one and land among an audience of students between 13 and 18. In these moments, the deadly, piercing needle of the opioid crisis briefly pauses its cruelty, performing a beautiful stitchery that brings together these three individuals, that weaves their stories with the pain, loss, hope, and community that is the opioid crisis of Addison County.

They each present as part of the Heroin Epidemic Learning Program (HELP). HELP, now in its second year, was co-founded by Jesse Brooks and Jeremy Holm. Holm is an actor in the Netflix series “House of Cards” and close friends with Philip Seymour Hoffman before Hoffman’s 2014 overdose death. HELP gives high school students the opportunity to participate in an 8 to 10-week program where, in the first half, they hear from a variety of speakers to learn about all aspects of heroin and the drug epidemic. The second half of the program empowers students to engage with what they have learned and, in teams, create their own PSA (video public service announcement), one of which is chosen to be professionally edited and aired on local and national television. In its first year, the program recruited 40 students throughout three Addison County high schools.

HELP exemplifies one of Addison County’s greatest antidotes in combating the epidemic: community collaboration. Collective impact work, as Huntly (CSAC) refers to it, means regular communication and coordination between various social service organizations including CSAC, DCF, law enforcement, schools, hospitals, governmental agencies, etc. The strong collaboration allows this small community to maximize its resources. Grimm (DCF) explains how they work from the top to the bottom of the triangle, the top being the highest need families and the base being prevention.

Grimm highlights two key components that nearly all interviewees identified as the central steps moving forward: prevention and treatment. Huntley frames it as “bending the curve. To do so you have to invest in both ends [prevention and treatment] at the same time.” But prevention is slow and, thus, funding for prevention is a hard sell in legislature. Dr. Brakeley agrees that education and treatment are both essential, but she is a proponent of the prioritization and importance of early intervention surrounding children and families.

The opioid crisis impacts every corner of a community, which also means that everyone in that community is a potential agent of change. Jesse tries to emphasize this to students when she speaks in schools, reminding them that “Ultimately, it takes a village. It takes everybody. It’s the lunch staff, it’s the janitorial staff, it’s the post office, and the schools, the medical staff. It’s everybody. All of us. It can be little things, just little basic things… I wish people knew how much change they can make as individuals. It could start with a person.”

V.
Now that you have met me, what will you do? Will you try me or not? It’s all up to you.

Trish, on one of her first days of group Dialectical Behavior Therapy (DBT), was told to bring a basket. She sat in a room with a group of others from all ages and walks of life, struggling with anything from cutting to addiction to depression. Together, they created their survival baskets. Hers started with knitting needles and yarn, a sad movie to provoke a cathartic cry, an iPod loaded with music, the serenity prayer on one notecard and the words “Take a walk” on another. Over the past two years, some of the most significant additions, namely mindfulness and yoga, have turned the basket less tangible. But the basket remains significant to Trish who, even four years later, still has cravings.

For Trish, the road to recovery meant seven full months of excruciating physical pain as her opioid receptors readjusted. It meant a 5-day emergency inpatient detox, 21 days at an inpatient recovery center, and years of daily meetings. It meant facing up to all the mental health issues that underlay the addiction. “It’s a lifelong process. I’ll always be in recovery.” She hopes, though, to be able to use the inescapable proximity of this piece of her life to continue supporting and coaching others in the community struggling with substance use disorders. She hopes to show them a roadmap of how to move forward, how to get where they want to be, without drugs. A roadmap she wishes someone had shown her.

Daley, too, speaks with a sense of optimism on an issue that on paper looks nearly hopeless in its trajectory. He points to a moment when he was walking into a high school to speak with students through HELP, and he and a co-officer ran into a couple students who they had caught using substances just about a week before. The guys high fived the officers, calling them by name, engaging with them, trusting them. And to Daley, reaching students and really being able to engage them through mutual respect and understanding, through blunt honesty and integrity, is how prevention and education are possible. “We’ve dug this hole and it’s a big hole and we just gotta claw our way out.” But hope prevails in the mind and heart of someone who has repeatedly walked into the worst of it. “It’s not a doomsday thing where it’s not gonna get any better. It’s definitely gonna get better, we just gotta figure out how to do it. And I think we’re on to something here. This is where it’s gonna happen. But it’s gonna take a few years.”

Jesse, who has never been shielded from the painful realities or dismal statistics, sounds perhaps the most hopeful of all. “Just looking at the data, it’s hopeful. Our youth are not using.” They know they have access to it. They’re aware of it, and they know where they can get it. Citing CDC Youth Risk Behavior Survey data, she notes that “50% of them don’t feel like their community cares about them. And there’s some opportunity there. I don’t see it as a negative, just as opportunity.” Opportunity to encourage and foster resiliency, strength, and the willpower to make different choices.

Her hope for this community is reflected in the hope in her own home, her own life. Out of everything Jesse, with her remarkable resilience and eagerness to make change, could be proud of, she feels the most pride about her 12-year-old son and her 10-year-old and 9-month-old daughters. And she parents with an openness, a closeness, that starkly contrasts with the home in which she grew up. Does she worry about her own kids, growing up in the heat of the epidemic? Of course. But with an honesty and willingness to share her own story, she does all she can to protect them. “My 10-year-old could probably school most 16 year olds on heroin.” And with the trajectory of her children’s lives and her work, Jesse’s life is also changing.

It’s December 2017, and Jesse stands in her kitchen, hot chocolate on the stove. She cozies up with her husband and three children as they poke fun at the Christmas movies: two of her kids are old enough now to realize “just how terrible Rudolph really is—but we love to laugh at it.” On the table sits this year’s new holiday book from the Vermont Book Shop, a downtown Middlebury staple, and, on the tree, a new ornament the family picked out at Shelburne’s trinket-filled Country Christmas Loft. “In all honesty Christmas is still not my favorite holiday, but I think it’s just because I’m not a very materialistic person.” Jesse has come to value the lead-up to the once dreaded holiday as she creates new traditions with her husband and children. Traditions that have transformed the holiday season into one of cookie-baking and snowshoeing, of time with the family she has created and a life of which she is proud. “Those little moments, that’s what I really love–– just all those little moments.”


Samantha Pearl is a junior at Middlebury College studying Psychology and Education.


The views expressed in this article are those of the writer. The Contemporary takes no position on matters of policy or opinion.


The cover graphic depicts a Vermont road at dusk. It was made by hobvias sudoneighm and is under a CC BY 2.0 license. The infographic and graph found in the text were created by the U.S. Department of Health and Human Services.

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