This past January Gov. Peter Shumlin dedicated his State of the State address to what has been called Vermont’s “full-blown opiate crisis.” Opiates include heroin and prescription painkillers (whose euphoria lasts less long than their dangers); death rates from overdoses are high. Shumlin brought passion to this year’s annual speech to Vermonters, highlighting the human cost of drug addiction, a lack of treatment options, and Vermont’s growing drug-related prison population. At the same time, he all but ignored one of the largest drivers of women’s drug addiction until the very end of his address: poverty.

It’s a stereotype to assume there is more drug use among the poor. The majority of the poor, or non-poor, do not use drugs. Vermont earned a ranking as the nation’s “number one state for illicit drugs,” when 15 percent of those surveyed admitted to having “used” in the past month, compared to 4 percent in lowest-ranking Utah. The ranking came from a 2011 survey reported by the Substance Abuse and Mental Health Services Administration, and included all substances from marijuana to cocaine.

In fact, “higher income levels” was cited as a possible reason for the state’s ranking by Barbara Cimaglio, deputy commissioner for alcohol and substance abuse programs at Vermont’s Dept. of Health, in an interview with Pamela Engel of Slate in October, 2013. Cimaglio also didn’t mention poverty, but considered “everything from the colder climate…to more liberal attitudes…to people having more access, but I don’t think anyone knows for sure.”

Poverty No Help

Yet according to a National Bureau of Economic Research’s report that asks the question: Does Drug Use Cause Poverty? Researcher Robert Kaestner writes, that public policies that focus on “reducing drug use would have some positive economic effects on people’s lives.”
Addicted people have many reasons for drug use. But some of the risk factors that come with drug use include poverty, and for women that risk is greater. A woman may use drugs or alcohol as a way to cope wither dangerous environment, or deal with her financial struggles, or as a way to manage emotional or physical trauma and abuse. Drugs and alcohol are often available in rundown neighborhoods, where economically vulnerable people sell drugs in hopes of escaping poverty.

Kaestner’s research indicates that marijuana and cocaine use significantly increases the probability of being poor. Drug users had lower family incomes, less stable relationships with family and friends, and are more likely to participate in public assistance programs.

Most often, poverty and drug addiction are linked issues that need a multifaceted approach to overcome— early education, anti-poverty measures, available drug treatment, access to mental healthcare, and new law enforcement programs are all involved.

In the unprecedented U.S. Senate Judiciary Field Hearing in Rutland on March 17 this year, Boys and Girls Club Executive Director, Mary Alice McKenzie told Vermont U.S. Sen. Patrick Leahy and Vermont U.S. Rep. Peter Welch, “We all have to engage. The trends [in drug abuse] are quite bad. The trends have gotten much worst over the last decade.”

McKenzie testified that the children supported by her organization, aged 5-19 years old, reported that drug dealers approached them to carry backpacks of drugs. She said some girls were being solicited for sex. The Burlington native expressed her concern, “We started seeing evidence of trafficking in a way we have not seen in my lifetime.”

Cultural Expectations

The illegal drug culture surrounds some children living in poverty, teaching them to behave like addicts even before they experiment with drugs. Living in a culture of poverty and drug addiction from birth is an all too familiar story for Karen Zucker, a St. Johnsbury resident. Zucker told VW that she was expelled from school by the time she was 16 years old; she ran away from her mother’s home; and soon after addicted to heroin.

Zucker, now 32 years old and clean since 2009, recalls 16 years of addiction, several incarcerations, four visits to drug treatment centers, and losing custody of all three of her children to the Vermont Department of Children and Families (DCF).

Like that of other children living in poverty, Zucker’s story of addiction and recovery began before she ever experimented with drugs. She grew up without her basic needs being met. We now know that caring relationships affect a child’s healthy development. Through her baby and toddler years, her mom struggled with her own addiction to alcohol. Her mother was unavailable and verbally abusive.

Zucker reports that her mom got “dry by the time I was four years old.” However, the verbal abuse and neglect by her mother continued. Without seeing others’ care for her, Zucker remembers that from an early age, she “didn’t care about herself.”

“Poverty makes you feel different from your peers. My mom wasn’t going to buy me new sneakers for basketball, ” she said matter-of-factly. In a world made smaller by poverty, Zucker talked about not having anything else to do but drugs.

Housing insecurity also played a large role in being isolated from her peers. “My mom didn’t pay the rent, so we moved around a lot. We even lived in a camper on my grandfather’s property,” said Zucker. “Poverty puts you around the right people [for drugs].” Zucker goes on to explain that poverty gave her access to friends who were just like her—broke and broken. These friends were older than Zucker, and already doing heroin.

Kingdom County Production’s The Hungry Heart drops the viewer right into the St. Albans office of Dr. Fred Holms, a gentle cross between T. Barry Brazelton and Mr. Rodgers. He cares for his patients, including the ones he calls, “youngsters,” suffering from addiction. He explains the opiate epidemic in town, his medical treatment that began five years ago, and the community’s duty. Dr. Holms highlights what is often left out of the recovery stories: the need for access to transportation, securing stable employment, finding adequate, affordable housing, access to education, qualified addiction counseling—and often Suboxone. Suboxone, a prescription drug, blocks the cravings for opiates and eliminates withdrawal symptoms. With his calm, reassuring tone, Dr. Holms explains, “I didn’t choose to take care of addicts.” He began when a lifelong patient: “Kyle walked into my office and asked if I would help him.” The beautiful documentation of the intimate relationships and conversations between Dr. Holms and his patients make The Hungry Heart a must see. Director Bess O’Brien assembled her film, intertwining music with breathless video photography, to push the viewer to see the human tragedy of addiction that plagues Vermont communities. O’Brien takes an unsavory topic that affects one in three families here, and transforms the stories to hit home—regardless of demographics. As Vermonters, we must take responsibility to better understand our neighbors. Bring tissues. To learn more about The Hungry Heart, visit: thehungryheartmovie.org

A Progession

Zucker’s experimenting with heroin soon turned into a full-blown drug addiction. To feed her heroin addiction, Zucker quit school, and ran away to go along with her boyfriend, as he trafficked drugs, traveling from Springfield, Mass., back to Vermont. Within nine months, Zucker was busted for shoplifting. The local police turned her over to her mother, who refused to take her back into her home. Zucker’s mother relinquished parental rights and gave custody to DCF.

Over the next year, DCF sent Zucker to several foster families. Each time she ran away to feed her drug addiction. After several attempts to keep Zucker safe, DCF placed her in a secure, locked-down addiction treatment facility for adolescents, called Valle Vista, located in Greenwood, Indiana.

Zucker stayed healthy for several years after getting off opiates at Valle Vista. She admits she still continued to use weed and alcohol to numb her pain, but stayed away from opiates. Zucker got married, had a daughter, and thought she had turned her life around.
Yet, the pattern of addiction began again. Zucker found herself over and over, bouncing from jail to treatment center, to living substance free. Zucker described the destructive pattern like this: “I kept making really bad choices.”

Now, Zucker realizes that her self-destructive behavior was coupled with childhood trauma. Since Zucker’s diagnosis with Post-Traumatic Stress Disorder, she has been able to access the mental health treatment she needs to function substance-free.

Adding a Weight

When Zucker reflected on her experience living in poverty and being an addict, she told Vermont Woman: “Drug addiction keeps people in poverty.” Zucker hopes to see more emphasis placed on long-term treatment options, especially in prison, where the majority of inmates have drug addictions, she says.

Kingdom Recovery Center co-coordinator Nancy Bassett illustrated that further, saying: “Suffering from the disease of addiction leads to doing anything to feed your addiction.” Bassett knows the story of drug addiction. For her, it’s personal. She told Vermont Woman in an interview that her addiction began when she “didn’t feel whole,” and she turned to “self-medicating with drugs to fill the whole.”

Ms. Bassett in St. Johnsbury said something similar to the testimony of Ms. McKenzie in Rutland: “Kids are buying prescription pain meds. Younger and younger people are getting addicted.” And when the availability of the more expensive prescriptions run out, kids turn to the readily available and cheaper option, heroin.

For the last ten years Bassett has worked with people recovering from addiction in the Northeast Kingdom, one of the poorest areas of the state. With joblessness and boredom plaguing the area, she said people often turn to drugs to fill the void. Bassett described how living in poverty sometimes drives people into addiction. “When the mother is left with the family, to make ends meet, selling drugs can make ends meet.” It is a profitable, if illegal and dangerous, business. According to Gov. Shumlin in his State of the State address, “A $6 bag of heroin in New York City can go for up to $30 here.”

Fixing the Problems

Gov. Shumlin and Vermont’s state legislature have met the outcry of Vermonters by proposing several bills that tackle both poverty and drug addiction. This legislative session, treatment and wrap-around services have been the focus of Gov. Shumlin’s administration.

During the Senate Judiciary hearing in Rutland, Sen. Leahy commended the hard work of communities by saying, “You cannot arrest your way out of this problem. You have prevention, education, and treatment—that has to go along with law enforcement. We need to get ahead of addiction. We can’t let it corrode our lives and communities.”

Vermont Legal Aid attorney and longtime advocate for people living in poverty, Chris Curtis, said that legislation this session is taking “big steps in the right direction.” But Curtis also talked with Vermont Woman about the need for including anti-poverty measures as a piece of Vermont’s solution to its drug epidemic. Curtis uses the example of DCF’s Reach Up program. A welfare-to-work program, Reach Up financially helps families with children access work training and education in order to move off assistance.

Last year, Reach Up took a political hit with a 60-month limit law that was passed by the legislature and signed by Gov. Shumlin. Five years of help and then you are cut off. That law goes into effect for some Reach Up participants in May. According to Curtis, because of legislative work by those who understood the complexities of poverty, the new law will not affect people reaching their work requirements; people caring for infants, sick or disabled family members; or if they are disabled.

As an example of this year’s policy shifts, Curtis said that there is a “better story for Reach-Up” this session. Curtis described working to improve the Reach-Up “benefit cliff” since before the Gov. Douglas administration. According to Curtis, right now, families with over $2,000 in assets begin losing Reach Up benefits. New legislation introduced this session will increase the threshold to $5,000 before benefits are reduced. “We should be encouraging families to save,” says Curtis, adding his sense that “the Administration is taking poverty reduction seriously.”

Backup Plan

An extensive safety net and drug abuse prevention don’t always work. Sometimes law enforcement needs to step in. Gov. Shumlin’s budget includes $760,000 to emulate the successful Chittenden County program, Rapid Intervention Community Court (RICC), extending the program to other state counties. Chittenden County State’s Attorney, T.J. Donovan led the way to establishing the first RICC in Vermont four years ago.

Donovan explained in an article at Seven Days the reasons for trying something new. He “pushed the envelope” to see what results showed; the current system that prosecutes all drug cases the same way doesn’t work. The typical four-to-six weeks between the crime and arraignment leaves too much time for re-offending and other risky behaviors.

By contrast, RICC screens offenders for those whose crimes have been driven by mental illness or untreated addictions. RICC provides swift arrest/citation and pre-charge diversion, as well as community services and treatment for those accepted.

Recently, the Vermont Center of Justice Research concluded a lengthy report on the Chittenden County RICC. The report data indicates a reduction in the re-conviction rate, Donovan’s goal:

“The RICC appears to be a promising approach for reducing the number of post-program re-convictions for participants who successfully complete the RICC.”

Another prosecutor, U.S. Attorney Tristram Coffin, testified at Sen. Leahy’s Judiciary hearing in March. He said that the need is to “stop people from entering the opiate and criminal justice pipeline—because once that happens there are no good outcomes, only varying degrees of bad ones.” Coffin has taken the pro-active approach to Vermont’s drug problem by distributing the documentary film, The Opiate Effect to all Vermont school districts.

Healing Possibilities

Over the last two years, I have talked and reported on dozens of women’s drug abuse stories. And the cycle seems to be largely the same cycle, different only in details. Childhood trauma leads to drug addiction, which often leads to drug-related crimes. Some women overcome their past addictions, heal their trauma, and move toward a healthier lifestyle. Others do not; they continue the cycle over and over again.

Unlike Karen Zucker, Shannon, whose last name has been withheld to protect her privacy, had all the ingredients for a successful life— a supportive family structure that included a tightly-knit extended family; after-school activities and sports; and a modest family income. However one distressing void kept creeping in. As a preschooler, Shannon’s mother had abandoned her family, leaving Shannon with what she characterized as “heartache with trauma.”

By the time she was 14 years old, Shannon was regularly numbing the pain by drinking and smoking pot. She remembers thinking, “I don’t’ want to feel the feelings I feel.” Soon her drug addiction got more serious, abusing with acid, mushrooms and Oxycodone, an opiate. She admits, “I was in the drug clique (at school). And I loved the attention.” The party girl ended her graduation day with her first DUI arrest for drinking under the influence.

Then after a year at Johnson State College, Shannon’s boyfriend introduced her to cocaine, and she loved it. “Once I found a drug I liked, I obsessed about it.”As Shannon reflects on that time, she realized, “I always tried to fill the void of my mother.” The downward spiral increased speed— Shannon dropped out of school and found herself smoking crack.

Lost and Found

Shannon illustrated what Nancy Bassett had said about the dangers: “Suffering from the disease of addiction leads to doing anything to feed your addiction.” The drug culture has special dangers of lifelong poverty for vulnerable young women. “I would sell myself to get drugs,” Shannon said.

Her recovery story began on Thanksgiving 2013, when police busted her for cocaine possession. Shannon had continued to abuse drugs and lied about it to her family, until her name appeared in the newspaper’s court listing. She remembers, “It was a Wednesday morning. My family, friends, and supervisor saw my name in the newspaper.”

Two days later her family intervened and Shannon began a year of recovery. On March 20, 2014, Shannon hit her one-year mark of sobriety. On drugs, Shannon said, “I thought, I was the shit.”
Today she thinks much differently.

“Now, I make gratitude lists,” Shannon exclaimed. Shannon’s healing plan includes family support, dance, prayers, meditation, and a willingness to improve. Shannon explains, “If you don’t have the willingness to do this [recovery], then it won’t work.”

To change Vermont’s full-blown opiate crisis, we are going to have to, as Donovan had said, “push the envelope.” Families, friends, the healthcare community, policymakers, and law enforcement will need to come together to create an expanded safety net to give addicts a reason to recover—a hope, the will, a healing—and increased access to public health measures.

Poverty for Vermont women now stands at 12 percent, but for single mothers with children, the figure is 28 percent. What would happen to our drug-using rates of 15 percent, if wages for Vermont’s working women were equitable, even livable? Or if traumatized women could more easily find the help they need, the time to heal, or get safe and go to court, using earned sick days? The argument that these would cost too much ignores the cost to women and our communities already felt.