This commentary was written by Ryan Landvater of Williston, a graduate of University of Vermont Larner College of Medicine and a resident physician in pathology at the University of Michigan.
I write with criticism over the choice of leniency in response to the prosecution of Bruce Erdmann for the multiple deaths that occurred within his South Burlington home a year ago. I express these criticisms not without significant deliberation and recognition that, as a member of the public, I lack the full details to which the state’s attorney is privileged. Nevertheless, I come to offer a perspective outside of your own as I am a physician with both public health experience and training in forensic pathology. I write these criticisms neither out of spite nor anger toward Erdmann, for his admittedly wanton disregard for the safety of his friends and family, but rather as a plea to see a future Vermont without these completely unnecessary tragedies.
The state’s attorney’s stance on drug charges appropriately emphasizes rehabilitation and reintegration rather than the punitive mentality of the post-Reagan era; however, this stance fails to appropriately distinguish between the decriminalization of a substance use disorder, an established psychiatric diagnosis to which certain segments of the population are naturally more predisposed, and the irresponsible endangerment of individuals who struggle with substance use.
What do I mean by this? An imperfect analogy would be intoxicated driving. Alcohol use is certainly not illegal and we know driving while intoxicated poses a risk to the driver, anyone in their car, and also to the general population. As such, societally we have appropriately outlawed driving after drinking excessively. It makes sense. Most adults, and frankly even teenagers, plan ahead to avoid the unnecessary risks of driving while drunk. We do not prosecute passengers that are intoxicated and we have two federal amendments that prove the outlawing of alcohol use is a bad idea. We do, however, aggressively prosecute intoxicated drivers as they place the lives of others at risk.
Changes in how we as a society confront opioids must change. This is especially true with the increasing prevalence of high-potency synthetic opioids such as fentanyl. You do not need to look much farther than the morgue to see this fact. From experience, I can tell you there are two populations that we see with greater frequency than any others: the elderly with multiple comorbid conditions and the young healthy twenty-something-year-old with a single problem — opioid abuse.
There are a plethora of socioeconomic factors that underlie the root of this crisis as well as, in my opinion, the criminal conduct of individuals such as the Sacklers. Nonetheless, these forces are only responsible for the substance use itself, not the true tragedy it brings: the death of our friends and our family. We cannot easily fix the former issues, but we can do something about the latter.
There is no simple solution for that first group I mentioned, the elderly with comorbidities, but we have a pocket-sized life-saving drug for the latter. It’s called Narcan (naloxone), a safe and effective opioid overdose antidote that fits in your pocket. If we had a medicine like Narcan for things like heart attacks or trauma in automobile accidents, it is no exaggeration to say medicine would change overnight.
Brian Miller was one of the closest and dearest people in my life (a sentiment echoed by an uncharacteristically high number of current Chittenden County residents and those who grew up here). While this letter is not about me, it is difficult to describe to you how profoundly his death has affected me and those close to Brian. I am adamantly opposed to hiding from the fact that he suffered from and fought against substance use disorders for a substantial portion of his life. Destigmatizing substance use and reducing the shame associated with a psychiatric disorder allows for greater rates of treatment and recovery. After Brian’s death, I now carry Narcan in my car glove compartment to have ready anywhere I go.
The heart of my criticisms against State’s Attorney Sarah George and her leniency with Bruce Erdmann is this: Bruce had shown a disregard for the safety of those within his home on two separate instances prior to Brian’s death. He opted to buy quiet irresponsibility and the avoidance of minor drug charges, but he paid for it with the irreplaceable safety of those to whom he supplied fatal or near-fatal substances, knowingly or otherwise.
For this irresponsibility, which led to two deaths and a third near-death, he is given only misdemeanors. I would like to be clear on this point: this mentality does not destigmatize substance use disorder; it destigmatizes irresponsibility. Would you treat a DWI that caused the death of a passenger or another motorist with the same leniency? I suspect you would not.
To the Legislature: As a medical doctor, I both strongly support safe use sites while simultaneously supporting severely increasing the penalties for drug charges in locations that do not have Narcan easily accessible. In locations with sober monitors and Narcan available, I encourage greater amnesty. We must use a bold-point marker to draw a clear distinction between substance use disorder and irresponsible abuse. Within this distinction lies the difference between a chronic, but treatable disorder, and a fatal one that strips us of our closest family.
To the readers: Regardless of how you feel about illicit substance use, please consider picking up free Narcan from one of many locations listed by Addiction Help Vermont, including the Howard Center in Burlington. You may never know what circumstances may arise in your life and intervening at the right moment could be the most life-altering decision you ever make for a friend, family or stranger.