the state were all significantly reduced. Vermont The number of opioid overdoses in Burlington, Vermont increased by 76% in 2020; the number of nonfatal overdose emergency room visits went up 100% in the same period, according to Burlington's police department. But the number of overdose fatalities went down for the first time since 2014. The overdose increases are due to an influx of fentanyl, a synthetic opioid, as well as the pressures of the COVID-19 pandemic; the mortality decreases are the result of safety measures, such as the community distribution of naloxone. Wisconsin The state of Wisconsin established the HOPE (Heroin, Opiate Prevention and Education) agenda to face the Opioid Epidemic. The Enactment of Act 262 took place on April 9, 2018. The act focuses on bettering substance use disorder counseling, which is critical in the opioid withdrawal process. Utah In 2017, Rep. Edward Redd and Sen. Todd Weiler proposed amendments to Utah's involuntary commitment statutes which would allow relatives to petition a court to mandate substance-abuse treatment for adults. Washington In February 2017, officials in Everett, Washington, filed a lawsuit against Purdue Pharma, the manufacturer of OxyContin, for negligence by first, allowing and also failing to prevent drugs being illegally trafficked to city residents. The city wants the company to pay the costs of handling the crisis. West Virginia In West Virginia, leading the nation in overdose deaths per capita, lawsuits sought to declare drug distribution companies a "public nuisance" in an effort to place accountability upon the drug industry for the costs associated with the epidemic. On May 3, 2021, the city of Huntington filed a lawsuit against three major drug manufacturers accusing them of their role in stoking the opioid crisis through their excessive shipment of painkillers. Economic Impact Massachusetts The Massachusetts Taxpayers' Foundation published a report which contains an analysis of the economic impact of the opioid epidemic in Massachusetts. In 2017, the state lost a total of $15.2 billion. Out of that total, at least $5.5 billion was dedicated to funding opioid-related services; and $9.7 billion was lost as a result of losses in productivity as 32,687 people were kept out of the workforce due to opioids. The report also analyzes forgone wages due to deaths related to opioid overdoses accounted for over $1.1 billion in losses from 2015 to 2017. Therefore, the total amount lost taking into account forgone wages and lost productivity is