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State Working Toward Immediate Access For Drug Abuse Treatment

The state of Vermont has been dealing with an increase in the number of people seeking treatment for addiction to prescription drugs and heroin.

A new treatment facility opened in South Burlington this fall and another is opening this week in Rutland.

But is the state succeeding in its prevention strategies and keeping people from slipping back into their addictions? VPR’s Mitch Wertlieb spoke with Barbara Cimaglio, Deputy Health Commissioner of Alcohol & Drug Abuse.

“About half the people who seek treatment are seeking treatment for opioid dependence. And we serve almost 10,000 clients per year. So that’s grown substantially and we’ve tried to make sure that our treatment capacity is growing to keep up with that demand,” Cimaglio said.

The problem cuts across also socio-economic strata. Drug abuse is not limited to one sector of the population, Cimaglio said, but people who are more affluent have access to private insurance. The state deals with publicly-funded clients, but sees the need for treatment in all communities.

While there has been a spike in drug abuse, the problem does not match that of decades past.

“The highest point in the country and in Vermont of reported substance dependence was actually in the 1980s, and we’ve seen that it’s come down in the years since then. The troubling thing is that in the last few years, we have seen this upturn in the number of people reporting opioid dependence and seeking treatment of opioid dependence,” Cimaglio said.

“It used to be all about heroin, but then with the availability of newer prescription drugs like OxyContin, Vicodin, those substances became more readily available as the medical community strove to adequately treat pain. Some of the unintended consequences are more availability of those drugs on the street,” Cimaglio said. And she noted that the drug manufacturers are trying to re-formulate the drugs to make them less prone to abuse.

There are still many people waiting for treatment in Vermont. Cimaglio pointed to the difficulty in citing a treatment center in South Burlington. That clinic opened in September, and that’s helped the waiting list.

“They are taking people and whittling down that waiting list. Rutland has not had a methadone and they are opening a new hub. So we do still have the waiting list, but we feel that we are making progress. In some parts of the state, Windsor and Windham counties, the new hub down there has eliminated the waiting list. So people have immediate access to treatment. That is our goal statewide,” Cimaglio said.

The state is working with a hub and spoke model for treatment. In addition to the 5 hubs, or treatment centers, there are also over 100 doctors acting as spokes. These are primary care doctors who can provide treatment.

“We may find that we need a few more locations of specialty treatment, but what we really is hope is that more physicians will step up and say these are people in my practice and I need to be able to help them with their addiction, just like I can help them with their diabetes. And that’s what’s really going to make this a meaningful part of health care reform,” Cimaglio said.

The programs are paid for through Medicaid and a block grant that pays for treatment for the uninsured, along with specialty grants.

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