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The home for VPR's coverage of health and health industry issues affecting the state of Vermont.

Waiting For Help: St. Johnsbury Clinic Hopes To Reduce Lines For Drug Treatment

Treatment for opiate addiction in Vermont has increased more than 700 percent since 2000. And as Gov. Peter Shumlin noted in his State of the State address, too many people are having to wait too long to find help, especially in the Northeast Kingdom. He’s asking lawmakers to spend $200,000 to reduce the backlog statewide.

One of the regional centers that dispenses opiate treatment medication for people addicted to prescription drugs and other substances is BAART, a for-profit business that started in California. BAART—Bay Area Addiction Research and Treatment--has contracted with the Vermont Department of Health to provide some of the services included in the Care Alliance for Opioid Addiction, a network of providers throughout the state.

In St. Johnsbury, the door to BAART’s crowded one-story building on a busy street opens at 5:30 every morning. The waiting room is usually full until the dispensary closes four hours later. On this frigid morning there’s a young mother with a child, a pregnant woman, a couple of sweat-shirted men in their twenties and thirties, and a white-haired, affable guy who wouldn’t look out of place in a corporate board room. He asks that we not use his name because there’s a lot of stigma attached to methadone use in a small town.

“But I take it once a day and I don’t think about it. I don’t have that little pillbox there when I’m really in a lot of pain and I’m really flummoxed. I don’t have to worry about that being there any more,” he says.

He says he first started coming here last November, after his doctor kicked him out of his practice.

“I had a disease that was undiagnosed for 12 years and that disease had a lot of pain. And I had a doctor who did not diagnose it and saw me as someone who was mentally ill, somebody who was a hypochondriac, somebody who was a drug seeker,” he says.

He admits he had, in his words, “issues” with his painkillers. But now he says he has stabilized his life with methadone, and does not take other prescription drugs. Like all clients here, he says he has to follow a lot of rules and pass a lot of drug screening tests to remain in the program. 

Alan Aiken is Program Manager for this clinic, another one in Newport, and the newest one in Berlin.

After today’s clients—114 of them--have received their daily doses, Aiken shows the dispensary van housed in a cramped garage. There’s a sliding glass window. Behind it a nurse fills a tube leading to a small cup on the ledge.

“A person comes up, they say 'my name' and 'my dose,' all part of the process, and the door is locked, of course, at all times,” Aiken explains.  

This mobile unit used to travel but now it’s kept here so clients can get both counseling and doses in the same place. The van has  been approved by the federal Drug Enforcement Agency. But Aiken says the clinic needs renovations and more staff in order to whittle down the fifty-person waiting list. Clinicians are hard to find in this rural area, even though dispensing nurse Bonnie Baraw says it’s rewarding, watching people conquer addiction.

“You know they finally have an apartment, they work toward getting their children back if their children have been taken into custody. All those things are great and you just see the happiness, and when they see that they are making progress they continue to move forward,” she says.

Director Aiken says most of the clients are local. He says many of them know each other, and yet many of their relatives or neighbors might be surprised to know they come here. He says it  hasn’t been easy convincing this community to accept a methadone clinic, and admits that not every client makes a smooth exit from drug substitutes.

But Aiken believes that BAART’s clinics—there are now five, statewide—can strengthen Vermont’s response to a troubling epidemic.  He says Vermont’s new plan to link programs like this—so-called “hubs”—with primary care practices—so-called “spokes” -- is unique nationwide, and he is hopeful that the governor’s promise to ramp up services will be kept.  

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