The Fix: The road to recovery

Published: Oct. 11, 2018 at 6:30 PM EDT
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Earlier this year Vermont officials announced there was no longer a waitlist for drug treatment. That's progress, from a peak in January 2014 when more than 500 people were waiting to get help.

Vermont spends $18 million per year on medication-assisted treatment. That doesn't include the costs of other programs helping people navigate their road to recovery. But there are still areas the state says need work.

"There's something in there. That's why they call it chasing the dragon," said Eric Charbonneau. The self-proclaimed drug addict says he used heroin for about a decade, starting when he was in his late teens. He says he's now 32 and has been in opioid treatment and on methadone for about four years now. "The clinic saved my life. If it wasn't for methadone, I'd still be out getting high."

Jolinda LaClair is the state's director of drug prevention policy. She says other states are now studying Vermont's hub-and-spoke system of treatment after it was nationally-recognized for its success.

Reporter Cat Viglienzoni: Where are we right now in the state with treatment?

Jolinda LaClair: We've come a long ways.

At the nine hubs, some 3,600 people in recovery receive more intensive daily outpatient treatment. All maintenance drugs are prescribed here, but it's the only place you can get methadone.

Those hubs work with some 200-plus spokes -- places like physician's offices or clinics that prescribe maintenance drugs like Suboxone or its generic form, buprenorphine. Thousands of other Vermonters in recovery get their help here. Vermont also has about 140 in-patient beds for residential treatment at private or nonprofit facilities, like Valley Vista or Serenity House, where patients often stay for three weeks or more.

"It depends on the person's needs. Some people need to be in a residential facility for a period of time," LaClair said.

LaClair estimates about 8,000 Vermonters are currently in treatment, but she guesses about 20,000 overall struggle with opioid use. She says the question of how to reach the other 12,000 not in treatment has no easy answer. "We have to think about how do you reach people closer to their homes," she said.

The hubs serving our region are well-distributed geographically, but several counties -- Addison, Lamoille, Bennington, Orange, Grand Isle, and Essex -- don't have one. Windsor doesn't either, but there is a treatment hub in West Lebanon, New Hampshire, just across the river.

And while there is some transportation help, LaClair says there are still gaps. "We need to help people reach their treatment," she said.

That's because the data shows the ones who are in treatment are finding success. Last year, the state surveyed 80 people in treatment about their drug use before and after starting treatment. They reported a 96 percent drop in opioid use, a 92 percent drop in injection drug use, and an 89 percent decrease in emergency room visits.

Reporter Cat Viglienzoni: What does that tell us about our approach?

Jolinda LaClair: It tells us we are spot on. It tells us that when people are ready and go to treatment, there are positive outcomes in a very short period of time.

Positive outcomes that are helped by what she calls "wraparound" treatment. Much of that starts at the recovery centers around the state, where coaches help people navigate through referrals to housing, employment, transportation, or child care. LaClair says expanding that program remains a priority. "The important thing to remember is that the first day of treatment is the first day of recovery. And you need human connection," she said.

A human connection that also helps -- during a relapse. On average, in the first year only 36 percent of people are able to sustain recovery. It takes a year of abstinence before less than half relapse. And after three years or so it gets better.

"There is a greater likelihood that you will not relapse. And if you do, there are people there," LaClair said.

Back at City Hall Park, Charbonneau says he’s seen what happens when people relapse. "I’m like, wow, that was me," he said. "The only message that I can give to any addict or any junkie, or whatever they want to say about us, is you can change yourself, but you have to want to do it for you. You can't do it for your girlfriend, do it for your kids, you have to do it for you, or else it's just not going to work."

LaClair says New Hampshire is also adopting Vermont's hub-and-spoke strategy. She says in the next year the Granite State plans to open nine hubs that will connect with other regional providers for treatment.