Despite Improvement, Expanded Access To Opiate Addiction Treatment In Vt. Still Needed

Nov 14, 2016

In 2012, Vermont had 650 people in some form of treatment for opiate addiction. Today, according to Vermont Department of Health, that number has ballooned to more than 7,500. But the state still lacks the capacity needed to treat all of the addicts seeking help.

The strides Vermont has made in treatment capacity over the last four years are undeniable. Overall waiting lists are at their lowest point in years, according to the Department of Health. And the average wait time for treatment in Chittenden County is, at 86 days, about half what it was at the beginning of 2016.

“That’s not acceptable, I agree with that 100 percent, but it’s getting better,” says Deputy Commissioner of Health Barbara Cimaglio.

On Monday afternoon, Cimaglio told lawmakers that the opening of a new northern Vermont treatment clinic in January will help reduce those wait times.

“We do feel with the advent of the new St. Albans clinic, we’re going to bring the waiting for the hubs down to a pretty reasonable amount of time,” she says.

Cimaglio credits the expansion in capacity to the creation of central clinics, known as “hubs,” like the one slated for St. Albans, as well as increased involvement by the broader medical establishment. In the last year alone, the state has seen 50 physicians earn the accreditation needed to prescribe addiction-treatment drugs buprenorphine or methadone.

"We do feel with the advent of the new St. Albans clinic, we're going to bring the waiting for the hubs down to a pretty reasonable amount of time." — Barbara Cimaglio, Deputy Commissioner of Health

Cimalgio says efforts by the state to convince people to seek help for their addictions has been successful.

“It also means that we’ve got a huge burden to ramp up more quickly to meet the demand,” Cimaglio says.

And therein lies the continuing challenge. While the arrival of the new St. Albans clinic will help stem the waiting list in Chittenden County, Cimaglio says her department is still working to expedite the delivery of treatment to people who ask for it.

“And the systems are not always well-coordinated, so we’re working toward bringing together all the partners to map out how the system flows,” she says.

Tom Dalton is coordinator of the Safe Recovery Program at the Howard Center, which runs a syringe-exchange program, and also dispenses an overdose-reversal drug called Narcan to addicts.

Dalton says the state’s progress is admirable.

“But we’re not currently meeting the need for what people have in terms of needing treatment,” Dalton says.

Dalton says waiting lists dramatically underestimate the number of people in need of treatment. The state needs to expand treatment capacity, Dalton says, if it hopes to serve all the addicts in need.

"We're not currently meeting the need for what people have in terms of needing treatment." — Tom Dalton, coordinator of the Safe Recovery Program at the Howard Center

“Part of what we want to talk about is the need for a renewed sense of urgency,” Dalton told lawmakers Monday.

Cimaglio says her department is using a triage process to get treatment to people who need it most. Right now, she says that in some instances means prioritizing parents with young children.

“And we’ve adjusted the assessment process so people that are involved with child welfare and have some court-related situations are being prioritized,” Cimaglio.

Gov.-elect Phil Scott will soon take over an opiate-treatment apparatus that outgoing Gov. Peter Shumlin has invested tens of millions of dollars in over the course of his tenure.