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‘Not dead shouldn’t be the end goal’

Val Velasquez, 33, a recovering drug user at the Turning Point Center in Burlington. Photo by Morgan True / VTDigger
Val Velasquez, 33, a recovering drug user at the Turning Point Center in Burlington. Photo by Morgan True / VTDigger

New approaches on the horizon for Vermont addiction treatment

By Morgan True

For Vermont Digger

The closure was supposed to be temporary. Within weeks, however, Vermont’s oldest residential drug rehab program had imploded, taking down an affiliated outpatient program and leaving recovering addicts in the lurch and state officials scrambling to pick up the pieces.

Maple Leaf Treatment Center in Underhill was a crucial component of Vermont’s drug treatment system. Its 41 inpatient beds — in close proximity to Burlington — accounted for 30 percent of the beds statewide.

Residential rehab programs give people space to examine their lives and a break from the hamster-wheel hunger to score drugs and stave off dope sickness, said Gary De Carolis, executive director of Burlington’s Turning Point Center, which helps people in recovery.

Maple Leaf’s closure earlier this year coincided with reports that opiate overdose deaths in Vermont spiked by 38 percent in 2016, from a total of 75 to 104, according to Health Department figures.

Deputy Health Commissioner Barbara Cimaglio said Maple Leaf’s undoing was a surprise but that other programs are stepping into the breach.

However, the combination of a bedrock rehab program closing and the spike in overdose deaths left many people worried that a bad situation was getting worse.

Burlington Mayor Miro Weinberger has repeatedly cited the growing number of overdose deaths as evidence that, despite good intentions, the state has done too little to address the crisis.

For members of the public concerned about property crime, the waste of tax dollars or the loss of loved ones to overdose, the question is simple: What comes next?

HITTING A SATURATION POINT

As opiate addiction became an epidemic crisis in the past decade, Vermont shifted away from incarcerating drug users to putting them into treatment.

That has meant increased access to the maintenance medications methadone and buprenorphine.

The drugs stave off opiate withdrawal, and if taken properly, they don’t give people the high they experience with heroin or misused prescription painkillers.

Officials developed the “hub and spoke” model for treatment. Large methadone clinics, or hubs, serve thousands of opiate-addicted patients. As their lives stabilize, people ideally transition to physician practices — the spokes — where they are typically prescribed buprenorphine.

The use of medication to treat addicts grew out of efforts to prevent overdose deaths, and it follows a basic harm reduction principle: Drug users have to be alive if they are to recover.

The state has also made naloxone, the opiate overdose reversal drug, widely available.

The research is unequivocal, experts say: Without access to treatment medication, people addicted to opiates are at greater risk of death.

Today, more than 1 percent of Vermont’s population is taking maintenance medication for an opiate addiction. One expert estimates that could be as high as two-thirds of the addicted population in the state, a rate that’s drawing national attention.

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