Opinion: January 17, 2014
Vermont Department of Health
Vermont is finding its way out of the darkness of opioid addiction. With the opening of West Ridge Addiction Treatment & Recovery Center in November, we marked a milestone in Rutland County and for our state. We now recognize addiction as a chronic illness, like diabetes and heart disease, requiring a similar approach to prevention and treatment.
Just as people with diabetes need medication like insulin along with lifestyle interventions, so too do people with addictions need medications like methadone or buprenorphine and lifestyle interventions to ensure the best outcomes: better health, steady work and a social network of support. The opening of West Ridge is especially meaningful for me, as a longtime former Rutland County resident and physician, but the real credit goes to the medical and treatment community, law enforcement, business leaders and neighbors who pulled together to make it a reality.
Addiction is not someone else’s problem – it’s our problem. Along with just about every other parent of young adults, I know several of their classmates who were well-adjusted kids with caring parents whose lives were taken over by the horrors of opiate addiction. Thankfully, nearly all are now in recovery and doing well.
At a cost of millions of dollars yearly, addiction is a problem we can’t afford to ignore. And we can’t forget the other immeasurable costs of poor health, broken families, unsafe and unstable communities. Addiction touches each of us.
Among the most innocent victims are newborn babies of women addicted to opiates. These are not “addicted” infants, but they do require special treatment at birth that fortunately prevents long-term detrimental effects. The vast majority of addicted mothers giving birth in Vermont are in treatment. From a public health perspective, this is precisely where we want them to be. We take pride in a prematurity rate that is among the lowest in the nation as a marker of our willingness to commit to our collective future.
Addiction stems from bad decisions, just like any of us might make to overeat or not exercise. But it quickly moves from a bad decision to disease. The end result is a chronic medical condition with profound implications for the individual and society. We must take the public health approach and confront addiction on all fronts – no one really expects we can arrest our way out of the problem.
With the opening of West Ridge, and BAART Behavioral Health Services in the Northeast Kingdom on January 1, we are implementing the Care Alliance for Opioid Addiction – the partnership of treatment centers and clinicians around the state using a Hub & Spoke model to offer medication-assisted therapy to Vermonters in need.
The treatment centers, or Hubs, will serve patients with complex needs. Hubs offer comprehensive assessment and specialty treatment with methadone or buprenorphine, providing treatment much closer to home for many. Connected with the Hubs are the Spokes – Blueprint for Health and primary care practices that treat patients using buprenorphine. Patient care, at a Hub or a Spoke, is supervised by a physician and supported by a network of community-based services aimed at our goal: enabling patients to be successful in life, work and as family members. This system of care gives a health home for people addicted to opiates. The federal government shares our enthusiasm for this model, acknowledging its innovative nature with enhanced federal start-up funding.
Two recent national reports underscore that all three branches of state government are committed to finding solutions. A report from the Trust for America’s Health commends Vermont’s use of all 10 nationally recommended strategies to reduce prescription drug abuse and overdose. A National Safety Council report credits our state as one of only three to meet all of its standards on state leadership and action, prescription drug monitoring, responsible prescribing, and overdose education and prevention.
As we work to address the demand side of the equation, we can’t underestimate the power of prevention. We see hope and progress in the 2013 Vermont Youth Risk Behavior Survey results that shows use of tobacco, alcohol and prescription drugs by Vermont youth declined significantly from 2011 – all priorities for our community-based prevention efforts. Investing early in the health of young people clearly yields the best return on investment.
I believe we are on the right path.
Harry Chen, MD
Vermont Commissioner of Health
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