How VT ‘Hub and Spoke’ System Treats Opioid Addicts

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Vermont has a relatively new addiction treatment program, which is unique in its comprehensiveness, reports Vox. The focus is on the science and research, with a desire to get even patients who can prove to be very difficult in treatment to save their lives. It’s a time-consuming effort, but one that providers in the state enthusiastically participate in to push back against the deadliest overdose crisis in U.S. history. Opioid overdoses alone could kill as many as 650,000 — more people than live in Vermont today — across the U.S. in the next decade.

Vermont’s effort appears to be working. According to the Centers for Disease Control and Prevention (CDC), the drug overdose death rate for New England was about 24.6 per 100,000 people in 2015, the highest for any U.S. region. Yet Vermont was not only below the regional average at 15.8, but below even the national average of 16.3, a fact that some people on the ground attribute in part to the state’s unique system, known as the hub and spoke. Vox tells the story of how it works by reviewing the case of an addict it calls Tyler. A 28-year-old, he had used two to eight bags of heroin each day for the past seven years. He was strongly resistant to medication-assisted treatment (MAT), in which patients use medications such as methadone or buprenorphine to stave off withdrawals and reduce cravings, widely considered the gold standard for opioid addiction care. He came into treatment five times, and each time, he abruptly dropped out.

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