Vermont has long struggled with high rates of opioid dependence.Katharine Q. Seelye, “In Annual Speech, Vermont Governor Shifts Focus to Drug Abuse,” New York Times, January 8, 2014 (noting dramatic increases in state in heroin overdose deaths and opiate addiction treatment rates).
The state is notable for its unique approach to opioid use disorders: an integrated hub-and-spoke treatment model that it has been developing since 2011. In the hub-and-spoke model, patients’ medical and psychiatric needs are assessed at a “hub” clinic where initial treatment options are chosen. They can then transfer to “spoke” providers for follow-up care and access to other resources.German Lopez, “I Looked for a State That’s Taken the Opioid Epidemic Seriously. I Found Vermont.,” Vox, October 31, 2017. The result: the number of people in treatment has increased, the waiting time for treatment has decreased, and the overdose death rate in Vermont is now below the national average.German Lopez, “I Looked for a State That’s Taken the Opioid Epidemic Seriously. I Found Vermont.,” Vox, October 31, 2017.