Last Updated: September 2024

Author: Division of Substance Use Programs, Vermont Department of Health

Access to Medications for Opioid Use Disorder has increased from 2012 to 2022 when treatment rates began to stablize. Compared to 2012, over 3 times as many people are receiving help for opioid addiction treatment. 

The use of heroin and misuse of other opioids (e.g., prescription narcotics, fentanyl) has been identified as a major public health challenge in Vermont. The potential health, social, and economic consequences of this problem have led to the development of a comprehensive treatment system that is focused on opioid addiction. This system, known as the Hub and Spokes, has significantly increased access to care and treatment, including medication for opioid use disorder (MOUD), in Vermont.

The number of people receiving MOUD has stabilized after many years of increases.  MOUD is readily available in both hubs and spokes.  Please note that the most recent two years of data should be considered preliminary due to data lags.

Medication for opioid use disorder is an effective evidence-based treatment for opioid addiction.

For those with opioid dependence, treatment with methadone or buprenorphine, medications used to reduce cravings for opioids (e.g., heroin, prescription pain relievers, etc.), can allow individuals the opportunity to lead normal lives. MOUD was originally developed because detoxification followed by abstinence-oriented treatment was not very effective in preventing a return to opioid use. People who use opioids after detoxing are at high risk over overdose. There is clear evidence that medication assisted treatment using either methadone or buprenorphine helps reduce the risk of overdose deaths and can increase the likelihood that people will stay in treatment and achieve recovery. The positive effects of medication assisted treatment can include: abstinence or reduced use of opioids; reduction in non-opioid drug use (e.g., cocaine); decreased criminal behavior; and decreased risk behavior linked to HIV and hepatitis C infections.

• Individuals receiving treatment and their families
• Community Providers-such as Licensed Alcohol & Drug Counselors (LADCs), primary care physicians and mental health practitioners
• DSU Preferred Providers
• Spoke facilities providing medication assisted treatment for those with opioid use disorders
• Recovery Centers
• Vermont Agency of Human Services (Department of Vermont Health Access, Vermont Department of Health-Division of Substance Use Programs, Department for Children and Families, Department of Corrections, Department of Aging and Independent Living, Department of Mental Health)

Vermont has a multifaceted approach to addressing opioid use disorder that involves multiple community partners. Programs and services include regional prevention efforts, drug take back programs, intervention services through the monitoring of opioid prescriptions with the Vermont Prescription Monitoring System (VPMS), recovery services at eleven Recovery Centers, overdose death prevention through the distribution of Naloxone rescue kits, and a full array of treatment modalities of varying intensities to fit individual needs.

The primary focus of the Hub and Spoke system has been to expand access to care for individuals with opioid use disorders. The number of people receiving MOUD services has continued to increase statewide.

Vermont is also has community initiatives, Rapid Access to Medication (RAM) for Opioid Use Disorder and Recovery Coaching in Emergency Departments to both increase ways people with opioid use disorders can get into treatment and to support them in staying in treatment.

This is based on the average monthly number of people receiving medication for opioid use disorder (MOUD) in hubs and spokes during the quarter as to minimize churn and not over represent the number of people receiving care.  Please note that numbers are subject to change due to lags in receipt of data and measures for the previous two years should be considered estimates.

The numerator is the number of hub and spoke clients receiving services in a month

Hub client – an individual receiving a MOUD service that is reported in the Substance Abuse Treatment Information System (SATIS) dataset. This includes all payers.  In addition, hub clients include Medicaid recipients treated at an out of state provider based on Medicaid claims data. 

Spoke client – an individual receiving a prescription for buprenorphine during the month.  The data source is the Vermont Prescription Monitoring System (VPMS) which includes all scheduled II-IV drugs dispensed by Vermont Licensed Pharmacies.  Please note that it does not include prescriptions filled by Vermonters in other states which means that the actual number may be somewhat higher.  It also excludes any prescription filled in Vermont by a person who does not live in Vermont.  

The denominator is the number of Vermonters aged 18-64 (based on Vermont Health Department and Census estimates) divided by 10,000.