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Substance Use Disorder Doesn’t Discriminate

photo cred Jerry Monkman mountain contemplation

After a century of life expectancy in the U.S. increasing, it is starting to decline. The average American can now expect to live 78.6 years. The Centers for Disease Control and Prevention (CDC) first documented this decline three years ago, and the trend continues despite all the advances made in medicine and health care.

The CDC attributes much of the decline to rising suicides and fatal drug overdoses, known as “deaths of despair,” along with alcoholism-related deaths. According to Vermont Commissioner of Health Dr. Mark Levine, drug-related fatalities in the state have increased by 159% since 2010; in 2017, 101 Vermonters died from drug overdoses. Much of this increase is driven by Fentanyl, an opioid narcotic prescribed for pain that drug dealers are using to create lethal mixtures with heroin, cocaine, and other drugs.

Substance use disorder doesn’t discriminate, impacting Vermonters from all walks of life... and it knows no age, race, or gender identity boundaries. More commonly known as addiction or substance abuse, the National Institutes of Health defines substance use disorder as “when a person’s use of alcohol or another substance (drug) leads to health issues or problems at work, school, or home.”

Compounding the problem is the stigma associated with substance use disorder and the lack of understanding that it is a mental and physical health issue. “It’s a disease of the brain,” according to Dr. Levine. “Addiction involves long-term changes in the brain that decrease pleasure, increase distress, and impair decision-making.”

Insufficient access to treatment, especially for rural parts of the state, has challenged those seeking recovery and treatment. While lack of public transportation or reliable personal vehicles is a common theme for Vermonters living in the opportunity gap, for those wrestling with substance use disorder, the ability to access daily treatment and therapeutic care is essential for recovery and maintaining sobriety.

Our mighty little state is leading the way in developing strategies and systems designed to enhance and expedite treatment for those in need. Vermont’s nationally recognized regional opioid treatment model—made up of a network of “hubs and spokes”—covers the state. Nine regional hubs are large licensed programs that are able to provide high-intensity, medically-assisted treatment. Spokes are local practices where specialty care teams of physicians, nurse practitioners, and licensed mental health/addiction counselors provide comprehensive outpatient care. The journey for Vermonters in recovery will often start at a hub and then transition to ongoing care at the spoke facility closest to them.

This hub and spoke network has dramatically reduced the waiting time for a Vermonter ready to enter recovery to zero, essentially offering treatment on demand. And it does much more by connecting patients and their families to case management, care coordination, family services, and referrals.

While access to treatment is critical, it’s just the beginning. Vermonters with substance use disorders need ongoing supports to maintain sobriety and to lift them up in the case of relapse. Transitional recovery housing and access to employment opportunities are essential steps on the journey to recovery. Eileen Peltier from Downstreet Housing and Community Development is helping lead an effort among affordable housing developers to increase the number of safe, affordable, and accountable living environments in Vermont. The goal is to create at least 12 transitional recovery homes across the state by mid-2020 and reduce evictions due to substance use disorder by 20%.

As the Foundation continues to focus on closing the opportunity gap and puts philanthropic dollars to work in communities, we want to connect with organizations that are at the leading edge of addressing prevention and recovery. At its very core, substance use disorder is a crisis that requires a whole-community approach to help those affected live fulfilling lives free of addiction and open to opportunity.