The Vermont Department of Health’s four-year-old "hub and spoke" model for treating opiate addiction led to a 96 percent reduction in patients’ usage of the dangerous drugs, according to a report released Monday.
Authored by University of Vermont professor Richard Rawson, the study found that hub and spoke patients recorded an 89 percent decrease in emergency department visits after they received treatment and a 90 percent drop in police stops and arrests. By several measures, the report found that users receiving care in the treatment system were dramatically better off than users who were not receiving care.
Perhaps most encouragingly, none of the participants in treatment had overdosed in the three months leading up to the study interview, compared to 25 percent who had overdosed in the three months before entering treatment.
“This report gives me hope,” Health Commissioner Mark Levine said.
The hub and spoke system has been the state’s primary tool to combat the surge in opiate abuse with medication-assisted treatment. At six “hub” facilities, patients in need of intensive treatment receive methadone and buprenorphine. Dozens of physicians’ offices make up the “spokes,” where buprenorphine is administered to patients who have made more progress in treating their addiction.
The report was not all positive. About 80 percent of participants receiving treatment at hubs were critical of the environment in the clinics, “citing disruptive and counter-therapeutic ‘drug talk’ by patients,” the report said. Patients also complained of high turnover among hub counselors.
But mostly, the patients said they were pleased with medication-assisted therapy.
A record 106 people died of fatal opiate overdoses in Vermont in 2016, three years after the launch of the hub and spoke initiative. Figures for 2017 have not been released.
The year-long study of 100 opioid users was funded by a $200,000 Health Department grant that relied on federal funds.