Alcohol and Drug Abuse Programs - Vermont Legislature

Dr. Mark Levine, Commissioner

Vermont Department of Health

February 2018

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Alcohol & Drug Abuse Programs


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Substances Used by Vermonters ages 12+ by Substance Type

58 59 60 60 61 60 62 6159 59

61 61 60

9 9 10 10 10 11 12 13 13 12 13

1517

5 5 5 5 5 5 5 5 5 4* 35

0.8 0.6

Alcohol- Past 30 day Marijuana - Past 30 day

Non-Medical Use of Pain Relievers - Past year Heroin - Past Year

Source: National Survey on Drug Use and Health, 2002-2016. Methodology changes for Rx drug occurred in 2015

Note: * delineates a significant drop since 2011/2012 (p<0.05)

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Hub & Spoke Evaluation: Lessons Learned


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Communications & Marketing

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Enhancement: Centralized Intake System

Centralized Intake System

Equal access to treatment information for all

Vermonters

Guide and support Vermonters in accessing the type of

treatment that meets their needs

Metrics to monitor inquiries, screenings, levels of care

needs and capacity

Status:

Request for Information (RFI) Posted

Request for Proposal (RFP) in DevelopmentVermont Department of Health

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Enhancement: Treatment on Demand

Treatment on Demand: Pilot

Identify and bring Vermonters with an opioid use

disorder into treatment who are not actively seeking

treatment

Medication Assisted Treatment (MAT) started within 72

hours

Status:

Awaiting Technical Assistance: Workflow


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Activities: Recovery

Vermont Recovery Network and

Recovery Centers Peer-based recovery supports (PRSS)

Recovery Meetings

Wellness and Recreational Activities

Community Engagement and Education

PRSS through “pathway guides” for individuals seeking or

engaged with Medication Assisted Treatment (MAT)

Supports for individuals re-entering from Corrections


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Enhancement: PRSS-ED

Peer Recovery Support Specialists (PRSS) in

Emergency Departments (ED)

Decrease opioid overdoses and increase use of

recovery and treatment services

Emergency Departments: CVMC, SVMC, UVMMC

Recovery Centers: Turning Point Center

Status:

Received training from Rhode Island’s Anchor ED Program


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Enhancement: Workforce

Strengthen the workforce & increase number of

qualified providers

Support workers in pursing path to certification/

licensure

Increase number of federally “waivered” prescribers

trained to provide office-based opioid use disorder

treatment

Expand opportunities for credentialed clinicians to

access training


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Progress: Hub & Spoke Evaluation

In-treatment Group:

Opioid use decreased by 96%; other substance use, except

marijuana, also decreased

Other significant change:

ED visits 89%

Arrests/police interactions 90%

Illegal activity 90%

No overdoses

Family conflict 70%

Depression, irritability/anger >50%

Out-of-Treatment:

Continued opioid and other substance use


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Recommendations: Hub & Spoke Evaluation


Increase access to MAT in spokes

Address crowding at high-volume hubs

Develop an addiction workforce plan

Establish a workgroup to improve clinical treatment

Increase mental health services

Provide services for family members/significant others

Provide vocational services

Review and update as needed system protocols and

procedures

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Progress: Total MME Opioid Analgesics per 100 Residents

18682

1721716252 16781

15959 15734 15891

0

5000

10000

15000

20000

25000

30000

Jan-Mar 2016 Apr-Jun 2016 Jul-Sep 2016 Oct-Dec 2016 Jan-Mar 2017 Apr-Jun 2017 Jul-Sep 2017

Data Source: VPMS

There was a 15% decrease in between Q1 2016 and Q3 2017

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Challenge: Drug-Related Fatalities Involving Opioids

4161

50

6961

76

106

3847

3745

25

32 38

0

9 9

20

34 34

51

55 6 12

18

29

51

2010 2011 2012 2013 2014 2015 2016

Total number of accidental and undetermined manner drug-related fatalities involving an opioid

(categories not mutually exclusive)

Total opioid Rx opioid Heroin Fentanyl

Source: Vermont Department of Health Vital Statistics System

Alcohol and Drug Abuse Programs - Vermont Legislature

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