Vermont is nice and almost everybody thinks so. It’s fertile and green; some even think its cold winters are the most fun. In Vermont, they have a good season of mud when most folks get spring. Still, you couldn't get most people who live in Vermont out of there with a John Deere tractor; people who move away seem certain to return. So it made news when Vermont Governor Peter Shumlin made substance use and overdose issues in the state the centerpiece of his 2014 State of the State address.
We talked to people in Vermont who have worked with the behavioral health issues, even lived the issues, about the changes in the social environment and what recovery looks like in the Green Mountain State.
Nancy Bassett, Director of the Kingdom Recovery Center in St. Johnsbury, said that prescription opioids were indeed a problem, but are increasingly expensive and hard to get. “The last three to four years, surveys of local high school kids indicated that illegal prescriptions [of opioids] were the biggest drugs on the street. If they can’t get the prescriptions, heroin is around,” said Bassett.
Peer-to-Peer Recovery Community Centers
The Kingdom Recovery Center is a peer-run recovery community center that is part of the peer-to-peer recovery structure in Vermont, called the Vermont Recovery Network. Bassett, in recovery from a substance use disorder and a lifelong Vermonter, said that the treatment facilities in the state increasingly see the efficacy of an incremental approach. The plan is to get people stabilized with medication, get a job, get therapy, and taper off drugs and into a recovery support program they are willing to commit to. “About half of the people who come to us (some completely voluntarily, some from drug court) want to change their lives, and the other half do not want to go through withdrawal. We need an opportunity to help them see they are on a path of inevitable destruction, get into medical assistance, get comfortable with case managers who have been in the same situation, then move to abstinence,” she said. That approach seems to work best.
Staff at Centers Are People in Recovery
Recovery community centers are staffed with people in recovery and paid for with state, local, and federal dollars. They are places where people can drop in and talk, and where they can receive relapse prevention support; peer recovery coaching; and assistance with housing, employment, and educational goals. Patty McCarthy Metcalf is the former executive director of Friends of Recovery Vermont, a statewide coalition of people in recovery from drug and alcohol addiction and its effects, and former chair of the Governor’s Advisory Council for substance abuse prevention, treatment, and recovery issues. She is currently the deputy project director of SAMHSA's BRSS TACS (Bringing Recovery Supports to Scale Technical Assistance Center Strategy).
“The staff of recovery centers are usually people in recovery,” said Metcalf. “That’s not required in Vermont, though. They are not credentialed, but they are trained as peer recovery coaches and recovery support workers. The training is five days, 30 hours total, in subjects that include ethical boundaries, mental health issues, medications that assist in recovery, how to find resources for clients and other navigation topics, and how to conduct motivational interviews and become agents of change. The recovery coach training is integrated with mental health training—addiction issues and mental health, not clinical training, but stuff like mental health social inclusion, discriminatory labeling, and wellness planning.”
“The recovery community centers collect data on the housing and employment situation of clients and will help find resources, help them apply for health care and housing, and help navigate other available state resources. We want to work with the people who need safe, stable, and substance-free housing to get them into a better situation, then we can work on other issues.”
Vermont’s issues with substance use seem no different from other states—the difference appears to be the willingness to confront the issue publicly and find a solution that works for each person.
This article was published in September 2014 to highlight the theme of Recovery. September is National Recovery Month.
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