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State promises more funds to fight opiates

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Posted on July 14, 2014 |
By John Flowers



MIDDLEBURY — State health care officials have promised to find additional financial support for a joint effort by Porter Medical Center and the Counseling Service of Addison County to expand medication assisted treatment services to local residents who are addicted to opiates.

Mark Larson, commissioner of the Department of Vermont Health Access, confirmed the offer of support last week during a phone interview with the Addison Independent. His comments came on the heels of a July 3 Independent article and editorial noting Porter and CSAC had elected to gradually ramp up a Suboxone program at Bristol Internal Medicine because the organizations were unable to secure state support for a standalone Suboxone clinic on the PMC campus.

“We will work with them to make sure the resources are available to start the clinic,” Larson said. “If that is the direction they are interested in going, we will support it.”

Larson acknowledged a “gap in services” to opiate addicts in Addison County. Bristol Internal Medicine physician Dr. Emily Glick has provided the only Suboxone program in the county, serving around 20 patients in need of the service. The clinic does not dispense Suboxone — a drug that helps wean patients off opiates — but can prescribe it after seeing patients. State officials acknowledge there are around 140 Medicaid patients in the Addison County area who are in need of medication-assisted treatment for opiate addiction. Most of these patients must currently seek treatment in Chittenden or Rutland counties. Some of those patients face major transportation hurdles.

“We will make sure to find resources to make sure services are expanded and I believe there are resources in the current (state) budget,” Larson said.

While Porter officials have not closed the door on a new clinic, they are currently committed to ramping up the Suboxone program at Bristol Internal Medicine, which will be beefed up over time to eventually accommodate 80-90 patients. A total of four primary care physicians based at the Bristol office will soon be able to prescribe Suboxone. A substance abuse coordinator and a case manager will also be added to the office to make sure the patients receive ancillary services — such as counseling and job search assistance — to help them in their overall recovery from opiate addiction.

The Porter Medical Center board in late June approved the expanded Suboxone program, and did so even with the prospect of a $200,000 annual budget hit.

James Daily, president of Porter Medical Center, gave the following statement in reaction to Larson’s offer of assistance:

“We are pleased by the news that the Department of Vermont Health Access is interested in exploring additional support for Porter’s collaboration with (CSAC) to offer expanded medication-assisted treatment services to Addison County residents suffering from opiate addiction. We have restarted conversations with Commissioner Larson and other DVHA officials to learn more about what assistance may be possible. In the meantime, however, Porter and CSAC are moving forward with the expansion of medication-assisted treatment services as an integrated service at Bristol Internal Medicine to address this serious community need.”

Larson and local officials will, in the days ahead, determine the extent of the state’s additional help and how it could be used most effectively in Addison County. It is unclear at this point whether the long-range plan for services to Addison County opiate patients will ultimately take the form of a centralized clinic or be spread out among multiple physician practices, a model that is being used in some other counties in Vermont.

“We will look at the options in the future going forward, making sure we are doing an appropriate job meeting the needs of this population,” Daily said.

Reporter John Flowers is at johnf@addisonindependent.com.

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