Substance abuse: State panel hears of ongoing need despite progress

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MONTPELIER >> Vermont has expanded addiction treatment in a big way in recent years, but a state Senate committee heard Thursday of continuing waiting lists for treatment and huge caseloads for substance abuse counselors.

The Senate Health and Welfare Committee got an update from senior human services officials about progress in addressing the state's opiate abuse crisis, but they also heard that there is much work to do. Among the highlights from the committee session and interviews with officials:

A big increase in need

A Health Department chart showed the number of Vermonters seeking treatment for heroin addiction grew from about 3,000 in 2012 to about twice that in 2015. Despite the increase in services and a new "hub and spoke" system for coordinating them, the number of people waiting for treatment statewide has remained stubbornly in the neighborhood of 500. Another chart showed it at 468 as of August. Officials said it was down more recently, in part due to staff additions at the University of Vermont Medical Center in Burlington.

A stressed workforce

Demand for services means high caseloads.

Catherine Iacuzzi, executive director of the Maple Leaf Farm addiction treatment center in Underhill, said caseloads of 100 patients were not unusual for drug abuse counselors in Vermont. She called that workload "crazy-making."

Others testified of high turnover on staff at treatment centers and recovery programs, due mainly to low pay. A licensed practical nurse with a year's education in the field can make significantly more than a social worker with a master's degree, the committee was told.

A big increase in effort

The state spent about $4.5 million on opiate treatment programs in fiscal 2013, and is spending $18.2 million this year, said Deputy Health Commissioner Barbara Cimaglio. Gov. Peter Shumlin said last week that the number of Vermonters in treatment has grown 65 percent in the past two years.

A debate over tobacco at treatment centers

The Health Department as of Jan. 1 required residential treatment centers to ban smoking on their properties. Such a ban exists for hospitals, and Cimaglio argued that facilities fighting addiction should not condone addiction to tobacco. "We don't let people go outside and have a drink," she said.

Iacuzzi said the new policy is "not working at Maple Leaf Farm," adding that two heroin addicts had recently left treatment due to the new policy.


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