In Vermont, more physicians treat addiction in primary care offices


Healthcare providers in Vermont have seen a shift in the philosophy behind treatment for opioid addiction, which has resulted in a move to treat patients in regular doctor’s offices, rather than centralized treatment centers, according to Vermont Public Radio (VPR).

The medical community increasingly understands the need to treat opioid addiction as a chronic health issue, rather than a transient condition, Alicia Jacobs, M.D., of Colchester, Vermont told VPR. She sees a “significant shift” in the number of doctors open to treating patients in a primary care office or their medical home as opposed to Vermont’s specialized “hubs” at which addicts have traditionally received care.

For stable patients, receiving treatment from local doctors is a way of normalizing their care, according to VPR. Recovering addict James Rebinskas described additional health benefits stemming from a closer relationship with a single physician who fills his Suboxone prescription as a part of regular office visits. As long as he doesn’t relapse, Rebinskas says, he can receive the same treatment as any other patient.

The idea that relapse can, and likely will, occur over the course of treating patients with substance use disorders presents a major challenge for physicians, according to Jacobs. “In the past we have really thought about it in a disease-model concept, where we’re aiming for abstinence and we don’t tolerate relapse,” she says.

The positive response from physicians in Vermont demonstrates a willingness to help provide broader access to treatment on the grounds that outcomes improve and mortality declines dramatically when patients are receiving treatment, even if they struggle during the process, says Jacobs. Such treatment also has a cost-cutting component, as the costs to society related to overdoses, inpatient treatments or dealing with addicts through the criminal justice system dwarf any increased expense associated with long-term treatment programs, she says.

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