New methadone facility in South Burlington will clear backlog, officials say

After a year of controversy, the Burlington-based HowardCenter opened its second methadone clinic on Dorset Street in South Burlington on Friday.

The decision to move forward with the treatment facility for opiate addiction comes as Rutland Regional Medical Center prepares to open Rutland’s first methadone clinic at the end of October.

Although the South Burlington School Board has appealed the HowardCenter’s local permit due to the clinic’s proximity to schools, a judge did not prevent the center from opening while the case is pending.

Bob Bick, director of the HowardCenter, said “The benefits of providing treatment to individuals in our community who need it far outweigh the economic risks if we don’t prevail.”

“These are individuals that are already in our communities,” Bick said. “To the extent that the community needs to be concerned with or afraid of individuals with an opiate addiction, it is in fact those individuals who are not in treatment … that present a far greater risk to the community.”

In October 2002, the HowardCenter opened the state’s first methadone clinic in collaboration with the University of Vermont and Fletcher Allen Health Care at the University Health Center. The center started with 40 patients; now about 500 are being served.

Even with that dramatic increase in opiate addiction treatment the situation is “untenable,” Bick says. More than 600 patients are on the center’s waiting list.

“What we know from many years of addiction treatment and research is that the more timely you can provide more treatment to someone who is seeking it, the greater potential for more desirable outcomes,” Bick said.

Barbara Cimaglio, deputy commissioner for alcohol and drug abuse programs, is optimistic that the new facility will reduce the HowardCenter’s waiting list to zero in the next year.

“Our expectation is that we decrease the waiting list to almost nothing,” she said. “Part of the challenge the state is experiencing is that there are people in need of treatment that are struggling to get treatment. We are seeing the correctional system wanting to refer people for treatment, and if these people hit a long waiting list, they are unlikely to wait. And they’ll be back on the street.”

The South Burlington clinic is the seventh treatment facility to administer methadone to Vermonters, and Rutland will be the eighth. There are already clinics in Newport, St. Johnsbury, Brattleboro, West Lebanon (N.H), Chittenden County and Central Vermont.

By Oct. 2014, Rutland Regional Medical Center expects its new West Ridge Center for Addiction Recovery to treat roughly 400 Rutland area residents. Jeff McKee, director of psychiatric services at Rutland Regional, says the need is “overwhelming.”

“We know for sure that we have about 50 patients who are ready to join the program as soon as we open the doors,” McKee said. “They are traveling in most cases almost one to two hours a day to get their methadone from other clinics. … There is some concern that 400 is not enough.”

The state gave Rutland roughly $250,000 for capital improvements at the new facility, which is about two miles from the main hospital. In the first year, McKee says Rutland Regional will receive a total of $500,000 in state dollars to get the program up and going.

“That’s what it takes to subsidize the fixed costs to ramp up to 400 patients during that first year,” he said.

The state has an enhanced Medicaid reimbursement for opiate treatment programs; 90 percent of funding will come from the federal government.

Tom Huebner, CEO of Rutland Regional, expects the clinic to be financially sustainable after the first year.

“It’s not anything anybody will be making money on,” he said. “We hope to break even on it.”

The new methadone clinics are part of a larger, regionalized system for treating opiate addiction that relies more on buprenorphine than methadone. Buprenorphine is a much safer and less addictive drug than methadone. For more on this system read here.