This commentary is by Daniel Barlow — executive director of the People’s Health & Wellness Clinic in Barre and board chair of Vermont’s Free and Referral Clinic association — and Dr. Allan Ramsay, medical director at the People’s Health & Wellness Clinic.
At the People’s Health & Wellness Clinic, we’ve always been guided by a simple mission: to care for our neighbors with compassion and dignity, regardless of their ability to pay. For over 30 years, we’ve offered free medical, dental and wellness services to thousands of central Vermonters who might otherwise go without. Our work is built on trust — between patients and providers, between the clinic and the community.
As the world around us has changed, so too have the needs of the people we serve. Today, many of our patients face far more complex challenges than we saw a decade ago. Homelessness, addiction, trauma, food insecurity, untreated chronic illness — these aren’t just background issues; they shape our patients’ lives and health in profound ways. We are proud to stand beside them through it all.
It’s with this understanding — and a deep commitment to safety — that we are updating our approach to prescribing controlled substances at PHWC. This new policy has been approved by our board of directors and will take effect on July 1.
Let us be clear: this is not about denying care. It’s about providing care responsibly in a way that protects everyone — patients, volunteers and the community.
For many years, PHWC has not prescribed opioids. That long standing policy remains in place and reflects our commitment to safe, appropriate care in a volunteer-based setting. This new policy builds on that foundation and strengthens our guidelines around other controlled substances, such as benzodiazepines and stimulants.
Vermont has not been immune to the devastating effects of the opioid epidemic. We’ve lost too many lives to addiction and overdose — including in small towns like ours, where everyone feels the ripple effects. What began with prescription opioids has evolved into more dangerous and deadly substances like fentanyl. But the problem doesn’t end there.
Medications like benzodiazepines (often prescribed for anxiety) and stimulants (used for ADHD) also carry high risks of misuse, dependency and diversion, especially when not closely monitored. When combined with opioids or used improperly, these medications can become lethal.
In a free clinic setting like ours, where patients may lack consistent housing, stable support networks or regular access to primary care, those risks increase. That’s why our updated policy limits the use of controlled substances to short-term situations, under clear guidelines.
Patients must complete a full evaluation, sign a medication agreement and commit to regular follow-ups. We will check the Vermont Prescription Monitoring System before each prescription or renewal and may require drug screenings. All prescriptions must come from, and be monitored by, the same provider.
We know medications can be helpful — even essential — but they must be used carefully. That’s why we’re emphasizing safer options first: non-controlled medications like ibuprofen or acetaminophen and non-drug approaches such as physical therapy, counseling and mindfulness. These approaches often offer real, long-term relief with far less risk.
This policy is not only about medication — it’s about our clinic’s identity. PHWC is a place where people come for thoughtful, compassionate care. Our staff and volunteers give their time because they believe in community health. It’s our responsibility to make sure that the care we provide keeps everyone — patients, volunteers and staff — safe.
We also understand that many in our community live with addiction or are in recovery. There is no judgment here — only support. Patients in need of treatment for substance use disorder will be referred to providers who specialize in that care. We’re also working to strengthen partnerships with mental health, housing and recovery programs to better serve our patients’ full range of needs.
In developing this new policy, we’ve drawn on best practices from across Vermont and beyond. We’ve consulted with pharmacists, primary care providers and mental health professionals.
Most importantly, we’ve listened — to our team, our board and our patients.
Change can be challenging, but we believe this change is necessary. It reflects who we are and the kind of care our patients deserve — thoughtful, careful and centered on long-term well-being.
If you’re a patient at PHWC and have questions, please talk to your provider. We’re here to listen. We’re here to help.
As always, we remain committed to serving central Vermont with dignity, respect and heart.
