Vermont Opens First heroin Treatment Clinic

Author: Julie Shumway

In the wake of increasing concern over the state's drug problems, Vermont opened its first heroin treatment clinic on Oct. 28. The Chittenden Center – An Addictions Treatment Program, is directed by Dr. Warren Bickel of the University of Vermont (UVM) Psychiatry Department. It is housed on the university Health Center campus, and is a program of the Howard Center for Mental Health Services and UVM.
As of Friday, Bickel noted, 10 patients started methadone treatment in the clinic. The current concern is that it will not meet the demand for addiction treatment in Vermont, whose residents have been traveling out of state for treatment of heroin addiction. The clinic's maximum capacity is 100 patients, so those patients currently traveling out of state and those who are pregnant will receive priority for treatment. With the number of Vermonters suffering from heroin addiction estimated at between 600 and 1,200 people, Bickel is hopeful that more clinics will open in Vermont in the future.
"After opening this clinic and showing how treatment can be provided in a way that is effective and does not cause trouble for the larger community, we're optimistic that other communities will also choose to open clinics," he said, pointing out that while heroin is contained in a series of pockets, it is by no means a regional issue. While the Rutland and Burlington areas have received more attention, Bickel noted that virtually every community in Vermont and throughout the country participates in the drug problem. He said,"Heroin addicts are people's wives, mothers, husbands, sons, and daughters." He commended the state for moving forward in the area of treatment. "There's a stool, with three legs: treatment, criminal justice, and prevention. Treatment has not been as strong in Vermont as the other two, but there's an improvement now through this clinic," Bickel said.
The Chittenden Center uses methadone, a drug that blocks withdrawal symptoms and help curb cravings for heroin. The drug is strictly regulated, however, and may only be dispensed by clinics that have received approval from the Drug Enforcement Administration.
The opening of the methadone clinic was followed closely by the Food and Drug Administration's approval of a new drug in the treatment of heroin, buprenorphine. Bickel was instrumental in the study of this new medecine, which he claimed was a long time coming. Having studied buprenorphine since 1983, Bickel was confident that the drug has an important role to play alongside methadone, since it is a "partial agonist." According to Bickel, this means that the drug has a limit of effectiveness, making it safe to give in multiple doses without fear of overdose. Methadone patients must come to the clinic daily, while those taking buprenorphine will be able to receive treatment once every few days.
While buprenorphine is safer and will be under less intense regulation than methadone, methadone may be more effective with patients who have a higher opiate tolerance.