New Therapy Announced for Some Vermont Opioid Addicts

Under a pilot project announced Tuesday, offenders leaving the custody of the Vermont Department of Corrections will receive injections of a medication that blocks the effects of opiate drugs in the brain.

Gov. Peter Shumlin, D-Vermont, and members of his administration told reporters they hope Naltrexone, commonly known as Vivitrol, will be a promising treatment to help move more people from opiate addiction to recovery.

"We're fighting an uphill battle against opiate addiction," Shumlin said. "We are trying to find every single tool available that we can to help us move people from addiction to recovery."

Shumlin pointed to progress in the effort to reduce heroin and prescription pill addiction in the state, including the opening of treatment facilities that have helped get 1,000 more Vermonters into treatment since 2013. Pre-trial services programs have also enabled addicts charged with non-violent crimes to better access treatment and avoid jail if they are successful, Shumlin noted. He added that the state has distributed thousands of overdose rescue kids.

"It's clear we have more to do," Shumlin told reporters.

The pilot project, starting in January, will give about 350 offenders the choice to receive monthly Vivitrol injections. The Vivitrol shots work by blocking receptors in the brain and nullifying the effects of opiate drugs, explained Dr. Harry Chen, the commissioner of the Vermont Department of Health.

The effort is funded as part of a three year, $3-million federal grant through the U.S. Department of Health and Human Services / Substance Abuse and Mental Health Services Administration. The Vermont Department of Health received the grant in August with a goal to expand access to medication-assisted therapy and improve recovery supports to people with the greatest need, the Shumlin administration said.

"It's not a magic bullet for all individuals who are addicted; it works for some," Chen told reporters. "The more strategies we have, the more we're able to tailor our therapy."

The first few weeks after release from prison are a particularly risky time for recovering addicts, explained Dr. Gordon Frankle of the West Ridge Center for Addiction Recovery in Rutland. "They're often at risk of overdose, they're at high risk for relapse, they're at high risk of reoffending and moving back into the Department of Corrections," he said.

Frankle and Chen said the Vivitrol treatment, which has also been used with alcoholics, has been available for a while but has not really taken off with recovering opiate addicts he treats, because it requires patients to have already gone through withdrawal and detox, and have no opiates remaining in their systems.

Many addicts seeking recovery try to avoid the painful symptoms of opiate addiction withdrawal by using other forms of treatment that enable them to taper down their opiate use, Frankle noted.

Shumlin said Vivitrol may be preferable to some people seeking long-term recovery, because patients only require one injection per month. Other therapies, like methadone, require more frequent visits. Another plus, Shumlin said, is that Vivitrol cannot be abused to get high, or diverted, as can, He said as an example, buprenorphine strips that are taken orally.

The pilot project will have a long-term study component through researchers at Dartmouth, noted Barbara Cimaglio of the Vermont Department of Health.

The study will start in the prison in Rutland, Shumlin said, but he added that he hopes to see it expanded to other parts of the state soon after. 

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