In an attempt to streamline the rehabilitation process for the states patients, Vermont created a Hub and Spoke system.  Once an addict is willing to go to rehab he or she is sent to a “hub” where they receive complex medication therapy with methadone or buprenorphine.  There are seven hubs in Vermont, with at least one in each of the five regions of the state.  The biggest hub is in Burlington, where the therapy is run through the Howard Center.  Once an addict is deemed to have been successfully treated and cured they are sent to a spoke.

Spokes tend not to have the medical resources that the hubs do, and so most of the spokes use the peer assistance method of rehab.  Many of the heads of these spokes that I talked to were adamant that their method of rehab was the most effective form of rehab.  The Turning Point houses in Vermont aren’t authorized for medical therapy, but their managers stand by the results they get with the peer method.  The peer method gives the recovering addict someone to connect with as they have both gone through the same struggles.  This connection helps the addict relate to their caretakers in a way that they never could with a doctor who is dealing with hundreds of patients.  Regardless of what method works best, both the hubs and spokes are doing great work that deserves the states support.

Map of the Hubs in Vermont (white circles)