There are three medications approved by the Food and Drug Administration (FDA) for the treatment of opioid use disorder:

• Methadone: A long-acting opioid that can fully activate opioid receptors and helps to reduce cravings and withdrawal symptoms. Methadone prescribed for an opioid use disorder can only be dispensed by a federally designated opioid treatment program (OTP). If you are interested in methadone, please contact your local OTP or “Hub” in Vermont, or use the national directory if you live outside of Vermont.
• Buprenorphine: An opioid that only partially activates opioid receptors. It suppresses and reduces cravings for opioids, significantly diminishes withdrawal symptoms and can blunt the effects of other opioids. Unlike methadone, it can be prescribed in a primary care provider’s office and obtained at a pharmacy.
• Naltrexone: A non-opioid medication that blocks opioid receptors to decrease the effects of opioids on the brain’s receptors and prevent a “high.” This medication comes in the form of a daily pill prescribed by your primary care provider, or a monthly injection administered in your provider’s office.

UVM Health offers two levels of care for those taking buprenorphine and/or naltrexone:

• Specialty office-based care: Includes on-site counseling, structured monitoring and regular medication management for individuals who are just starting MOUD, have recently changed providers or need intensive services to stabilize
• Primary care office-based treatment: For those who are stable in their recovery and need less frequent support and monitoring

UVM Health also provides rapid access to MOUD programs in many of our emergency departments. These programs offer same-day access to medications that treat OUD, rapid referral for specialty care and connection with peer recovery coaches to support you in your initial steps towards recovery.

Behavioral therapy — also known as counseling or talk therapy — is one of the primary ways we treat OUD. Through regular meetings with a psychologist or mental health counselor specializing in addiction treatment, you can learn ways to cope with the feelings that arise when you stop using opioids. Behavioral therapy can also address underlying mental health conditions that may contribute to your OUD.

UVM Health offers different levels of care to treat patients at all stages of OUD:

• Intensive Outpatient Program (IOP): Intensive treatment for those who have recently completed inpatient treatment or rehab, are new to recovery, or have had a recent return to use. This consists of structured group therapy three days per week for three hours a day and weekly individual counseling as needed.
• Group counseling – early recovery: Group counseling twice a week for two hours per day, for people in early recovery and who do not need more intensive treatment.
• Group counseling – recovery support: Group therapy once a week or twice a month for one and a half hours, for those who are stable in their recovery and want ongoing support.
• Individual counseling: Weekly or as-needed individual therapy for people who need short-term (two to six months) support.

Case managers and social workers are available to support you in your treatment and recovery. They offer:

• Referrals to community resources for housing and transportation needs
• Help enrolling in Medicaid and other benefits programs
• Continued care planning (discharge planning) for after you complete treatment
• Care coordination with outside providers

Some people may require more intensive treatment for OUD. Providers at UVM Health can refer you to programs offering round-the-clock medical supervision and monitoring (often called detox) to help you safely stop using opioids. Many of these programs also offer residential treatment (rehab), which typically lasts two to four weeks and can help you learn the skills needed to change your thoughts and behaviors around alcohol.

SBIRT is a comprehensive, integrated public health approach to the delivery of early intervention and treatment services for patients at risk of developing substance use disorders. Screening is incorporated into some UVM Health primary care offices, which allows our trained counselors to identify and intervene with patients using tobacco, alcohol or drugs at risky levels.

Our SBIRT program offers free individual behavioral health counseling to those identified as being at risk for OUD. Our counselors work closely with your primary care provider in order to coordinate your care and support the changes you desire. When a referral is necessary, your counselor will keep in contact with you and your doctor to offer ongoing support and continuity of care.

As part of a health system anchored by an academic center, our physician-leaders have a rich history of introducing research and innovation to improve patient care.

Your provider may talk with you about participating in a clinical trial or research study. Participation is entirely voluntary and can give access to new care methods before they are widely available.

If you are eligible for a specific trial, your provider will explain the benefits and risks of participating and the steps for enrollment.