In Vermont, recovery centers fill gaps in system

Last modified: Friday, July 10, 2015
Here, there are no clinicians administering Suboxone or methadone. No requirements to participate in a 12-step program. No judgment, however, if you happen to be in one – or interested in joining.

Instead, in this former pet store at the edge of Barre – a Vermont town of about 9,000 in the middle of rolling hills, a few miles away from the state capital – there’s a pool table and a communal kitchen. There are couches and a deck of cards. The walls and tables from the front entrance to the sprawling community room are lined with signs and brochures and other pamphlets about a free health shuttle, a cooking academy, a therapeutic yoga class, an adult education program, a list of resources for drug and alcohol addiction. There are a handful of staffers who sit ready to welcome whoever walks through the front door with a conversation about what help they might need and where they might be able to find it. There’s one part-time staffer, in particular, who serves as a bridge between this space and clinical treatment options for opiate addiction.

This is the Turning Point Center of Central Vermont, one of 11 such “recovery community centers” that make up the Vermont Recovery Network. The network was born from a desire to offer a safe, sober space for people at all stages of recovery from alcohol or drug addiction, not just those who were involved in Alcoholics Anonymous or other programs. It remains a work in progress, and its leaders are continuing to refine not only how it works but also how to measure that it is working.

But the centers have attracted attention, in Vermont and beyond, for their attempts to fill gaps in the space between addiction and sobriety – by serving as a starting point for people who want help recovering from addiction, but might not know where to begin.

As New Hampshire grapples with its own addiction crisis, those calling for more emphasis on recovery services might not have to look farther than this network on the other side of the Connecticut River for inspiration.

A supportive, sober 
social space

Vermont, like New Hampshire, has been grappling with alcohol and drug abuse for decades. A 2001 legislative report began: “Substance abuse and addiction is a public health problem the people of Vermont cannot afford to ignore or underestimate.”

One paragraph in that report pointed to The Turning Point Club in White River Junction, which had existed since the 1990s. The club, the report noted, hosted 12-step meetings, conducted community outreach programs and hosted a library, a recreation room and child care space.

“Programs such as these merit our encouragement and support,” the report read. “They are examples of how we can realize a significant return on a modest investment.”

That Turning Point Center was the birthplace of the state’s recovery network as it exists today.

Mark Ames, the network coordinator and a former official with the bureau of alcohol and drug, said the leader of the White River Junction center, Mark Helijas, asked the legislature to fund something that would be kind of like an Alcoholics Anonymous club for more than just members of Alcoholics Anonymous. Eventually, the idea of a recovery community center was pitched – something that would be “open to all people across the recovery spectrum.”

The state’s 2002 appropriations bill included $90,000 from the state’s tobacco fund for “the establishment of community recovery centers,” with instructions to the state’s division of alcohol and drug abuse programs to “contract with one or more experienced recovery centers to develop at least three other recovery centers located around the state.”

Today, the 11 recovery centers throughout the state operate as independent nonprofit organizations under the oversight of the Vermont Recovery Network. For the 2016 fiscal year, the centers are on track to receive a collective $1.17 million in state funding.

Thanks to a $100,000 grant from the Substance Abuse and Mental Health Services Administration, the network has been able to hire one part-time employee at each location who focuses solely on helping people who are “seeking or receiving” medicated-assisted opiate addiction treatment.

With additional state funding in recent years, the centers have been able to add staff members and pay existing ones for more hours worked. (For example, Robert Purvis, the director of the Turning Point center in Barre, had been working full time but was only paid for about 30 hours per week.) The additional funding, according to a report Ames prepared for the legislature earlier this year, has also supplemented evaluation and research, as well as equipment and maintenance costs at the centers.

“We’ve been kind of punching above our weight for a while now, doing more than we could really sustain to try to prove what we were doing was worthwhile,” Purvis said of the centers’ sparse financial resources. “And it’s been a really exciting trip, you know, but we’re all kind of tired.”

The network also relies heavily on volunteers. According to its annual report, the estimated value of “donated volunteer time” accounts for the largest portion of its “funding” – estimated to be some $1.06 million, or 38.1 percent. State recovery center grants valued at $1.04 million make up another 37.6 percent of the funding, while local community support is $402,814 or 14.5 percent. Additional state funding and SAMSHA support make up the remaining 9.8 percent, at $271,700.

These funds, the networks’ leaders argue, are worth the payoff in the long run – financially, if you compare to the costs associated with incarcerating someone or treating them in a hospital after an overdose, but also in a broader sense.

“If you do this right, it’s not just about being a do-gooder,” Purvis said. “It’s, hey, we’re saving money, and we’re also repairing communities.”

Finding the answers

Each center differs slightly in the services it offers, depending on the needs or resources of each surrounding community, but the core mission remains the same across all locations: a safe space where people can drop in and find someone to talk to about their options in dealing with an addiction.

“The first thing we offer is that if you’re a person who wants to be in recovery, we will support you, individually,” said Purvis, who is also in recovery himself from alcohol dependency. “We can do that casually – a lot of it, for me, is that people come in and just want to talk, so they sit down and I talk to them for an hour or two. And maybe that’s the only time they’ll talk with me. Maybe they want to continue to do work on things, and we might get into a more formal kind of relationship.”

That more formal relationship often comes in the form of something called “recovery coaching,” which differs from traditional therapy or “sponsor” approaches. The coaches – some of whom have been through the recovery process themselves – use a question-driven technique to help the other person define goals that might assist them in putting certain parts of their life back on track. That could mean connecting with therapy or clinical services, but it could also mean figuring out other elements that bring the kind of stability that can help bolster someone’s recovery: securing a place to live, repairing frayed ties with family or friends, finding a steady place to work, and so on. The centers are especially invaluable for those whose challenges go beyond addiction alone, Purvis explained.

“The more pieces of a life you have together, the less you may feel the need to come here,” he said.

The goal isn’t to tell people what to do. Instead, it’s to help guide them toward finding their own answers.

“We operate from the premise that the person has the answers to their questions inside themselves, and the knowledge that the most convincing voice a person hears is their own voice,” Purvis said. “So what we do is – through questions and occasional comments – we get them to think through and articulate what it is they’re doing, what they want to do and how to get there, and what they need to do.”

That process serves a few purposes. It can help the person who’s pursuing recovery to connect with needed social or clinical services, but it can also help them connect with another individual – something that can be particularly powerful during the recovery process, according to Purvis and others speaking from firsthand experience.

The recovery centers help serve as a forum for new social connections in other ways, too. Many of them offer space to support groups – including Alcoholics and Narcotics Anonymous – but they can also give people a chance to just hang out in an environment where drugs and alcohol are not present.

“Moving from groups of people you’ve spent time with initially who are your using or drinking buddies to a new peer group” can be a major hurdle, Ames said. “You can’t make that life change without finding that new group of people to associate with.”

In Barre, the Turning Point center has benefited from its close proximity to other agencies and support services that deal with people who are struggling with addiction. So Purvis and the others who work at the center are, in many cases, able to refer people to a local clinic, a welfare agency or a library where they can get computer classes. And, now that the folks at the center have established relationships with those other agencies, the reverse holds true – the agencies can point people toward the recovery center as needed, too.

In Vermont – with its predominantly rural landscape and small, isolated communities – the centers can be somewhat of a place of refuge for people with few other options.

“When your life starts to go to hell, you can’t stay there. There’s no place for you to stay there,” Purvis said. “Little towns and villages don’t have social services. They don’t have transitional housing. They don’t have homeless shelters. They don’t have all the things that people who need social help, social support, go to.”

What’s next

There’s still work to be done, those in the recovery network agree. But they’re hopeful that a continued focus on providing ongoing support in the form of these community centers will help to further alleviate the state’s heroin epidemic.

Purvis, Ames and others said a political will to see the big picture on these investments is a crucial part of making a system like this work, in Vermont or elsewhere.

If New Hampshire were to embark on this path forward, it might not look exactly like what you see in Vermont. The state, with its more urban centers in the south, might need a different model to support larger populations in certain regions. Still, Vermont recovery advocates said the key is to focus on building these centers from the ground up, not the top down. Gather those who have a stake in this issue, and shape the center around what best suits the surrounding community, the Vermonters advised. The needs of Colebrook, for example, are presumably different from the needs of Concord.

As the Vermont network grows, Ames said it faces its own challenges in making sure a more structured system doesn’t drown out this peer-driven approach.

“We don’t want to have it get so complicated that it takes the nature of having someone helping another away,” Ames said.

“A key is going to be to identify and bring together the community of people who are committed to peer-based recovery, who can see beyond their own pathway to recovery to see that there are other pathways possible,” Purvis said.

And indeed, he said, neighboring states like Vermont – among New England neighbors that operate recovery community centers – can offer a blueprint. It might not work to copy another state’s model exactly, but still, Purvis said, “New Hampshire shouldn’t try to reinvent the wheel.”

(Casey McDermott can be reached at 369-3306 or cmcdermott@cmonitor.com or on Twitter @caseymcdermott.)