The field of addiction care has seen several important developments in the past 10 years. Many, but not all, have been driven by efforts to respond to the nationwide opioid crisis. From my perspective, the most significant advance in the last decade has been the ‘hub and spoke’ treatment model — an innovation in addiction care that was started here in Vermont and has been adopted by a number of states across the nation.

In Vermont, nine regional hubs comprise a system of intensive medication-assisted treatment that offers daily support in the form of buprenorphine (or methadone) dosing and other services for people in recovery from opioid-use disorder. And with more than 75 spokes, trained healthcare providers across our state provide ongoing treatment in community settings (i.e., primary-care practices) for opioid-use disorder that is fully integrated with general healthcare and wellness services. Hub and spoke is an evidence-based model that has increased access to addiction care while lowering costs and producing great results. That’s significant.

In the next 10 years, it is my great hope that access to addiction-treatment services will be vastly improved and that the current opioid crisis will be on the wane. To reach this goal, we will need to simultaneously work on reducing the stigma around addiction and mental illness in general. Because the roots of stigma are old and deep, they act as a serious barrier to treatment. I think we can — and will — make great strides toward reducing stigma by 2030 through education and awareness. I think this will go hand-in-hand with greater scientific understandings of addiction as a brain-based disease process rather than a personal moral failing.

Dr. Louis Josephson is the President and CEO of the Brattleboro Retreat

This piece was part of the Healthcare News Vision 2020 article "Twenty Area Health Leaders on What's New - and What the Next Decade Will Bring" by Joseph Bednar published on December 17, 2019.