Dawn Siebert JD works with the Vermont Bar Association's Drug Policy Project.

One big change was the opening of the methadone clinic in Burlington. I had a case, my first exposure to methadone as a treatment option, came with a client who was incarcerated but also on methadone maintenance, he had been going to Greenfield in Massachusetts.

He was thrown into jail for a 10 day sanction and was forced to withdraw cold turkey, which is pretty common in the corrections system. It is something which would be completely contraindicated in the community setting. It was a real education for me, I hadn’t encountered that before. It also educated corrections. Some folks from central office became converts to the idea of methadone maintenance as an acceptable approach to opiate addiction. So we won the case twice- we got two different orders from the court mandating that our client be able to take the methadone. And they discharged him instead of allowing him to take the methadone. It was important for the court refusing to allow that to happen. And I think the physicians from Massachusetts who testified were very persuasive. There were other cases that followed that. When the methadone clinic opened in Vermont, then all of a sudden methadone treatment was the standard in Vermont.

At that time, there was a state law which prohibited corrections from functionally being able to distribute methadone. Methadone maintenance is quite circumscribed in Vermont, even moreso than the federal reg’s. So what happened after the clinic opened in Burlington, the way corrections had done a 180 on the issue, they practically formed an arrangement with the clinic so that if someone comes in for a short hit- currently 30 days or less I think- and they are in good standing with the clinic in Burlington, they will be housed at the jail and transported daily to get the medication. Corrections became converted to the idea.

Which is pretty exciting, because there are very, very few- I can think of only one other state prison system which allows methadone maintenance and that’s Rhode Island. I could be wrong, I know some prisons in Maine allow for methadone, Riker’s Island does. The climate in Vermont is changing. And the advent of buprenorphine has helped with that.