Across Vermont, a quiet but significant shift is reshaping how people access substance use treatment. As some private providers adjust or wind down their services, community-based organizations are stepping forward to fill the gaps and, in many cases, strengthen the system in the process.
Better Life Partners, a national online addiction treatment provider, ended its Vermont operations at the close of 2025 and stopped accepting new referrals. For people in active recovery, transitions like this create real vulnerability. Disruptions to medication-assisted treatment, including buprenorphine for opioid use disorder, can put people at risk of relapse and overdose. Continuity of care is not an administrative concern. It is a matter of survival.
Vermont’s community-based network recognized that risk and moved to absorb it.
Washington County Mental Health Services recently expanded its outreach capacity through its Center for Substance Use Services, hiring a new substance use clinician to join its mobile outreach team. That addition allows staff to meet people directly in the community, rather than waiting for individuals to find their way to a clinic. For people navigating housing instability, transportation barriers, or the paralysis that can accompany untreated addiction, that distinction matters enormously.
The expansion reflects a broader, coordinated effort across Washington County. The Central Vermont Prevention Coalition and the Rapid Access to Medication Assisted Treatment Coalition, known as the RAM Coalition, regularly bring together providers, advocates, and peer support specialists to review community needs, track emerging substance use trends, and keep recovery services both accessible and responsive. These groups had been anticipating changes in the treatment environment and planning accordingly.
Partners in that effort include Central Vermont Medical Center, BAART (the Washington County HUB), local primary care physicians, the Turning Point Center, and Washington County Mental Health Services’ Center for Substance Use Services. Because of that coordination, someone seeking treatment in Washington County can access medication for opioid use disorder almost immediately, through multiple entry points in the community.
That kind of rapid access is not common across the country. It takes deliberate infrastructure, sustained relationships, and a shared commitment to removing barriers rather than adding them. Vermont’s model, built on collaboration between community mental health agencies, outpatient clinics, peer-support networks, hospitals, and primary care providers, offers a practical example of what accessible care can look like when providers treat it as a collective responsibility.
Vermont Care Partners supports these agencies statewide, and VT Helplink continues to operate around the clock, connecting Vermonters to treatment providers across the state. For anyone unsure where to start, that 24/7 resource provides a direct line to available services.
The story in Washington County also points to something public health advocates have argued for years. Community-based care is not a backup plan. It is often the most effective plan. Peer support specialists who have lived experience with addiction, mobile clinicians who bring services to people rather than demanding people come to services, coalitions that meet regularly and adjust to real-time community data: these structures build trust and reach populations that formal systems frequently miss.
As the treatment environment continues to shift, driven by federal policy changes, funding fluctuations, and private provider decisions, the durability of any regional care system will depend on how well local partners have invested in those relationships before a crisis hits. Vermont’s example suggests that preparation is possible, and that it makes a measurable difference.
For students at Dartmouth and across the Upper Valley, this story has direct relevance. Many students come from communities where substance use disorder affects families and neighbors. Understanding how treatment access actually works, and who holds it together when larger systems falter, builds the kind of structural awareness that health and public health careers demand. It also makes clear that accessible care requires ongoing advocacy, not just good intentions.
The providers and coalitions working across Washington County are not waiting for conditions to improve on their own. They are building the systems that make improvement possible.
