Every September, communities and care providers across the nation,
including in the Northeast Kingdom (NEK) of Vermont, recognize National
Recovery Month, a time to celebrate the millions of Americans who are in
recovery from mental health and/or substance use disorders—and to
recommit to breaking down barriers to treatment.
This year’s theme, Recovery is REAL (Restoring Every Aspect of Life),
highlights the truth that recovery goes far beyond abstinence. It’s about
restoring health, a sense of purpose and overall wellbeing. But achieving
these goals often depends on one critical factor: access to recovery services.
Why Integrating Recovery Services into Primary Care Matters
Recovery begins with hope and the conviction that healing and change are
possible. Building on an individual’s strengths, readiness, and available
resources; recovery is a holistic process that extends beyond symptom
management to encompass the whole person.
For nearly 20 years, Northern Counties Health Care (NCHC) has embraced
holistic, patient-centered care through the integration of mental health and
substance use (behavioral health) services within their Primary Care
practices throughout Vermont’s Northeast Kingdom. Because of this,
NCHC’s Primary Care practices provide not only a medical entry point, but
also a cornerstone of recovery. NCHC’s Primary Care providers are often the
first and most consistent point of contact, ensuring whole-person care that
integrates physical health, mental health, social health, and substance use
support.
“I have heard for years, and from many patients, that it is reassuring to
know that we see them and care for them as entire beings, and not just as
patients with substance use disorder. And that it makes it comfortable and
convenient to receive all services in one place,” says Jeri Wohlberg, Family
Nurse Practitioner at Hardwick Area Health Center and NCHC’s Assistant
Medical Director.
“This program and the ones (who) run it, saved my life. I’ve never felt so
comfortable with a medical team before,” said a patient in recovery from
substance use disorder (SUD) with NCHC’s Hardwick Area Health Center.
Substance Use Disorder (SUD)
A substance use disorder (SUD) is a chronic but treatable medical condition.
It occurs when someone continues using alcohol, drugs, or other substances
despite harmful effects on their health, relationships, or daily life.
In 2022, more than 1 in 6 Americans aged 12 and older reported having a
SUD. SUDs can range from mild to severe and can affect anyone, regardless
of race, gender, income, or background.
Substances linked to SUDs include:
- Alcohol
- Cannabis
- Hallucinogens
- Inhalants
- Opioids (prescription and illicit)
- Sedatives, hypnotics, or anti-anxiety drugs
- Stimulants (like cocaine or methamphetamine)
- Tobacco/nicotine
Substance use disorders can happen to anyone. Some people begin using
substances to cope with trauma, stress, or mental health conditions. Others
develop SUD after being prescribed opioids for pain. Over time, substance
use can change the brain, creating strong cravings that drive continued use.
Treatment and Recovery
Recovery looks different for every person – there is no single “right way.” For
some, recovery may include counseling, medical treatment including medication, or peer groups; for others, it may involve faith, family support, or self-care practices. Often, it’s a combination.
Because SUD is complex and requires a personalized approach, NCHC
Primary Care teams provide a variety of options for patients including access
to compassionate and specialized staff to address many key components of
recovery:
- Behavioral health care and counseling staff, including psychiatry, for
support with related mental health needs, understanding triggers and
building coping skills, and encouraging patient participation in
meaningful daily activities—like work, school, caring for loved ones,
volunteering, or exploring creative outlets. - Community Health Workers and Peer Support Workers to connect
patients and families to community resources (housing, food,
transportation), facilitate access to social services, self-management
programs and peer support groups, and provide guidance and
encouragement. - Licensed medical Primary Care providers (Doctors, Nurse Practitioners,
Physician Assistants) to maintain a schedule of ongoing checkups and
treatment. Many are trained to prescribe medications that reduce
cravings or ease withdrawal like those used for Medication for Opioid
Use Disorder (MOUD) (formerly known as Medication Assisted
Treatment or MAT), or to provide referrals to specialized care when it
isn’t available right in the practice. - MOUD specialists to coordinate medical care, use of medications,
counseling and behavioral therapies, and support services to provide a
whole-patient approach to the treatment of opioid use disorder.
Reducing Stigma
People with SUDs often struggle to stop using substances, even when they
understand the risks, and even when services like those at NCHC Primary
Care practices are available. Overcoming SUD almost always requires more
than “willpower.”
Addiction stigma, the negative and unfair belief that those who develop
SUDs are morally weak and that they should “just quit,” often keeps people
from seeking help. Over time, stigma may become internalized and lead
people to believe that they are of lesser value or unworthy of help because
they can’t tackle SUD on their own.
Understanding SUD as a health condition—and not a personal failure—can
make it easier for individuals and families to access life-saving treatment
and long-term recovery. This understanding and compassionate
environment is one that NCHC Primary Care practices seek to cultivate.
“The research shows us that the biggest reason people don’t reach out for
help with substance use is stigma, and anecdotally, this is what I hear from
patients. It is both heart-breaking and affirming when patients say, ‘I wish I’d
done this 20 years ago.’ We still have a long way to go, but when I hear that,
I know that we have provided a safe space where people feel heard and
supported –and I know we’re on the right track,” says Brook Marcotte, RN at
Hardwick Area Health Center and NCHC MOUD Program Coordinator.
When this type of care is available, recovery is not only possible—it is
happening every day. “My MAT RN is amazing and is so helpful and kind,
and I believe she actually cares about my recovery. She is always advocating
for me, listens to me and helps me in any way that I need,” says a patient at
NCHC’s Hardwick Area Health Center.
Ready When You Are
Seeking treatment for substance use disorders can be scary and
overwhelming. The journey is easier with the right people by your side. At
Northern Counties Health Care, our award-winning team is here to support
you — without judgment, pressure, or stigma. As your local Primary Care
provider, we offer confidential, comprehensive care — no one in the waiting
room will know the reason for your visit. We’re ready when you are to
create a plan that works for you. Take that first brave step and visit
www.nchcvt.org, or call your local Northern Counties clinic in Concord,
Danville, Hardwick, Island Pond, or St. Johnsbury.
About Northern Counties Health Care:
Northern Counties Health Care (NCHC), Vermont’s first Federally Qualified
Health Center, was established in 1976. NCHC’s Mission is to provide high-
quality, accessible, patient-centered health care to the medically
underserved, 2,000+ square mile rural region of VT known as the Northeast
Kingdom (NEK). Annually, NCHC provides quality care to over 20,000
individuals; nearly one-third of the residents of the NEK. Over 64,000
encounters are made each year through a rural network of seven community
health centers – including two walk-in primary care clinics, three dental
centers, and a home health care and hospice division. All NCHC Health
Centers are Patient Centered Medical Homes, recognized by the National
Committee for Quality Assurance (NCQA). From preventative care,
gynecological care, chronic disease management, and behavioral health
services to dental care, physical therapy, home care and hospice, we provide
complete, compassionate care for the whole family, in our home or yours.
Learn more at www.nchcvt.org
The Health Resources and Services Administration (HRSA), Department of Health and Human Services (HHS) provided financial support for this article as part of the FY 2024 Behavioral Health Service Expansion (BHSE) grant. The award provided 76% of total BHSE program costs and totaled $600,000. The contents are those of the author. They may not reflect the policies of HRSA, HHS, or the U.S. Government.
