Join us for our 30th Anniversary Open House! Stop by the DayOne Program on Monday, November 13, anytime 3-5pm, at 1 South Prospect, St. Joseph Level 3, to help us celebrate 30 incredible years of treating substance use disorders within our community. Enjoy refreshments, meet our team and discover what DayOne is all about! Learn more >

This year, DayOne, the substance abuse disorder clinic at the University of Vermont Medical Center, turns 30 years old. Our services, our roles, and our patients have changed in the past 30 years. Here’s how, and here’s what the future looks like.

Where it all started

DayOne started in 1987 when we noticed patients coming to the hospital with substance-related problems. There was a need to take care of the special needs of these patients. As a result, Dick Casey, the first director of DayOne, got “a certificate of need” from the State of Vermont. In the summer of that year, the program launched and started accepting patients.

We were originally located at 56 West Twin Oaks Terrace, South Burlington, Vermont. In order to be closer to psychiatric services and research opportunities, DayOne relocated to its current location at One South Prospect Street in 2006.

Substance abuse: What has changed in 30 years

Initially, DayOne was a 25-day intensive program. We met with patients in the evening for five days a week for four hours. One of the five weeks was dedicated to including family members.

Over time, the program changed to meet the needs of patients and family members — and what was being reimbursed by insurance carriers. DayOne is now in a daytime format. This allows for the inclusion of psychiatric care. The treatment of co-occurring substance use and mental health disorders was expanded to include a diagnostic evaluation and medication management. It also includes follow-up care by a psychiatrist who works collaboratively as part of the clinical team.

The rise of co-occuring disorders

We noticed that our patients have co-occurring disorders. As a result, we treat them for substance use disorders as well as mental health issues. For example, a patient may have a substance abuse problem as well as depression.

DayOne worked cooperatively with HowardCenter to co-facilitate the area’s first co-occurring disorders Intensive Outpatient Program (IOP) until 2009. This began the dismantling of silos that separated substance use disorders and mental health issues.  DayOne currently has two IOPs, a morning and an afternoon, that treat substance use disorders along with co-occurring disorders in one setting instead of sending patients to different locations for help.

My personal story

I have been a part of DayOne’s evolution for the past 28 years. Initially hired as a family therapist, my role changed over time. I now provide direct services for three levels of care:

  • Level III is the Intensive Outpatient Program which lasts for one month;
  • Level II is step-down care for ongoing stabilization, which meets two times per week for six weeks; and
  • Level I is the continued care group meeting once per week for a minimum of three months and up to twelve months.

I am a first-person witness to the development of the addiction treatment field. Thirty years ago, addiction treatment had little credibility. Many good hearted and well-intentioned people entered the field after they successfully became sober. They did not necessarily have the licenses or degrees to treat patients. They wanted to help others achieve what they had — a clean and sober life. Much has changed.

Treatment now, and where we must go

In these more advanced times, substance use disorders have gained parity with mental health issues as a public health issue. Insurance companies may no longer discriminate between these health conditions. Additionally, colleges and universities offer degrees in treating addictive disorders and mental health issues.

The State of Vermont licensing board has addressed the need to streamline the process for individuals to become licensed or certified to offer treatment. The problem of opiate/heroin use problems has been in the news for several years now. Addictive disorders and mental health issues are a part of our community. The shame and stigma associated with alcoholism, addiction, and mental health problems still exists. Fortunately, we have help available by trained professionals to assist people on their journey back to health.

I have seen the benefits of recovery in patients and families for nearly 40 years. It is a joy to see people reconnect with themselves, their families, their communities, and sometimes their God.

Denis Dees, MA, LADC, NCACII, is a mental health clinician at the University of Vermont Medical Center.

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