How University of Vermont’s Stacey Sigmon is using technology to fight opioid addiction

The rates of opioid drug abuse are similar in rural and urban areas, but overdoses and deaths are more frequent in less populated regions, where access to treatment lags. Stacey Sigmon, a director of Vermont’s largest outpatient opioid treatment clinic, has developed a program that improves outcomes. A key factor is ensuring that patients can get a regular, monitored dose of buprenorphine, which is similar to methadone but has fewer barriers for prescribing (methadone for treating addiction is available only in liquid form and through designated clinics, while buprenorphine pills can be prescribed in primary care offices). Each month, patients receive an automated medication dispenser that unlocks a dose at scheduled intervals. Participants get daily check-ins through a voice-response phone system, and can be called in for surprise “spot checks.” In a two-year pilot, the protocol reduced injection drug use and symptoms of anxiety and depression compared to controls, and 99% of patients stuck with their medication regimen. Last September, Sigmon was awarded a $6.6 million HRSA grant to open the Center on Rural Addiction, which will train healthcare providers in rural Maine, New Hampshire, and Vermont to treat opioid addiction. “We need more people to get certified to prescribe,” Sigmon says. “Some providers are reluctant—they’re concerned about the reliability of patients following through.” As more doctors fold telemedicine into their services in the wake of the COVID-­19 pandemic, “technology-­assisted drug treatment holds immense promise beyond the rural population.”