White River Junction — A discussion of Vermont’s response to a surge in misuse of prescription painkillers and heroin nearly filled the seats of the new Barrette Center for the Arts Wednesday evening.

“Vermont’s response has been great,” said Mark McGovern, a Dartmouth-Hitchcock psychiatrist who is chief editor of the Journal of Substance Abuse Treatment.

McGovern described the state’s “hub-and-spoke” treatment system.

Six Vermont hubs provide treatment for patients with severe needs, McGovern said. An additional hub, the Habit Opco center in West Lebanon, which treats about 300 patients a day, sees many Vermonters, he said.

Spokes offer medication-assisted and other treatments in which teams of doctors and other providers support the recovery of less severely ill patients, he added.

No one treatment is effective for all substance misusers, said Renee Davis, director of substance abuse and criminal justice services at the Clara Martin Center, a Randolph-based behavioral health care center.

“We need to have many different avenues for these people coming through the door,” she said.

The number of Vermonters receiving methadone treatment increased from less than 1,000 in January 2013 to over 3,000 currently, McGovern said.

Housing remains scarce for patients who are seeking treatment for their addiction, Davis said.

“If they don’t have their basic needs met, they’re not going to be able to focus on recovery,” she said.

In Vermont, 108 people died of drug overdoses in 2015, including 76 deaths where prescription painkillers, heroin or fentanyl were factors, according to the state Health Department.

In New Hampshire, there were 437 drug overdose deaths, and fentanyl was a factor in a majority of them, according to the state’s Chief Medical Examiner.

The event was organized by VtDigger, a statewide news website, and sponsored by D-H and Blue Cross Blue Shield of Vermont.

Illness is a key element of understanding the opioid crisis, McGovern said: “Think about addiction as a chronic disease that affects the brain.”

“So much of addiction … has to do with filling a hole,” said Bess O’Brien, the director of The Hungry Heart, a film on the opioid crisis in Vermont. “We’re all looking for self-esteem in our lives.”

The final word belonged to Sarah Laros, a Hartford High School graduate who said she has not misused substances for nearly four years.

“I am not a bad person trying to get good,” she said. “I am a sick person trying to get well.”

Rick Jurgens can be reached at rjurgens@vnews.com or 603-727-3229.