Bridging the gap between shelter and treatment
Vermont has made meaningful progress in addressing substance use disorder, including the development of recovery housing models and a broader system of care that emphasizes coordination between housing and treatment. However, a critical gap remains, particularly for individuals experiencing homelessness. Across the state, individuals living in shelters often face significant barriers to accessing consistent and timely substance use treatment. While shelters may provide safety and temporary stability, they do not consistently offer integrated or on-site recovery support services.
As a result, individuals who are actively seeking help may remain disconnected from the very services that support long-term recovery and housing stability. I am aware of this gap not only through my training as a social work graduate student, but also as a person in long-term recovery who has experienced periods of being unhoused. These experiences, combined with my work in the field, have made it clear that individuals are not invariably unwilling to engage in treatment, but are too often unsupported when they are ready.
This gap is especially pronounced in rural areas, where transportation challenges, workforce shortages, and stigma further limit access to care. Research has shown that individuals experiencing homelessness face substantial barriers to treatment access, which are associated with poorer health outcomes and increased challenges to recovery (Assaf et al., 2025). There is an opportunity for Vermont to strengthen its approach. Policymakers should consider requiring or meaningfully incentivizing shelters that receive public funding to provide access to substance use disorder treatment, such as on-site clinical services, embedded peer recovery support specialists, or formal partnerships with licensed providers.
My argument does not mandate treatment or remove personal choice. It is about ensuring that when individuals are ready and ask for help, that help is accessible to them, where they are, when they need it. Effective recovery systems meet people where they are, not where we expect them to be. Strengthening the connection between shelter services and treatment is a practical, humane, and evidence-informed step Vermont can take now. With thoughtful policy, Vermont can continue to lead in building a more responsive and effective system of care, one that recognizes recovery as both possible and worth supporting at every stage.