Hub & Spoke (Medication Assisted Treatment for Opioid Addiction)

Welcome to the Hub & Spoke

Hub & Spoke is Vermont's network of Medication Assisted Treatment (MAT) that supports people recovering from opioid addiction. MAT can take place at an Opioid Treatment Program (OTP or Hub) or at an Office Based Opioid Treatment (OBOT or Spoke). The Retreat offers both.

Our Hub program is an OTP that provides intensive "daily dispensing" of buprenorphine combined with outpatient services often leading to the opportunity for take-home medication. We offer the treatment intensity and staff expertise that many people require at the beginning of their recovery, at points during their recovery, or all throughout their recovery. 

The Retreat's Starting Now MAT (SNMAT) is our Spoke. It serves people with less complex needs. Our SNMAT Spoke provides prescription buprenorphine for people who can start in an OBOT setting without needing the Hub's intensive service, or who are prepared to transition from our Hub. Like our Hub, the staff of our SNMAT spoke has the knowledge and expertise to support people in recovery so they can live a quality life free of active addiction.

What to Expect

Treatment Philosophy

We believe that recovery from addiction is a process of change through which individuals improve their quality of life by living a self-directed lifestyle consistent with one's personal values. We believe in patient-centered and evidence-based treatment. Our belief is that MAT for opioid addiction is the most effective treatment for most people. This is supported by the American Medical Association, the American Academy of Addiction Psychiatry, and the American Society of Addiction Medicine.

Hub & Spoke Fundamentals & Approach
  • The Retreat Hub provides inductions and daily dispensing of buprenorphine (Suboxone) and in some circumstances mono-buprenorphine. Hub offers a structure level of care for people who are either starting out in treatment or who have fewer supports along with more fundamental stressors (homelessness, for example). Hub is also designed for people who, for whatever reason, have difficulty managing prescriptions in an Office Based Opioid Treatment (OBOT) or Spoke. If we determine that methadone is more appropriate, we will assist in a transfer to another Hub. If OBOT is more appropriate, we can help people transition to our Starting Now MAT (SNMAT) Spoke program. 
  • Our SNMAT Spoke is a prescription medication program with individual and group engagement. Clients will meet with our prescribing provider, nurse case manager, and a licensed alcohol and drug counselor. Everyone starts weekly services in SNMAT Spoke and will eventually require less engagement depending on a person's individual needs and progress.

The Hub and SNMAT Spoke will provide support and skills to help you lead a healthier life. Our staff is committed to assisting you in developing the foundation of a strong recovery. We strive toward an atmosphere of respect, empathy, and hope for people whose lives have been adversely affected by addiction and  mental illness. Both the Hub and SNMAT Spoke programs provide group and individual therapy, community-based supports, and case management (sometimes referred to as health home services).

What is MAT?

Medication-Assisted Treatment (MAT) is the use of medications in combination with counseling and behavioral therapies to provide a "whole-patient" approach to substance use disorder treatment.

Program Hours

Hub Program Hours

Dosing: Monday through Saturday, 6:00 am - 9:30 am.

Counseling Services: Monday through Friday, 7:00 am - 3:00 pm.

Medical Services: Tuesday through Thursday, 7:00 am - 10:00 am.

SNMAT Spoke Program Hours

Direct Service Hours: Monday through Friday, 9:00 am - 5:00 pm.

For more information please call 802-258-3737

Intake Hours
Day Type Hours
Weekdays Phone 6:00 am - 6:00 pm
Weekdays Walk-in 6:00 am - 4:00 pm



For more information or to schedule a Hub & Spoke intake, please call 802-258-3737, available 24 hours a day.

Rapid Access to Medication (RAM)

People who need immediate help with opioid withdrawal can start with RAPID ACCESS to Medication at the Brattleboro Memorial Hospital Emergency Department (ED). The RAM at the BMH ED offers a 24/7 program with on-site buprenorphine induction and a next business day referral to the Brattleboro Retreat Hub. The goal of prescribing MAT in the ED is to reach people who need support with addiction recovery and need ongoing community treatment through Vermont's Hub and Spoke system.

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