Date of Completion


Thesis Type

College of Arts and Science Honors



First Advisor

Dr. Cheryl Morse


Vermont, opioids, health geographies, oral history, geographies of care


According to the Center for Disease Control and Prevention, the United States has lost more than 400,000 people from opioid-related fatalities since 1999. The federal government has been slow to respond to this crisis which has prompted local communities to form grassroots networks of care to save the lives of their residents. In 2018, the Department of Health reported that there were 110 opioid related fatalities in the state of Vermont. This number of deaths in the sparsely populated, rural landscape of just over 623,500 people has a profound impact on communities across the state. Vermont is unique among other rural states struggling with this epidemic in its proven ability to mobilize, most notably through the state’s Hub and Spoke Model for increased access to medication-assisted treatment and early adoption of harm reduction services. This thesis explores the historic and social construction of opioid use disorder care networks in Vermont using archival and oral history methods. Major geographic themes that emerged in the research include the epidemic’s disruption of the Vermont ideal, rural geography’s role in the production of a new care model, the continued spatial discipline of opioid use disorder care, and the role of storytelling in altering Vermont’s imagined geographies of opioids. This research demonstrates the importance of oral history as a method for understanding the social geography of care in Vermont.