BERLIN, Vt. » It was a long way down for Michael Kenney. As he neared the depths of heroin addiction, he stole prescription painkillers from his dying father, replacing them with Tylenol and leaving his father writhing in pain.

But when Kenney, 39, a wiry man full of nervous energy, tired last year of living so many lies, the road back could not have been more daunting. He sought help at a clinic here, only to discover that 200 people were ahead of him on a waiting list. It might be three months before he could get treatment, he was told. He was so discouraged that he continued taking painkillers and shooting heroin.

Then the phone rang. It was the clinic.

In 2014, Gov. Peter Shumlin devoted his State of the State address to what he called a "full-blown heroin crisis" in Vermont. The state Legislature enacted many of his initiatives, including giving one-time grants to addiction clinics to help them reduce the size of their waiting lists. The Central Vermont Addiction Medicine clinic here used its share of the grant to extend the hours of its lone doctor. Counselors reached out to people on the waiting list, moving active needle-users like Kenney and pregnant women to the top.

Kenney says he is alive today because of the clinic’s sudden ability to treat him. He has been clean for several months now and has a full-time job at a gas station, answering roadside assistance calls. He lives with his wife and children and is preparing to open a bank account for the first time.

"This is great, what the governor has done for us," he said. "He has saved a lot of lives. He definitely saved mine."

Officials here say they have made strides against addiction, a nationwide scourge that is particularly acute across New England. About 40 percent more Vermonters are seeking treatment for addiction today than a year ago, state health officials said.

"This is by no means ‘mission accomplished,’" Shumlin said. "We have a lot more work to do. But I’m proud of the progress we’re making as a state and as a region."

Still, a year after Shumlin’s call to arms, progress can be measured only in baby steps. As aggressively as Vermont is attacking opioid addiction, the number of deaths from heroin is going up.

Preliminary data from the state health department shows that the number of deaths involving heroin reached 35 in 2014, an increase of 66 percent from 21 deaths in 2013. (Deaths from prescription opioids stayed the same.)

It is a familiar story across the region. Middlesex County, Mass., which encompasses much of the metropolitan area outside Boston and is the most populous county in New England, reported 103 heroin fatalities in 2014, an increase of 212 percent from the 33 deaths reported in 2013.

Dr. Harry Chen, Vermont’s health commissioner, said the rise in deaths underscored the extent of the heroin problem.

"We’re just scratching the surface," he said. "Even if we almost double the number of people in treatment, for each person who seeks it, there are probably 10 others who need it."

Vermont has attacked addiction in several ways. Although the state has a budget deficit of about $100 million, Shumlin has gradually increased spending in fighting drug dependence. The state spent $8.7 million in the 2014 fiscal year for methadone and buprenorphine treatments at five regional centers that serve as hubs. It raised the amount to $13.3 million in 2015, and Shumlin has proposed allocating $18.2 million in 2016.

Vermont also now has a so-called good Samaritan law, which gives immunity to anyone who calls an ambulance if someone has overdosed. And it has made naloxone, which can reverse the effects of a heroin overdose, available to all emergency medical workers and at community clinics, and it can be bought over the counter at pharmacies.

The state has also put in place pilot programs in four counties to send addicts involved in minor crimes to treatment centers instead of jail; if they successfully complete treatment, they will never have the blot of incarceration on their records.

"There has been a cultural and philosophical shift in law enforcement in combating drug addiction in the last year," said T.J. Donovan, the state’s attorney in Chittenden County, which encompasses Burlington.

Another initiative was to give copies of "The Hungry Heart," an intimate documentary about addiction in rural Vermont, to every high school and middle school in the state. Bess O’Brien, who directed the movie, said that three dozen schools had requested presentations by the filmmakers, which led to frank discussions with students and parents about drug use.

Chen, the state’s health commissioner, said that it would take time for the full effects of the governor’s initiatives to be felt.

"You don’t see immediate results," he said. "But I still think we’re on the right track."

The Central Vermont Addiction Medicine clinic, where Kenney receives treatment, is a former diner with two house trailers on the outskirts of Berlin, a rural town nestled in the Green Mountains. With the infusion of cash from the state, the clinic, which dispenses daily doses of maintenance drugs like methadone, suboxone and buprenorphine, extended its doctor’s hours to 30 a week from 18, and it hired more counselors.

The clinic was able to admit many of the 200 people on its waiting list, and it whittled down that list to 12 people last summer.

But the funding lasted only three months, and the doctor’s hours had to be curtailed again. The waiting list has climbed back to 100 people.

"We can only do so many intakes," said Brenda Gagnon, director of the clinic. "For every three that we do a day, we’ve got six people calling who go on the wait list."

Although the funding was short-lived, it served as a catalyst for growth. The clinic now serves 370 people a day, up from 165 a year ago. This was the case with all five clinics in the state that received the one-time grants: All reduced their waiting lists, but all are now at or approaching capacity, said Barbara Cimaglio, the deputy health commissioner of Vermont.

Because of the rapid growth, the clinic here is urgently seeking a new location, with more space, and plans to hire additional medical employees.

"We’re seeing people less and less afraid to come forward and say, ‘I have an issue,’" Gagnon said. "At 5:30 in the morning, you’ll see people in scrubs. You’ll see the working man. You’ll see people with private insurance who have 40-hour-a-week jobs and three kids and volunteer for the PTA."

But she knows there are even more people who are not coming, and she hopes the governor will continue to press for public awareness and acceptance of the issues surrounding addiction.

"A lot of people still have that ‘not in my backyard’ attitude about clinics, but you know what?" Gagnon said. "Never mind your backyard. It’s probably in your living room. You just haven’t figured it out yet."

© 2015 The New York Times Company