RUTLAND, Vt. — Block by block, this city in central Vermont has been fighting a heroin epidemic so entrenched that it has confounded all efforts to combat it.  On Cottage Street, the foot traffic is heavy in and out of No. 24 ½, a red two-story cottage set back from the street, where visitors stay less than a minute.  “We know what they’re doing in there,” Victoria DeLong, a longtime neighbor, said of the house, which the police say is owned by an absentee landlord and is a haven for drug dealers. “It’s like shopping at the Grand Union,” Ms. DeLong said. “In and out, in and out.”  Long visible at the street level in towns and cities across the country, the extent of the opiate scourge in rural Vermont burst into the national consciousness last month, when Gov. Peter Shumlin devoted his entire State of the State message to what he said was a “full-blown heroin crisis.” Much of New England is now also reporting record overdoses and deaths.  For some communities just starting to reckon with drugs, Mr. Shumlin’s words were a call to arms; for Rutland, they offered a sense of solidarity as this city of 17,000 moves ahead with efforts to help reclaim its neighborhoods and its young people, not to mention its reputation.  Rutland is a blue-collar town that rose to prominence in the mid-1800s with the excavation of nearby marble quarries and the arrival of the railroad. It stepped up its fight against heroin more than a year ago much the way addicts do when they try to stop using — by finally admitting the problem.  “There’s probably not a person in Rutland County whose life has not been affected by opiate addiction in one way or another,” said Jeffrey D. McKee, director of psychiatric services at the Rutland Regional Medical Center.  Since acknowledging the problem, the police have come to view addiction as a disease, not just a law enforcement issue, and have joined with social service providers to take a more data-driven, coordinated approach to homes with multiple problems. City agencies and residents have joined forces to revitalize their neighborhoods and eliminate blight.  Mr. Shumlin, a Democrat, has directed money to Rutland to help put in place a rapid intervention program to divert certain drug abusers into treatment instead of jail; if they complete the treatment, they will not be prosecuted, giving them a better chance of finding a job.  And the city has opened its first methadone clinic. Residents had opposed one for years, but the need became too acute. Now, those needing this form of treatment do not have to travel an hour away; the clinic, which opened in November, expects to serve 400 people by the end of the year.  One of the galvanizing events occurred in September 2012, when a man was inhaling gas from an aerosol can while driving on city streets. The police say he passed out with his foot on the accelerator and plowed into a bank of parked cars at 80 miles an hour, killing Carly Ferro, 17, a high school student who was leaving work.  It was a sign to many that the city had spun out of control. Rutland was still mired in the recession, burglaries were up and residents had little confidence in city institutions. The Police Department, for example, faced allegations of officer misconduct, including watching pornography at work.  “I was shocked at the depth of addiction here,” said James W. Baker, a former director of the Vermont State Police, who was brought in as police chief in 2012 to overhaul the department. “We had open drug markets going on in the street.”  And residents began to feel that the relaxed quality of life they cherished in Vermont was eroding.  “More and more people’s homes were being broken into, and that raised the alarm,” said Korrine Rodrigue, a public health researcher here.  It became clear that the city could not arrest its way out of addiction and that the police alone could not handle the multiple issues that were arising from drug abuse. And so the police began meeting with social workers, advocates for victims of domestic violence and child abuse, building inspectors and others.  “You can’t separate child abuse, domestic violence and opiate abuse because in many situations, it all resides in the same house,” Chief Baker said. “Now we’ll set up an intervention, not just wait for something to happen.”  They began mapping service calls to detect patterns. This led to the identification of a 10-block target zone in the city’s Northwest sector as its most critical “hot spot.” It receives 73 percent of all police calls, Ms. Rodrigue said, and 80 percent of burglaries.  In this zone, troubled houses are interspersed with those that are better kept.  During a stroll last week in the neighborhood, Sherri Durgin-Campbell, a volunteer community mediator who owns a well-tended Victorian, pointed out drug houses and also stately homes, including one for sale with a wraparound porch and fancy kitchen.  “That guy’s house has been on the market for over a year,” she said. “He was originally asking $300,000 but he would gladly take $99,000.”  The next day, the police conducted a drug raid on a nearby house, and a few hours later it went up in flames; investigators said the cause was arson but they have not determined the motive.  Many believe that part of the drug problem lies in the high conversion rate of single-family homes into multiunit rentals. The police say such units can be breeding grounds for drugs because of a well-established network, mostly of young women, who live in them and play host to out-of-town dealers. The dealers can make quick money by buying heroin in New York or Springfield, Mass., for as little as $6 a bag and selling it here for $30. About $2 million in heroin is trafficked every week in Vermont.  “If you’re a guy from New York, you can come here with 500 bags of heroin, sell it and sleep with three different women before you go home the next day,” said Chief Baker. Many of the women, he said, receive rent subsidies and food stamps and use heroin themselves. “The entire infrastructure is here for these guys to function, make quick money and leave,” he said.  To help focus more attention on the drug problem, Rutland applied a year ago for a $1 million federal grant from the Department of Justice, which it did not get. But it used the application as a blueprint to organize a communitywide coalition of concerned citizens and government agencies. It calls itself Project Vision and it complements the work of the police and social services.  The project’s overarching goals are to revitalize the 10-block target area, strengthen neighborhoods and reduce substance abuse. One of its first steps was to hold a block party last fall near where Ms. Ferro was killed.  “The point was to say, ‘This is our community and we’re taking it back,’ ” said Joseph Kraus, a former utility executive who is chairman of Project Vision.  Last week, after months of preliminary work, its members laid out specific goals. The police want to cut residential burglaries in half by the end of the year. Project Vision intends to reduce the number of blighted homes in the target zone to 15 from 21 by rehabilitating or razing six of them.  Two-thirds of the homes in the target area are multiunit apartments; Project Vision hopes to reduce that number to 50 percent within three years by buying back properties, perhaps having nonprofit groups restore them and resell them to owners who would live in them.  The frenzy of activity has inspired people like Linda Justin to do outreach on their own. Moved by what she said were “deteriorating” conditions, Ms. Justin, 65, has wound down her real estate business, cashed in her 401(k) and “adopted” a square city block, where she has been meeting residents every Sunday and “building relationships.” She offers to help clean up houses and was preparing recently to connect a young heroin addict she had met with the proper agencies for treatment.  Mayor Christopher Louras has been going door to door with work crews as they install brighter streetlights.  “A byproduct of that outreach is to talk to neighbors and let them know that we’re interested in their quality of life and giving them a greater sense of security,” said the mayor, whose own nephew was arrested in 2012 on drug-related charges.  These efforts are in their earliest stages, but burglaries and thefts in Rutland were already down slightly in 2013 from 2012, according to police figures, although drug offenses — and overdoses — were up.  Anecdotally, some business owners said they had seen little change, so far.  Paul Ross, for one, who owns Ramunto’s Pizza Shop, said he still sees drug deals “right in my parking lot.” And some residents of the target area resent that so many people from outside the zone are making decisions for their neighborhood.  Mr. Kraus, the Project Vision chairman, said the project was “a work in progress,” but he was positive about Rutland’s future.  “Nobody’s proud that we find ourselves in this circumstance,” he said. “But we confront our problems and deal with them.” He vowed improvements by this time next year.  A version of this article appears in print on February 28, 2014, on page A1 of the New York edition with the headline: A Call to Arms on a Vermont Heroin Epidemic. 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Rutland has begun an effort to attack a drug problem with social services, as well as with law enforcement.