Rides to Recovery: Accessing Substance Use Disorder Treatment

When Shaun was in addiction, he says he had no sense of responsibility. “I had lost hope and burned a lot of bridges,” he recalled. “I really got tired of living like that; I finally reached my rock bottom.” He began attending the intensive outpatient therapy ordered by the court, 3 hours/day and 3 days/week. But attending these sessions presented a challenge: Shaun had lost his driver’s license and car as a result of his addiction, and lived in the rural Upper Cumberland Region of Tennessee with few transit options that could meet his needs.

A Yale School of Medicine study has found that a longer travel time to substance use disorder (SUD) treatment may have serious implications for treatment and recovery. These longer trips are especially prevalent in rural counties, such as those comprising Shaun’s area of Tennessee, where there is an overall poverty rate of 14.4%. This area is also vastly underserved in the realm of substance use disorder (SUD) prevention, treatment, and recovery service providers and resources.

Even when rides are available in such rural areas, the rides alone may not be enough. Sometimes an individual battling addiction will be on the fence about confronting their addiction for the first several months of their treatment. One Tennessee counselor shared a story of a person literally jumping out of the vehicle taking them to treatment at a stop sign, as they remained so conflicted about choosing the treatment journey. They often need more from the driver than a ride.

To address this, the Upper Cumberland Human Resource Agency in Upper Cumberland, TN began its Ride to Recovery service in 2022. However, the service struggled with drivers, especially after hours, and in their success rates with riders. UCHRA then applied for and received a 2023 grant from the federally funded National Center for Mobility Management (NCMM). With the grant funds, UCHRA was able to incorporate drivers who were state-certified peer recovery specialists (CPRS) into its Ride to Recovery program. A CPRS — one who has lived experience, is trained to offer peer support, and has a working knowledge of local recovery resources—can make all the difference. They are able to notice red flags of a possible relapse and intervene in a compassionate way to guide the participant to the appropriate help and resources.

Shaun was able to connect to the program. “UCHRA has provided me with a ride to and from my intensive therapy,” Shaun explained. “I looked forward to the rides because the drivers were encouraging me. I didn’t have to explain anything but they knew they were helping me.”

UCHRA’s Ride-to-Recovery program is run through UCHRA’s public transit division. It supports individuals in early recovery by providing 90 days of transportation to treatment, meetings, mental health or probation appointments, and other recovery-related activities, all at no cost to the participants. Trips are provided during regular transit hours, and as much as possible, outside regular public transit hours and in response to last-minute requests. The UCHRA team knows full well that once an individual decides to seek treatment, the window for their actually going through with this decision is very limited and needs to be accommodated immediately.

Within the scope of the NCMM grant, Ride-to-Recovery has provided 904 trips to 204 riders, covering over 25,000 miles and 430 hours of transportation. Among these, 93 riders have become repeat users, highlighting the program’s effectiveness and reliability. Overall, the rides have enabled several individuals to complete intensive outpatient program meetings and access other essential recovery services.

Ryan Henry, the mobility manager coordinating the project, stated, “The success of the program lies in its ability to tailor transportation services to meet the unique needs of each individual. With staff expertise and lived experience, we ensure empathy and understanding are at the forefront of every trip, fostering trust and rapport among our riders.”

And, in the words of one of the CPRS drivers: “Anyone could give someone transport to detox or for treatment services; this is true. But I had a client I picked up on July 18th and when I arrived she was dead set on changing her mind. This moment was an opportunity for me to tell her my story and let her know that I was there in her shoes and that it was scary. It was more than just a transport, it was being able to connect with people and give them hope for a future that doesn’t involve coping with drugs.”