Offering free rides could help people recovering from addiction

CONNERSVILLE, Ind. – Charmin Gabbard cares deeply for people struggling with addiction because it’s a struggle she can relate to.

In her twenties, Gabbard had three DUIs in five years. Two of these violations resulted in prison sentences. She was eager to change her life.

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But when she was released from prison in 2015, she had been banned from driving due to her previous DUIs. And she lived five miles from Connersville, a rural town in eastern Indiana. When she wanted to attend recovery meetings, or even run errands, she had to hitchhike with a family member. Or she would run away.

“And then after a while I bought a bike,” Gabbard, 48, said. “It was like a hundred and some dollars – the best investment ever.”

Gabbard eventually moved to town, but had to find jobs close enough to walk there. Gabbard has two children, and when her youngest son started middle school, she had to move closer to school so he could participate in sports and other activities. She had to move again when he started high school.

In addition to her children’s schedules, Gabbard had her own commitments: probation appointments, visits with mental health providers, and meetings to purchase insurance and obtain other social services. Gabbard said transportation is a huge barrier for many people with a history of substance use. Not being able to get to where you need to go makes it difficult to maintain recovery.

“Without having that ability to get to that appointment, then you have that fear of – I just raped. Or I miss a date with my kids, I let them down,” Gabbard said. “So this cycle of guilt and shame and regret and feeling like a failure and then all these things you never thought about are right there, right ahead. And so it’s easier to give up.

The idea that lack of transportation can affect a person’s ability to access health care has captured the attention of policymakers in recent years. A 2017 federal survey found that 4% of people under age 65 enrolled in Medicaid reported delay medical care because they lacked means of transport. The discoveries led at least 35 states attempt to solve the problem by covering ride-sharing services for medical appointments.

Dr. Paul Joudrey is a primary care physician and addiction medicine specialist at the University of Pittsburgh. He said the lack of transportation for all of life’s needs overlaps and can affect someone’s recovery.

“When people talk about transportation, it’s not just about transportation to health services, but transportation to all the important things in their lives,” he said. “Get to work, babysit, go to the grocery store.”

Those on the front lines of Indiana’s addiction crisis are taking steps in that direction.

Free rides for all aspects of life in recovery

A few years ago, Indiana focused on the transportation needs of people in addiction recovery and started a partnership with Lyft to provide free rides for people to and from drug treatment and recovery programs. drug addiction.

The Indiana Recovery Network — a statewide collaboration of recovery organizations — has expanded the state’s efforts to provide free rides to recovering individuals through Lyft. The program is available to anyone actively engaged with one of Indiana’s recovery networks 20 regional recovery centers. Rides are free for everything as long as it relates to the four pillars of recovery: home, health, community and purpose.

“It can be to and from jobs, school … things like that,” said Heather Rodriguez, who runs the network. “Even though, you know, someone has to get the kids to daycare before they go on a date or a job.”

Rodriguez says more than 300 people have taken advantage of the free rides so far – and many say they appreciate the service.

It is too early to know whether carpooling programs increase a person’s likelihood of accessing treatment or remaining in recovery. But studies on barriers to recovery suggest that transportation issues can prevent access to drug treatments. Joudrey at the University of Pittsburgh studies access to methadone, a drug used to treat opioid use disorder.

Joudrey said methadone can only be prescribed in opioid treatment programs. But he said there were not enough clinics. In Indiana, the Family and Social Services Administration oversees 23 clinics, which is fewer than the federal Substance Abuse and Mental Health Services Administration reports for states neighboring Indiana. According to SAMHSA, Illinois has 89, Kentucky has 31, Michigan has 50 and Ohio has 112.

And for some, opioid treatment programs are difficult to access.

“Particularly in rural communities, transportation is very often presented as a challenge,” Joudrey said.

In a 2019 study, Joudrey analyzed travel times to opioid treatment programs in Indiana, Kentucky, Ohio, Virginia and West Virginia. The study found that travel times to the nearest opioid treatment program in rural counties were longer than those in urban counties.

Joudrey said the lack of clinics, combined with transportation barriers and policies surrounding methadone prescriptions, can make it difficult for someone in a rural county to access medication.

“They should try to find the nearest methadone clinic, which can often be an hour or more away,” he said. “They should either not work because they have to drive an hour round trip six days a week in order to get this drug administered in person for the first 90 days of treatment, which means everything else in life is sort of set aside so that you can just get treatment.

Joudrey said that for these reasons, some people in rural communities might not stick to drug treatment.

“They will try, but they won’t last very long in treatment because the barriers will eventually cause them to throw in the towel,” he said. “And that’s a shame.”

Finding creative solutions for rural areas

Gabbard, who lives in rural Indiana, now runs Connection Cafe, one of the Indiana Recovery Network’s regional recovery centers. It’s a place where people recovering from substance use disorders can meet for support groups or just hang out. They serve hot meals throughout the week, provide clean clothes for those in need, and even provide showers.

“We’re just a community showing up as you are, and our greatest strength is loving people,” Gabbard said. “We’re not faith-based, we’re not 12-step. We are just an open community.

Gabbard said she loves Indiana Recovery Network’s Lyft program. There’s just one problem: There aren’t many Lyft drivers in his area.

“So it’s a great program, and I can’t say enough about it,” Gabbard said. “But with most of my counties, that doesn’t apply.”

Charmin Gabbard takes abandoned bikes donated by the city of Connersville and gives them to those in need. She keeps the bikes at the Connection Cafe. If a bike needs fixing, she’ll fix it before she gives it away. Darian Benson/Side Effects Public Media

Having a bike has made a huge difference in Gabbard’s ability to get around town. Last year, she learned that the city of Connersville was auctioning off found bikes and scrapping those that didn’t sell. She had the idea to reuse these bikes.

She asked the city if she could have them, and they said yes.

Gabbard keeps the bikes at the Connection Cafe. If a bike needs fixing, she’ll fix it before she gives it away. Ten people have accepted her offer for a bike, and she is happy to help more. She said the people she has helped have been grateful.

“Just to see the joy and as their road to recovery starts to accelerate, then you start to see their potential. It’s just amazing,” Gabbard said.

Free bikes and rides cannot entirely solve the problem. Better public transit in rural communities would help. And the researchers say policy changes – which lead to more treatment centres, closer to home and easier to access – will have the biggest impact.

This story comes from Side Effects Public Media – a public health news initiative based at WFYI. Follow Darian on Twitter: @HelloImDarian

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