Mobile addiction treatment clinic travels where it's needed
The trailer hitched to a Ford pickup is a XLR Hyper Lite, designed for family vacations and campgrounds.
But parked under a black, netless basketball hoop in an asphalt parking lot in Kittanning, it serves a very different purpose as an addiction recovery clinic.
One overcast August morning, Eric McFarren, 36, of Carrick hops out of the pickup and flips on a portable Honda generator. Inside the trailer, Amanda Cope, 38, of Monroeville sets up two laptops in the banquet seating area and a folding chair.
Cope is tall and gregarious, wearing cross earrings and a cross necklace. McFarren, a sturdy, soft-spoken veteran UPMC operating room technician, soon joins her inside and stacks boxes of a drug called Vivitrol on the windowsill.
Cope is the chief operating officer of Positive Recovery Solutions, a Washington, Pa.-based private clinic that specializes in addiction recovery services.
A year ago, she discovered that many of her clients were driving several hours to get there. So she had an idea: Take the treatment to them via a mobile addiction clinic that could travel to remote locations where people were not getting proper treatment.
She pitched the concept to the company's board of directors. A few weeks later, she went to an RV dealership with a cashier's check in hand.
Once considered a primarily urban narcotic, heroin's use has surged in rural counties across Pennsylvania. According to statistics reported by coroners offices statewide and analyzed by the federal Drug Enforcement Administration, an average of 43 out of 100,000 people died of a drug overdose last year in Armstrong County, where Kittanning is the county seat. In Philadelphia County, the most populous in Pennsylvania, the overdose death rate in 2015 was 45 out of 100,000.
Yet Armstrong County has 4.5 percent of the population of Philadelphia County in an area almost five times its size. In the other counties where PRS operates, Indiana posted a similar rate with 41 deaths per 100,000 people. Allegheny County recorded about 34 deaths per 100,000 people.
Cities like Pittsburgh or Philadelphia have well-established networks of addiction recovery services and public transportation systems that allows patients to get to and from clinics. In rural counties, there are fewer nonprofits and many counties have limited medical treatment options. People trying to kick addictions primarily rely on therapy programs such as Narcotics Anonymous or Alcoholics Anonymous or on risky opioid treatments, like taking Suboxone.
“The hardest problem we have is a lack of doctors that are interested in recovery and want to do that type of medical practice,” said Kami Anderson, executive director of the Armstrong-Indiana-Clarion Drug and Alcohol Commission. Anderson recalled doctors telling her that they don't want addicts “in their waiting rooms or offices.”
Cope's mobile recovery unit provides a specific and unique solution — medical treatment that's fast, flexible and largely discreet. The gray and white trailer looks like any other recreational trailer. Only the pickup carries signs indicating it belongs to PRS.
Around 9:30 a.m., the first patient arrives. McFarren pulls a bottle of water out of the fridge, grabs a urine specimen cup and races off to go speak with her.
A family using such a trailer might fill the fridge with soda, beer and other junk food. Here it's packed with bottles of water and Vivitrol, a drug that helps heads off relapses.
Earl Wack, 33, of Kittanning arrives about a half hour later for his monthly shot of Vivitrol. It works by reducing cravings and blocking serotonin receptors, which takes away the feelings of euphoria involved in using opioids or drinking alcohol.
Wack was hit by a drunken driver in 2009 while leaving work at a construction site in Kittanning. His back was badly injured, and he was prescribed opioid painkillers. He became addicted to OxyContin. When the pills became too expensive for him at $35 each, he turned to heroin.
This is his first attempt at getting clean. Wack wears long jean shorts and a long blue T-shirt. He has a tattoo on his neck that reads “God's favorite.”
“That's going to hurt real bad,” Wack said, watching Cope prepare the needle.
“I'm better than your last nurse,” she joked.
“That's what she said,” Wack replied with a chuckle.
Cope treats 20 patients this day when the trailer is parked in Kittanning. The trailer makes seven other stops across Western Pennsylvania.
McFarren, PRS' logistics director, takes the trailer out about two times a week, going as far as Meadville, Crawford County, and Altoona, Blair County.
Since opening the mobile unit last year, Cope has started to spend more time in Harrisburg negotiating contracts with state agencies and counties than in the trailer with McFarren.
“I put 5,000 miles on my car in the month of March,” she said.
She said she misses working with the patients primarily, but with the widespread interest in the program, PRS will grow exponentially in the next year. By the end of the year, it plans to have 18 other stops or fixed locations at other facilities across the state, in addition to several programs inside prisons.
Cope recently celebrated 10 years of sobriety. She recalled how she was inspired to start working as an addiction recovery specialist.
When she was 27, she was checked into a room alone at then-Mercy Hospital, sick with alcohol withdrawal. She could hear a group of nurses outside on a break laughing. One of the nurses asked the others to quiet down so Cope could get some rest.
That simple and small act of kindness “was the most profound moment of my life,” she said. “I realized I need to be that person in someone's life one day.”
Max Siegelbaum is a Tribune-Review staff writer. Reach him at firstname.lastname@example.org or 412-388-5803.