Medication and Recovery: Doctors Say Access to Critical Addiction Care is Difficult in Appalachia

Clean Slate Clinic is an in-home detox service that helps people receive a medicated detox plan including pharmaceuticals and vitamins, as well as daily telehealth sessions, rehabilitation support and check-ins. These detox services are currently undergoing a trial period that will tailor the program according to the unique needs of people in more rural and remote settings.

West Virginia University and Monongalia County's intensive, clinically-integrated harm reduction model and Ohio University and Athens County's community-centered, peer-support program offer two distinct approaches to combating the opioid epidemic in Appalachian communities. Both programs leverage harm reduction practices and have seen significant decreases in overdose deaths.

Project CARA (Care that Advocates Respect/Resilience/Recovery for All) supports pregnant and parenting people with substance use disorders, providing healthcare, addiction resources and obstetrics care in one spot. The program's hub-and-spokes model makes care more accessible, especially for those in remote areas. Data from the Project also indicates that participants of the program are more likely to attend prenatal and postpartum appointments than those outside of the program.

First Day Forward provides support and assistance to people with substance use disorders who are reentering the community after incarceration in seven rural counties. The program is driven by peer-support specialists who have lived experience to provide trusting support to those seeking assistance. The program has been shown to work as the recidivism rate for those who’ve successfully completed it has dropped to 23.5%, compared to 53.2% in a nearby county.

Agencies like the SHARE Center are beginning to hire peer support specialists, who are individuals who have lived experience of recovery from mental health conditions and substance use disorders. Peer support specialists provide non-clinical, strengths-based support and build trusting relationships with those in need of care. Since the COVID-19 pandemic, demand for peer support specialists has grown exponentially and reports show that working with a peer support specialist can improve health outcomes and quality of life among other benefits.

Merging accountability with treatment promotes recovery for those charged with drug possession. In Franklin County, Ohio, the municipal court system operates a program called Helping Achieve Recovery Together. The court recovery program provides a two-year track for participants to receive mental health support from peers and the courts, with the goal of moving them from the criminal justice system and into treatment.

The hub-and-spoke model allows local partners to provide individuals with access to resources earmarked specifically for opioid addiction treatment. The system of care, which uses regional clinics and non-profits as access points to treatment, has already proven effective in Vermont. Currently, a similar program is assisting individuals suffering from opioid addiction receive the help they need through entry points at nonprofits like The Doorway office at Harbor Homes.

Businesses across New Hampshire are contributing to the fight against the opioid epidemic by increasing efforts to recruit and support employees in recovery from addiction. Strategies include outreach to hire more people in recovery (with possible tax incentives pending as well) and training for workplaces on how to better support people who are struggling with addiction, either for themselves or a loved one.

Anchor Recovery is a government-funded program that hires former opioid users to reach out to addicts. They’re called “recovery coaches.” The idea is to use their former experiences with addiction as a source of connection with opioid addicts. So far, the program has helped an estimated 400 people get treatment. “I have been in this room. I have been in your position. I know exactly how you feel at this moment.”

More lives are being touched by sorrow as the opioid crisis continues to escalate. For mothers of addicts, recovered addicts, and addicts themselves, programs like Pathways to Housing and Prevention Point are bringing together this community in a effort to heal.