Special Interest Mobile Healthcare: Substance Use Disorder
Addiction mobile healthcare clinics provide another tool for lessening the effects of the opiate epidemic and other addictions. Canada and various US cities have legalized supervised injection sites, and there are mobile clinics fulfilling that role. Mobile clinics can also be used for public education or to treat addiction-related ailments. A mobile clinic is an excellent alternative should a permanent facility face local opposition.
Goals
- Provide a safe space for addicts to inject (in Canada and various US cities where legislation permits).
- Minimize fatal overdoses.
- Mitigate disease transfer related to addiction and needles.
- Provide wound care related to addiction.
- Provide public education around addiction.
Considerations
Services:
Supervised injection sites: In Canada and various US cities, where safe injection sites are legal, some mobile clinics are designed as supervised injection sites. They hand out clean needles, and provide booths for injections and recovery areas in the event of an overdose. Everything is stainless steel and hospital grade to minimize infection and disease.
Overdose care: Distribute Narcan kits to reverse the effects of an overdose away from the mobile clinic or administer Narcan in the event of an on-site overdose and call emergency responders.
Needles: Deliver clean needles to minimize the spread of infection and disease and collect used needles.
Wound care: Many individuals with opiate addictions have poor hygiene and troublesome wounds. Many also suffer from diabetes. Sanitizing and dressing open wounds, especially on the feet, mitigate the likelihood of gangrene, which is only treatable by amputation.
Public education: MADD (Mothers Against Drunk Driving) originally had mobile clinics to educate about the harmful effects of alcohol and alcoholism. It was especially effective with young kids, who are attracted to trucks and things on wheels. For teens, this route is more effective if you include film and music.
Referrals: In Canadian supervised injection sites, the diversion rate is poor. It’s not the silver bullet for getting users into treatment and recovery. But clinics should have referral options for those who seek assistance, and education about the possibilities of treatment and recovery.
Materials: Clean needles, simple surgical tools and dressings for wound care, educational public health materials, and information on addiction, treatment and recovery.
Staffing: A nurse, who is on hand to supervise the injections, deliver wound care, resuscitate if necessary and call 911; and a social worker, who can assist with the psychological needs and make referrals to treatment or related issues like mental health, housing, poverty.
Trust: This can take a long time to develop. Consistent visits will help.
Safety: Consider vehicle mounted video camera(s) for security purposes.
Parking: Can be challenging due to community resistance, which a mobile program in Canada solves by parking on government owned land and on the land of business owners committed to the cause. This clinic visits commercial and residential areas.
Resources
- Mobile Health Map
- The scope and impact of mobile health clinics in the United States: a literature review
Next Steps
- Become a member of Mobile Healthcare Association
- Review our start-up resources, some for members only.