$3.75M Grant Widens Long Island's Mobile Addiction Outreach
SAMHSA awarded CN Guidance & Counseling Services $3.75 million to expand mobile opioid treatment outreach and overdose prevention across Nassau and Suffolk.
Three million seven hundred fifty thousand dollars does not buy a cure for opioid use disorder. Spent the way CN Guidance & Counseling Services plans to spend it, the money buys something narrower and more concrete: clinician hours in a parking lot, a refrigerated cabinet inside a motorhome, naloxone in a canvas bag, and the diesel to keep two vehicles circling Nassau and Suffolk counties.
The Hicksville nonprofit announced Monday that the federal Substance Abuse and Mental Health Services Administration had awarded it $3.75 million to expand opioid outreach, treatment linkage and overdose prevention across both counties. There is no new building in the plan. The grant expands the organization's existing Mobile Recovery Unit — the "Hope Rides Here" fleet of a clinically equipped RV and a smaller service truck that has been parking beside libraries, food pantries and transit stops for several years.
The timing is not accidental. New York's overdose toll has fallen steeply, from roughly 6,630 deaths in 2022 to about 3,775 in 2025, a 45% decline state officials credit to settlement-funded treatment expansion, mass naloxone distribution and wider access to medication. What remains is the harder half of the epidemic: the people who have never touched the treatment system at all, and who are not going to walk into a clinic lobby to start.
What the Money Actually Buys
The award pays for staffing and mobility rather than real estate, which is the whole logic of the model. CN Guidance's unit typically carries a registered nurse, certified peer specialists who are themselves in recovery from a substance use disorder, and up to four clinicians at a time. The RV is fitted with an exam table, medical refrigeration for medication-assisted treatment, a work station, a restroom and a small waiting area. The box truck handles sites the larger vehicle cannot enter.
That staffing mix is deliberate. A peer specialist with lived experience can open a conversation with someone sitting on a park bench in a way a clinician holding a clipboard usually cannot, and the federal program language follows the same instinct: the work is described as identifying and engaging people with opioid use disorder, not waiting for referrals to arrive. The organization says it serves people 12 and older and their families in multiple languages, regardless of ability to pay.
Services on board run well past the opioid question. The unit provides behavioral therapies and case management, recovery support, overdose prevention education with naloxone distribution, tobacco cessation folded into substance use treatment, and screening and referral for infectious disease. Connections to medication for opioid use disorder — methadone and other FDA-approved drugs — sit on the same menu.
"Many people struggling with substance use face significant barriers that prevent them from getting the care and support they need," Mary Silberstein, a senior director at CN Guidance, said in the announcement. "By meeting people where they are and building trusted relationships within the community, we can connect individuals and their families to lifesaving prevention, treatment and recovery resources."
The organization's own materials frame the scale it is working against: one in five Long Islanders faces a mental health challenge in a given year, it says, and more than one in six residents aged 12 and older meet criteria for a substance use disorder.
Where the Vehicles Will Park
The grant names the kinds of locations the unit will target, and the list doubles as a map of where untreated addiction actually lives on Long Island: community centers, parks, transportation hubs, shopping centers, food pantries, libraries, health care facilities, Department of Social Services offices and probation offices.
Some of those are obvious. Food pantries and libraries are where people with thin margins already go, and neither requires an appointment or an insurance card. Transit hubs catch the commuter who is sleeping somewhere unstable. Shopping centers are where the pharmacy is.
Why Probation Offices Are on the List
The probation office is the entry that says most about how addiction treatment now works in New York. People under criminal justice supervision carry elevated rates of opioid use disorder and a compressed window in which to act on it — a missed appointment can become a violation, and a violation can become a jail cell where withdrawal and relapse risk climb fast. Meeting someone in the lot outside an office they are already required to visit removes a second trip, a second form and a second chance to reconsider.
Jeffrey Friedman, the organization's chief executive, described the award in terms of reach rather than capacity. "This federal investment allows us to expand our reach and bring critical services directly to those who may not otherwise receive care," he said. "We are grateful to SAMHSA for supporting this important initiative and helping us strengthen Long Island's response to the opioid epidemic."
Two Counties, Two Different Epidemics
Nassau and Suffolk share a highway network, a commuter railroad and a television market. They do not share an overdose curve.
State health department data for 2023 put Suffolk County at 418 opioid overdose deaths, a crude rate of 27.4 per 100,000 residents, down from 464 the year before. A broader measure in the same report — opioid overdose deaths combined with nonfatal opioid-related hospital events — separates the two counties more sharply still.
| County | Opioid deaths and nonfatal hospital events, 2023 | Rate per 100,000 residents |
|---|---|---|
| Suffolk | 2,746 | 180.3 |
| Nassau | 1,595 | 115.4 |
| Westchester | 1,227 | 123.8 |
| Bronx | 7,252 | 534.6 |
Suffolk's combined rate runs roughly 56% above Nassau's, and both sit far below the Bronx, where the same measure is nearly five times Nassau's. The gap is no mystery to anyone who works the eastern end of the island, where towns are farther apart, buses run less often, and the nearest clinic can be forty minutes away in good weather.
Both counties also sit inside a state that has spent heavily on the problem. New York has directed more than $500 million in opioid settlement funds toward treatment, prevention and harm reduction, and it has distributed naloxone by the million. Against those totals a single $3.75 million federal grant is close to a rounding error, which is the honest way to read it: this money does not buy scale. It buys presence.
The Travel Problem a Vehicle Solves
The argument for bringing treatment to people is easiest to make with a stopwatch. A study published in JAMA Network Open surveyed patients at a large multisite opioid treatment program in Washington state and found that the average round trip for a methadone dosing visit took 82.5 minutes and cost $15.80 in travel expenses. Individual trips ranged from ten minutes to five and a half hours. Only 55.1% of patients drove themselves; nearly one in five reported a disability that made the journey harder.
Those figures describe methadone specifically, and that matters, because federal rules still tie the drug to observed dosing at a certified opioid treatment program. A medication that must be swallowed in front of a nurse five or six days a week is only as reliable as the ride that gets the patient to the window, and the study's interviews made the collision plain: dosing visits competed directly with jobs, with children, with other medical care, and missing them raised the risk of returning to opioid use.
Nationally, only about a quarter of people with opioid use disorder received any medication for it as of 2022. That gap is not mainly a matter of willingness. It is hours, cars, childcare and the cumulative cost of a round trip that can run into the hundreds of dollars a month for someone working shifts.
Where Mobile Units Fit in Federal Rules
Mobile treatment is no longer an improvisation. Under 42 CFR Part 8, a certified opioid treatment program may establish "medication units," a category the regulation defines to include both brick-and-mortar sites and mobile units, from which medication for opioid use disorder can be dispensed away from the main clinic. A program must notify the federal government before opening one and comply with Drug Enforcement Administration requirements, but the pathway exists.
That regulatory shift is why vehicles like CN Guidance's can function as more than a referral table. The organization's fleet has been operating for several years; what the new award changes is how many days a week the vehicles roll and how far east they travel.
Linkage, Not Dosing
There is a limit built into the announcement that is easy to skim past. The grant, as described, pays for connections to medication for opioid use disorder — methadone and other FDA-approved drugs — not for dispensing it. Someone who walks up to the RV in a shopping center lot will not leave with a dose of methadone. They will leave with an intake appointment, a prescriber's name, a plan, or a referral to a program that can dose them.
For a lot of people that is the hardest step, and it is a genuine service. It is also not the same thing as a mobile methadone clinic, and the difference determines whether the unit closes the gap the travel data describes. Buprenorphine is the easier half: any DEA-registered prescriber can write it, and a unit with a nurse and clinicians aboard could plausibly start someone the same day. Methadone cannot move at that speed through a parking lot.
Whether CN Guidance will eventually seek medication-unit status for its fleet is a question the organization has not answered publicly. For now the model is navigation, low-threshold engagement and naloxone with a clinical team attached — high-touch, and dependent on the clinics it refers into having room.
What the Grant Does Not Fix
Capacity on the receiving end is the constraint nobody put money behind this week. The mobile unit sends people toward opioid treatment programs that already operate at their own staffing and slot limits, and a referral that lands on a four-week waitlist has failed quietly. New York's own data shows how much room there is to close: more than 87,000 state residents received at least one buprenorphine prescription for opioid use disorder in 2024, but only about a quarter of people with the disorder nationally get any medication at all.
The award is also time-limited, as federal grants are. Programs built on soft money tend to scale up during the award period and contract when it ends, and peer specialist positions are often the first line cut. Nothing in the announcement describes the out-years, and the people the unit reaches will still need somewhere to go in year six.
Geography is stubborn too. Two counties, roughly 2.9 million residents, one RV and one truck. Suffolk alone covers about 900 square miles, most of it low density. A vehicle that parks in Brentwood on a Tuesday will not be in Riverhead, thirty-some miles east, until some later date. Presence, in other words, is not the same as coverage.
How to Reach the Unit
CN Guidance takes requests for the mobile unit by phone at 516-396-2778 and offers house calls across Long Island. The organization also operates a 24-hour community crisis center alongside its clinic in Hicksville, and its services are open to people 12 and older regardless of ability to pay.
For anyone who cannot wait for a vehicle to reach their block, the federal 988 line handles mental health and substance use crises around the clock, and the state's treatment locator through the Office of Addiction Services and Supports lists open programs by county. Both routes are faster than a schedule.
Written by
MTNYC Editorial TeamThe MTNYC Editorial Team is a group of healthcare writers, researchers, and addiction specialists dedicated to providing accurate, compassionate, and evidence-based information about addiction treatment and recovery resources in New York State.
