April 26, 2011 | When Kevin McDonald came to Durham, N.C., in 1994 to start a drug treatment center, the county gave him an old schoolhouse in a rough neighborhood flanked by empty warehouses. He saw some neighborhood kids throwing rocks through the windows, bribed them with $1 a day to guard the place and shot video of them holding up the letters with the initials of his organization -- T-R-O-S-A -- like cheerleaders.

Inside, he beamed over the swimming pool. “Hey, this is pretty classy,” he thought. Then he realized it was a basketball gym submerged by leaky pipes.

“It was wild, wild West at first,” he said.

But McDonald figured out a way to turn what was broken into something useful. Starting with $18,000 raised by local advocates, McDonald used convicted drunk-drivers completing court-ordered community service to make the building habitable.

“Duke got all the Ph.D.’s,” he said; “I got the Hell’s Angels and the drug addicts.

“I started bringing people in. I used kerosene heat, a little four-burner electric stove,” he said. “It was just real rough, but what the hell, you’ve got to start; people are on the street.”

Seventeen years and 1,100 graduates later, McDonald has built Triangle Residential Options for Substance Abusers into the largest drug treatment facility in North Carolina and a national model for both treatment and social entrepreneurship. He took a social problem -- addiction -- and made its victims the solution.

With seven distinct businesses ranging from masonry to moving, TROSA offers residents two years of free treatment, plus an aftercare program that sets them up with low-cost housing, cars and ongoing group therapy, all while they’re gaining the job skills and the confidence that will usher them into their new lives.

The organization is able to operate with only about 10 percent of its $10 million annual budget coming from government and private grants; its businesses generate more than $6 million a year, and in-kind contributions exceed $3 million.

“Even if I got a lot of money donated, I would never stop,” McDonald said. “It’s not just money. It’s about therapy, it’s about work ethic, it’s about learning job skills. You can just say, ‘Stop shooting dope,’ but once you stop shooting dope, you’ve got to be able to work, you’ve got to be able to get along with people.”

Made in California

McDonald, 63, didn’t invent this model. He learned it from the Delancey Street Foundation, a therapeutic community in San Francisco that works on an “extended family model”: residents work and contribute what they can. In the late 1970s the organization began to establish satellite campuses in select cities, and in the 1980s McDonald helped set up a Delancey Street facility in Greensboro, N.C.

McDonald never graduated from college. He spent his 20s and 30s in and out of jail and hooked on heroin until a judge sent him to Delancey Street. Over the course of 12 years recovering from addiction, McDonald learned the moving and construction trades and rose to leadership in the organization.

Out of Delancey Street grew McDonald’s “each one, teach one” philosophy, the notion that everyone has something to learn and to teach, and that lost, broken addicts have something to offer the world if they just believe that they do.

McDonald talks in a sarcastic Boston dialect, peppered with four-letter words and barely dulled by decades in California and North Carolina. McDonald’s past as a “street punk” gives him credibility with the clients and insight into what works. He puts in long days, showing his face on the TROSA campus day and night.

“I can’t spell ‘entrepreneur,’” McDonald said, with self-deprecating humor. But he is one, and the development of TROSA shows his skill in tending to the health of the people in his care and of the organization that supports them.

“The heart and soul of TROSA has always been Kevin McDonald,” said Jerr Boschee, a co-founder of the Social Enterprise Alliance, which honored TROSA for innovative fundraising in 2004 and 2009. “Kevin McDonald is one of the stars in the social enterprise universe.”

When the founding TROSA board recruited McDonald to Durham, he wanted to open the doors to physically sick, injured and mentally ill addicts, populations Delancey Street couldn’t accommodate. To do that, he needed to develop moneymaking businesses to support the high cost of care.

Adapting the model

At first, McDonald followed Delancey Street’s pattern, relying on skills residents already had or responding to specific business opportunities that arose: peeling potatoes for a local caterer, painting, removing trees that fell during Hurricane Fran in 1996. But that strategy was haphazard and resulted in a revolving door of businesses as residents came and went and community needs changed.

Seeking sustainability, McDonald realized that long-term employees could give the businesses the strong word-of-mouth reputation they needed to survive, because TROSA could never use typical advertising.

“Would you do a marketing campaign, ‘Hire a junkie to move you’?” he said.

McDonald shifted the model to build expertise from within, encouraging residents to remain after graduation in inexpensive housing and management positions in the businesses. That served both to strengthen the businesses and to support the graduates’ personal recovery. Among the model’s successes is the moving company, which regularly wins “best mover” awards from local newspaper readers.

McDonald later adapted the model further and began hiring talented people from outside TROSA with know-how he couldn’t find within. For example, Wendy Noel had a vision and the experience to open a grocery store in an underserved neighborhood but lacked the capital. TROSA hired her to execute her vision.

“I couldn’t have done this exact store myself,” Noel said. “TROSA’s infrastructure has made this store possible.”

By building its own leadership, TROSA has made a name for its moving and landscape companies, frame shop and holiday tree sales. Jobs range from retail sales and physical labor to back-office accounting. The division of labor not only allows the businesses to grow but also teaches residents diverse job skills and the confidence they need to succeed on the outside.

These businesses require no mere manual labor but careful craft and knowledge of complex computer software to keep track of millions of dollars of commerce every year.

“When people think they’re just drug addicts, we’re not doing anything but using an old-days abacus or something like that,” McDonald said. “But you can stretch people, and you can put ’em in jobs where they can succeed, and that’s what a lot of this is about. …

“Most of our people have been raped physically, beaten or verbally abused. That isn’t fixed by medication.”

McDonald said the size and complexity of the businesses demand greater and greater expertise from their managers. If TROSA is to keep growing, he said, it’s going to need a stronger internal leadership program in order to train graduates to replace him and other veteran managers. Two 75-bed dorms are under construction, but McDonald said he needs to solve the long-term leadership problem before pursuing his goal of expanding into nearby Raleigh.

Time makes a difference

At most treatment facilities, 30 days is the end; at TROSA, 30 days is just the start.

Experts who have studied TROSA say it’s the combination of financial sustainability and social mission that make it stand out, earning national awards from the Social Enterprise Alliance and the Ford Foundation’s Leadership for a Changing World initiative.

Meaningful work in a therapeutic setting not only builds confidence but also buys time for other treatment strategies such as group therapy, one-on-one counseling, psychiatric care and community-building exercises like a weekly seminar on current events to have an effect. These cost the organization about $75 a day per person.

“The big difference is that TROSA isn’t treating substance abuse as a disease; it’s treating the whole person,” said Deena Murphy, an N.C. State University psychology professor who studied TROSA graduates and found that fewer than 10 percent return to drugs or crime within a year, compared with 40 percent or more of those who finish other programs. She also found that 95 percent had jobs a year after graduation, compared with about 60 percent from other treatment programs.

“Most … treatment programs are outpatient: they’re treated and then they leave, and there’s no real understanding of what the factors are in their outside lives,” Murphy said.

TROSA is a place for resurrection, but first comes the death of residents’ former lives. They break off most contact with the outside world, committing to two years of sobriety, unpaid labor and strict rules in exchange for housing, meals and treatment.

“Each one, teach one” might mean words of encouragement, but it also means holding one another accountable.

“Recovering addicts, you give ’em an inch, they’ll take a foot,” said Anthony Stanford, who went from homelessness to become head of TROSA’s intake office. His recovery reunited him with his wife and three daughters after years of aimlessness. “If you’re going to joke and play, then you’re not taking it seriously.”

Some people like Stanford remain beyond their mandatory two-year commitments, staying on as staff members or “TROSA scholars,” finishing community college degrees. The ongoing connection to the TROSA community through support groups and just plain friendships helps graduates cope without drugs or alcohol when hard times come on the outside.

McDonald, a Catholic, said TROSA is a spiritual experience in the sense that residents are trying to live rightly: caring for themselves and others, volunteering in the community.

“It’s the pride of belonging to something,” he said.