Implementing hospital-based peer recovery support services for substance use disorder

Abstract

Background:The rise in drug overdose deaths in the United States necessitates novel approaches to reduce harms. In response, peer recovery support services for substance use disorder have been implemented in clinical and community settings in several states. Objectives: This descriptive analysis aimed to describe the implementation of hospital-based peer recovery support services for substance use disorder. Methods: We describe the implementation of the Peer Recovery Program, which delivers recovery support services 24 hours a day, seven days a week, for patients with substance use disorder in emergency departments and inpatient settings across 20 hospitals. We report program, patient, and referral characteristics and program process measures. Results: From 2016 to 2019, Recovery Specialists received referrals during 30,263 patient visits. In 2019, 65.4% (n = 7,564) of patients were male. Across three subsamples of referrals, patient acceptance of continued recovery support services ranged from 74.8% to 83.0%. At affiliated hospitals in 2019, the median response time from referral to Recovery Specialist arrival at patient bedside was eight minutes (interquartile range = 4-16), and the median duration of initial bedside consultation was 35 minutes (interquartile range = 25-45). In 2019, Recovery Specialists and Patient Navigators attempted 113,442 follow-up contacts, and patients accepted 4,696 referrals provided by Patient Navigators to substance use disorder treatment and other medical, social, and recovery services and supports. Conclusions: This study describes peer recovery support services for substance use disorder delivered in emergency departments and inpatient settings. Evidence of improved patient outcomes is needed prior to widespread adoption.

“We need to build a better bridge”: findings from a multi-site qualitative analysis of opportunities for improving opioid treatment services for youth

“…The benefit of peer support in harm reduction, community-based substance use treatment, and hospital settings is increasingly supported by empirical evidence [ 55 , 72 , 73 ]. In addition to the relational benefits (e.g., reduced stigma, reduced power imbalances) [ 55 , 74 ], research suggests that peer support may increase the delivery of information about harm reduction and treatment [ 75 ] and connection to services [ 76 ]. Thus, peer support models may be especially important in overcoming many of the challenges that youth have described regarding their need for more information about available opioid treatment services and preference for youth-friendly environments.…”

Hospitalist perspectives on buprenorphine treatment for inpatients with opioid use disorder

“…Expanded use of certified recovery specialists, or peers with lived experiences of substance use disorders, can assist hospitalists achieve this goal. ( Liebling et al., 2021 ). Other initiatives, such as a clinical pathway for universal screening to identify patients at risk of opioid withdrawal, may help identify and treat additional patients ( Williams et al., 2022 ).…”

Barriers and Facilitators to Peer Support Services for Patients With Opioid Use Disorder in the Emergency Department

“…As noted in this technical report, multiple approaches can be employed to engage patients resulting in several unique barriers related to the initiation of services and subsequent coordination of care upon disposition of ED patients. One study examined median response time across 20 hospitals from initial referral to peer supporter arrival at the bedside to be eight minutes, which may be largely dependent on the operational and staffing model used [ 20 ].…”

“…These many challenges and barriers require further investigation with an emphasis on clinical outcomes and further investment as noted in this technical report [ 19 ]. Despite these limitations, data from inpatient peer recovery services have demonstrated improved clinical outcomes through a reduction in hospital readmissions and ED visits [ 20 ]. Other studies have focused on the impact of peer services on substance use, such as toxicology reports or treatment retention [ 21 ].…”