Boston Medical Center (BMC)'s Grayken Center for Addiction is leading a study on the impact of peer recovery coaches on patients with substance use disorder (SUD), including focusing on providing support to patients and helping them achieve sustained recovery.
BMC's Project RECOVER (Referral, Engagement, Case management and Overdose preVention Education in Recovery) will bridge a gap in care by linking and engaging people who are injecting opioids in outpatient treatment with medication for a minimum of six months through interventions delivered by trained peer recovery coaches. These interventions include developing a wellness recovery plan, keeping patients engaged in their care, and addressing other social determinants of health such as housing, food insecurity, child care and job training.
"Peer recovery coaches are increasingly common across the country, but we're still seeing disparities in treatment, especially among black and Hispanic patient populations," said Ricardo Cruz, MD, the principal investigator of Project RECOVER and a researcher with the Grayken Center for Addiction at BMC. "This study will serve residents in our local communities who are disproportionately impacted by the opioid epidemic."
A study in The Journal of Substance Abuse Treatment found that 90 percent of patients with SUD relapsed or overdosed within a year after discharge from inpatient detoxification. The period of drug abstinence results in an increased risk for patients if they are not in long-term treatment, with some patients relapsing within days. In addition, despite the patients' near-universal preference for post-discharge care, more than two-thirds of the patients failed to engage in outpatient treatment with medication for SUD.
Project RECOVER will also link patients completing detoxification to primary care practices that offer comprehensive care for the prevention and treatment of other chronic diseases, like HIV and hepatitis B and C, and can provide referrals to behavioral health specialists. The program aims to serve 180 patients and provide 360 naloxone kits to patients and members of their support networks.
The last goal of the project is to ensure that patients and their family members and friends receive overdose education and naloxone kits in conjunction with detoxification or within seven days of their discharge from the hospital. Two Boston-based opioid detoxification programs, Lahey Health Behavioral Services Boston Treatment Center and Dimock Community Health Center, have agreed to serve as partners on the project.
BMC's peer recovery coaches are certified and have undergone training through the Massachusetts Recovery Coach Academy or a similar program. They are also trained in motivational interviewing and use of naloxone if they are not already experienced.
"Patients who are just entering recovery want to receive help from individuals who have overcome addiction themselves. Peer coaches have a high level of understanding and know how to connect with patients who have substance use disorders on a more personal level, as well as navigate the complexities of recovery resources and the healthcare system."
Project RECOVER is supported by $1 million grant from the U.S. Department of Health and Human Services, Office of Minority Health as part of the Empowered Communities for a Healthier Nation Initiative. Effective and replicable interventions of the study will be compiled in a Project RECOVER toolkit to share results nationwide and help further combat the opioid crisis.