Peer recovery coaches in emergency departments (ED) decreased subsequent ED utilization for patients with substance use disorders.
Patients with substance use disorders (SUD) disproportionately seek health care services in EDs, often for acute treatment related to their substance use (e.g., overdose, intoxication, withdrawal), or other related medical condition. Standard ED discharge procedures, including referrals to SUD providers in the community, may not encourage long-term engagement in SUD treatment and services. An emerging strategy to bridge this gap is the use of peer recovery coaches (PRC) in the ED. PRCs are individuals with lived experience with an SUD, who are trained to provide informational, social, and emotional support to those with SUDs using nonclinical, self-empowerment, and strengths-based methods. This study evaluates the feasibility and efficacy of an ED-based PRC program.
This analysis included 448 individuals, a majority (66%) of whom were male with a mean age of 44. Most patients identified alcohol as the primary substance they used (65%), followed by heroin/opiates (20%). At 30, 60, and 90 days after the PRC engagement visit, there were 25%, 18%, and 16% of patients who were still actively engaged with the PRC, respectively. There were no decreases in mean ED visits before versus after the PRC engagement visit. However, among patients who had at least one prior SUD related ED visit, there were significant differences in mean visits across all visit-types.
The authors noted there was often poor patient follow-up with the PRC in outpatient settings, indicating a need for additional research on how to keep patients engaged with the PRC after linkage to outpatient settings. Although there has been growing research on PRCs in ED to address the needs of people with opioid use disorder, this program is unique in how it provided support to patients with a range of SUDs, including alcohol use disorder, which is highly prevalent among ED admissions.