A St. Louis-based project that uses former drug users to convince overdose victims in emergency rooms to seek treatment will soon focus on patients who refuse emergency transport.
For two years, the Engaging Patients in Care Coordination project has enlisted peer-recovery coaches from participating treatment centers to area ERs to meet with people who have overdosed on opioids.
Starting this month, the project will send the coaches — themselves in recovery — to meet with overdose victims who refused to go to the ER.
After reviving patients, paramedics will ask them if they would like to meet with peer-recovery coaches the next day. If they agree, a coach will arrive to help them find treatment options.
Using people who are actively in recovery to coax drug users to get help can prove that treatment works, said Wendy Orson, CEO of the Behavioral Health Network of Greater St. Louis. The nonprofit organizes the project, which involves five treatment centers and 14 hospitals.
“The innovative piece of this is rather than using case managers or counselors, we use people with lived experience,” Orson said.
Until now, the project has focused on meeting people in hospital emergency rooms. Within an hour of a patient's arrival, a recovery coach will arrive and offer a referral to an area addiction-treatment facility.
An overdose can be a turning point for some, said Spring Schmidt, acting co-director of the St. Louis County Health Department.
“They’re at a moment where there’s a chance for the intervention, and if you pair that with a really credible messenger who also has this perspective of 'gone through it and come out the other side,' there’s a hope in that,” she said.
Time is of the essence when it comes to getting victims to treatment, Schmidt said. It’s not just psychological, either. Opioid withdrawal symptoms can be so unbearable that a person will go back to using even if they are ready to quit.
“There’s a very large drop-off for individuals because they go into withdrawal symptoms,” Orson said. “They might turn to elicit drugs in that period of times they might need to wait for treatment.”
Some hospitals involved in the EPICC project also immediately give addiction medicine such as buprenorphine to overdose victims. The medicine eases cravings and can prevent people from using.
Additionally, one-fourth of the people who participate in the EPICC project are homeless, said Orson. “If we didn’t catch them at the emergency department, we may never find them.”
About 140 people each month are referred to treatment through the program. Close to 40 percent of those people go on to medical care.
Similar projects are underway in other states. The EPICC program is modeled after one in Rhode Island called AnchorEd. While the Rhode Island program has spawned several others, that state’s health department found nearly half of the overdose victims refused to speak to a recovery coach in the emergency room.
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