Connecting Opioid Overdose Survivors to Treatment and Recovery Support: Early Findings from a Promising Intervention Delivered By Peers and Patient Navigators

Background and Purpose: Opioid misuse has increased substantially in recent years, resulting in unprecedented rates of opioid use disorder and an increase of more than 300% in the rate of fatal opioid overdose between 1999 and 2016. Although there have been widespread efforts to expand the availability and use of naloxone to prevent fatal opioid overdose, referral to treatment and recovery support services for those reversed from an overdose have not occurred at the same rate. To address this gap, the New Jersey Single State Authority on Substance Abuse implemented the Opioid Overdose Recovery Program (OORP), an intervention model utilizing peer recovery specialists (RSs) and patient navigators (PNs) to engage individuals within emergency departments immediately following an overdose reversal. These personnel provide assistance, recovery supports, and referrals to treatment and support services while maintaining follow-up for eight weeks following the reversal. The current study presents early findings regarding referrals and peer support delivered by the OORP. These findings are instrumental to understanding the feasibility and utility of implementing such programs.

Methods: Data for this study are from three OORP providers who implemented services between March and November 2017. Using a client-level data collection instrument, providers documented client characteristics, referrals, and outreach efforts for all 226 clients served during this period. The sample is 71% male, 70% white, and averages 35 years old. Proximal outcomes, including service referrals and peer support efforts, are presented. Analyses using logistic regression and ordinary least squares regression were performed to assess whether rates of referral differed according to baseline characteristics. Pairwise deletion was used to account for missing data for all analyses.

Results: Treatment or recovery support service referrals were made for 82% of the sample. A total of 73% of clients were referred to treatment at various levels of care. Recovery support service referrals were made for 74% of clients, including referrals to self-help (e.g., AA, NA) meetings, sober living, and health care services. Referrals did not differ significantly according to measured baseline characteristics, including age, gender, race/ethnicity, employment, and housing status. OORP staff consistently engaged in telephone support and follow-up, with RSs and PNs contacting patients or their loved ones an average of 7 times during the follow-up period.

Conclusions and Implications: The data reveal that the OORP successfully facilitated referrals to treatment and provided peer recovery support following a non-fatal opioid overdose. Findings provide support for the feasibility and utility of interventions utilizing RSs and PNs responding to individuals reversed from an opioid overdose. Programs similar to the OORP may be an effective strategy for linking overdose survivors to needed services at a critical moment, thereby improving the well-being of individuals, families, and communities affected by opioid misuse. Future research should focus on assessing long-term outcomes of the OORP, including whether it results in successful treatment linkages, reductions in substance use and overdoses, long-term recovery, and improvements in related psychosocial areas. Future studies should also examine whether an intervention model utilizing RSs and PNs can be successfully implemented in other settings.