Peers are helping others overcome this illness

Sometimes the best person to help with a problem is someone who has gone through the same problem themselves. That is the premise behind the Peer Recovery Specialist program at Cape Cod Healthcare that began last June in partnership with Gosnold, Inc. When Emergency Department staff suspect a patient has a substance use disorder, they refer that patient to a social worker and a peer recovery specialist to help the patient get into treatment as soon as possible.

“It’s been a great program and their success rate is remarkable,” said Nate Rudman, MD, medical director of the Cape Cod Hospital Emergency Center. “I would guess prior to instituting the program we maybe got 20 to 40 percent of people in treatment, and that number may be high. Now, the people they’ve touched, it’s pretty close to 80 or 90 percent that they get into treatment programs.”

The idea for the program began about two years ago, when Cape Cod Healthcare dedicated up to $2.5 million grants towards fighting substance abuse on Cape Cod with innovative programming, Dr. Rudman said. One of the offshoots of that grant was the Peer Recovery Specialist program which hired people who were in long-term recovery themselves to be embedded in the Emergency Centers at Cape Cod and Falmouth Hospitals as part of the care team.

“I’ve gone into the rooms with them to see what the magic is,” Dr. Rudman said. “The best analogy is going to a foreign country and trying to speak English, which is what we were doing in the past. Now when we have a recovery specialist go in, they speak the language of addiction. They understand all of the nuances. They understand what is going on with the person and what the roadblocks are going to be. They know how to circumvent those roadblocks and convince them treatment is the best thing for them.

“It’s really like going to Spain and watching two people fluent in Spanish speak. It makes a huge difference.”

Justin Campbell

Dr. Rudman credits lead peer recovery specialist Justin Campbell with making the program such a success. Campbell has been in recovery since February 5, 2016. A little over a year after his recovery, he began working as a part-time recovery aide for Gosnold at their Acute Treatment Services Center in Falmouth. He was promoted to recovery specialist in January of 2018.

“I quickly fell in love with being able to help people at the beginning of their journey,” Campbell said. “Part of being in recovery is giving back to other individuals who suffer from the disease of addiction and helping guide them as others helped guide me.”

In addition to ongoing internal training at Gosnold, Campbell attended the Connecticut Community for Addiction Recovery Emergency Department Recovery Coach Program. Motivational interviewing is the primary specialty he and the other peer recovery specialists practice.

Motivational interviewing is a counseling method that helps create an internal motivation to change a behavior. It is an empathetic process that takes into consideration how difficult such changes can be. The other important component for peer recovery specialists is enthusiasm over their own recovery.

“The peer model of intervention is so vital because the team has lived a life similar to the patient,” Campbell said. “In a world where motivation and the ability to live life productively eludes some wrapped up in the depths of addiction, we sit down with the patient, build a bond with them and make them comfortable. This feeling of security allows the patient to become open and willing to experience a new life. Peer-to-peer recovery models are developing up all over the country because of their proven therapeutic value. We hold credibility in our experience that makes the patients potential for success seem achievable.”

Campbell agrees with Dr. Rudman that speaking the language of addiction is important and peer recovery specialists are very fluent in that language because of their own experiences. When he receives a referral to a patient, he sits down and talks to them about why they are in the hospital. Some patients are receptive to going straight to treatment, but others require more convincing to build their confidence that recovery is possible.

Once the patient agrees to enter treatment, Campbell and the team make referrals to verified treatment centers. They are given a warm hand-off to the next step of medical/clinical attention along with the contact information of the recovery specialist. If a patient refuses treatment, Campbell gives the patient his contact information and then follows up by contacting the patient again within three to five days. Even after treatment, the relationship doesn’t end. Recovery specialists are available to offer guidance over bumps and to celebrate successes.

Now On Inpatient Floors

Since the program has been so successful in the Emergency Centers, it has now grown to include patients with substance use disorders on the inpatient floors, Dr. Rudman said.

Both he and Campbell said that the program has also educated the hospital community and changed their views about addiction and recovery in ways that reduce the stigma.

“From 20 years ago when I started doing this until now, the biggest frameshift for most medical professionals is not being judgmental and understanding it’s an opportunity to help people out,” Dr. Rudman said. “It’s not a weakness and it’s not always volitional. Around 15 to 20 percent of all people are genetically predisposed to addiction.”

The problem is that doctors can’t identify who those people are going to be, Dr. Rudman said. That creates a quandary of treating pain adequately for someone who has a surgery or is in legitimate pain, while not creating a problem for someone who is predisposed towards addiction.

For Campbell, his new job is a way to help others, but also to give back to the actual organizations that helped him in his journey towards recovery.

“I am grateful for this program and the grant from Cape Cod Healthcare, as I am a direct benefactor of the other project under this grant with Gosnold’s collaboration with police departments,” he said. “I gained hope and access to treatment. I am just one of over a thousand lives that has been impacted by the Gosnold and Cape Cod Healthcare partnership, and I am blessed to be in the role I am in, to be that symbol of hope and catalyst for patients to start their journeys.”