Implementing hospital-based peer recovery support services for substance use disorder

Background The rise in drug overdose deaths in the United States necessitates novel approaches to reduce harms. In response, peer recovery support services for substance use disorder have been implemented in clinical and community settings in several states. Objectives This descriptive analysis aimed to describe the implementation of hospital-based peer recovery support services for substance use disorder. Methods We describe the implementation of the Peer Recovery Program, which delivers recovery support services 24 hours a day, seven days a week, for patients with substance use disorder in emergency departments and inpatient settings across 20 hospitals. We report program, patient, and referral characteristics and program process measures. Results From 2016 to 2019, Recovery Specialists received referrals during 30,263 patient visits. In 2019, 65.4% (n = 7,564) of patients were male. Across three subsamples of referrals, patient acceptance of continued recovery support services ranged from 74.8% to 83.0%. At affiliated hospitals in 2019, the median response time from referral to Recovery Specialist arrival at patient bedside was eight minutes (interquartile range = 4-16), and the median duration of initial bedside consultation was 35 minutes (interquartile range = 25-45). In 2019, Recovery Specialists and Patient Navigators attempted 113,442 follow-up contacts, and patients accepted 4,696 referrals provided by Patient Navigators to substance use disorder treatment and other medical, social, and recovery services and supports. Conclusions This study describes peer recovery support services for substance use disorder delivered in emergency departments and inpatient settings. Evidence of improved patient outcomes is needed prior to widespread adoption.