'Recovery coaches' help send nearly 700 substance abuse patients into treatment

Hundreds of overdose victims and people with addiction have been paired up with coaches who direct them to recovery programs in the first year of an effort that has expanded to eight hospital emergency rooms since March.

Coaches with the Connecticut Community for Addiction Recovery have helped about 700 people in eight emergency departments across the state by telling them about local treatment programs, connecting them to the recovery communities near them and advising them about their medical options for treating addiction.

With support from the state Department of Mental Health and Addiction Services and funding through the 21st Century Cures Act, the recovery coach program opened in four hospitals last year: Lawrence + Memorial Hospital in New London, The William W. Backus Hospital in Norwich, Manchester Memorial and Windham Hospital.

Since then, using a grant from the federal Substance Abuse and Mental Health Services Administration, the program has expanded into four more hospitals: Danbury Hospital, Day Kimball Hospital in Putnam, Midstate Medical Center in Meriden and St. Francis Hospital and Medical Center in Hartford.

The eight coaches, who work in eight-hour shifts and together cover every day of the week, have up to two hours to arrive at the hospital if a patient tells their doctor or nurse that they want to meet with them.

"We ask them ... 'What's one or two things that could help jump start that recovery?'" said Jay Osborne, one of the coaches. "We don't come in with a clipboard and a questionnaire; we're there just to have a conversation that means something."

Osborne said he first asks the people he meets what their idea of recovery involves. The coaches are trained to then help the patients achieve that vision, rather than telling them what to do.

For one woman who met Osborne in the emergency department of L+M in April, it was as simple as a conversation and a ride to a rehabilitation program.

Shortly after the recovery coach program came to L+M, Osborne met Alex, a 45-year-old woman who had driven with a friend to New London looking for a bed in a detox facility.

When she arrived and there was no bed, she went to the emergency room at L+M. She had been in and out of rehab programs for alcoholism six times in two years. She had divorced her husband and lost her job and custody of her children.

"I had every desire and everything in my core of my body wanted to not have this problem," Alex said in a phone interview Tuesday. "I'd get clean for a period of 30 or 60 days and I'd feel like my old self again."

It never lasted, until Osborne sat next to her in the hallway at L+M and started to talk.

"He kept me company, he made me feel valued and important ... He made me just feel like, 'You can do this, I've seen it happen before. We're going to get you what you need,'" she said.

In the morning, Jennifer Chadukiewicz, CCAR's emergency department recovery coach manager, met Alex at L+M, drove her home for a change of clothes and then took her to a rehab facility in Bridgeport. She spent 28 days there, and when she came out started attending Alcoholics Anonymous meetings, got a job and has agreed to use a blood alcohol monitor so her ex-husband would let her spend time with her children.

"I just listened and did what they told me," Alex said. "This month I'll have nine months (sober)."

A CCAR coach calls Alex once a week to check in, and now each time they call, she can tell them she's doing well. If Osborne hadn't pushed her to go back to rehab, Alex said, she would have tried to toughen it out like she had so many times before.

"My normal instinct was to fight it ... and say, 'I can do this, and I don't need anyone,'" she said. "If they hadn't come back, I would have gone home."

Chadukiewicz said she plans to announce soon that CCAR will expand the recovery coach program into two more hospitals in western Connecticut this year. Another three are negotiating contracts with CCAR to pay to bring recovery coaches into their emergency room departments.

The $8,000-per-month cost of the program is worth the money hospitals save when overdose or substance abuse patients enter treatment programs and don't come back to the emergency room, Chadukiewicz said.

Coaches, who are on call every day between 8 a.m. and midnight, meet with patients in the hospitals' emergency rooms and remain in contact with them for a minimum of 10 days, giving them advice about everything from finding a 12-step program to finding a doctor.

"Then we'll stay in touch for as long as they let us," Chadukiewicz said. "The coach that meets them in the (emergency department) is the coach that stays with them."

The coaches can help people who come to the emergency room because of an overdose on heroin or other drugs, but the program isn't limited to treatment for drug abuse.

"We'll respond to anyone with any substance use disorder," Chadukiewicz said.

Most of the patients already have been treated for addiction or substance abuse. A small number have never been treated for addiction.

Chadukiewicz said the recovery coaches are helping in emergency rooms where on-call social workers are overworked and too busy to follow up with patients revived after an overdose or who have a substance use disorder.

"Social workers in emergency departments are so overworked and so taxed already," Chadukiewicz said. "As much as the hospital cared for these people, they didn't have the resources to connect them to. A lot of times they would wait for them to ... sober up. They would be given a list of 12-step programs and be told to find a program."

A total of 62 patients statewide who have spoken to a recovery coach came to their local emergency room as a result of a drug overdose; the rest, about 634 people, were there for some other alcohol or drug-related medical emergency.

Coaches have met with 179 patients at Backus Hospital and more than 200 people at L+M since last spring.

Chadukiewicz said recovery coaches have referred more than 97 percent of the emergency room patients they met with to a formal treatment program or recovery support service.

Most of those patients — 380 of them — were referred to detox facilities. Another 151 were referred to community organizations or support systems, and the rest were referred to inpatient or outpatient recovery treatment facilities or to medication-assisted treatment.

Chadukiewicz said the success of the program has led agencies in other states to consider implementing it in emergency rooms outside Connecticut.

"We were just thrilled," she said. "We know the power of that connection ... but there was never evidence-based research to back it up."



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