Dawn Moody works in Carroll Hospital’s new Overdoses Survivor Outreach Program, meeting with patients who have come to the hospital after experiencing an opioid drug overdose. But not just in the hospital.
“I go into the community and follow the patients that present in the emergency department with an overdose for up to 90 days,” she said. “I try to provide them with resources, Narcan; the list goes on and on depending on what their needs might be.”
But Moody isn’t just another doctor, nurse or physician assistant. In fact, as she always points out to patients right as she meets them, she’s not a medical professional at all. She’s a person in long-term recovery for her own substance use issues, and now serves as one of the hospital’s new peer recovery coaches.
“I have 17 years in recovery and it didn’t happen overnight, and it didn’t happen the first time,” Moody said. “It started with desperation, realizing that things that were happening to me weren’t just bad coincidences — like every time I drank I would end up in handcuffs.”
Moody has walked that walk, and can now bring that experience to bear when interacting with people who come to the hospital, whether they’ve overdosed or are just looking for help.
“Since the peer recovery coaches are individuals who are in long-term recovery themselves, that’s a new type of professional that we’ve not had within our staffing in the past,” said Cheryl Gosaguio, manager of outpatient social work and community resources at the hospital. “That’s really powerful. They are really living proof that recovery can happen and does happen.”
The hospital now employs four coaches, including Moody, according to Gosaguio.
“Three are dedicated to working with any substance use concern for patients in the hospital, and then one who works specifically with opioid overdose survivor,s and provide much of that support in the community,” Gosaguio said. “They are paid professionals and really as a profession itself, peer recovery Is really an emerging role in the field of behavioral health. We’re really excited to be a part of the development of that as well.”
The program got its start in March, according to Gosaguio, along with the hospital’s Screening Brief Intervention and Referral to Treatment program, known as SBIRT for short.
“Any patient that comes to the hospital will be universally screened for any concerning issues related to substance use disorder,” she said. “We do universal screening as a way to normalize and destigmatize and also identify potential issues of patients that may be in ED for something completely unrelated.”
It is here where peers like Moody may begin their role.
“The new piece is that when somebody screens positive now there are new dedicated staff to provide a more in-depth intervention with the patient, while they are still in the hospital,” Gosaguio said.
That intervention is all about the patient, and is entirely voluntary, according to Moody. She will introduce herself and try to meet people where they are. Have they ever been to a 12-step meeting? Have they ever tried medication-assisted treatment for opioid use disorder, perhaps with buprenorphine? Moody will help them get connected with whatever treatment path they are interested in, or, as they sometimes request, leave them alone altogether.
“It’s absolutely empowerment and never about me, at all,” she said. “I sometimes really have to disengage myself from thinking I know what’s best for the patient at any given time.”
Around the same times the SBIRT program launched, the hospital also began offering initial doses of medications for the treatment of opioid use disorder, including naltrexone and buprenorphine, to patients in the emergency department, according to Gosaguio.
“There is still some education going on there, specifically on the medication-assisted treatment, because there is still some stigma attached to some of those medications,” she said. “But there is a lot of scientific research showing that it is a really important and effective module of treatment, especially in combination with other behavior-based treatments. We’re excited about it.”
Starting someone on one of those medications only takes place in the context of their being a provider in the community that they can follow up with the next day, Gosaguio said, and that’s where peers like Moody are essential. They can start coordinating such treatment right in the emergency department.
“I will pull out my phone and call for them, ‘Hey, I have so-and-so here and they are interested in doing Suboxone maintenance, when can they get an appointment?’” Moody said. “If they are nervous going there, I will meet them and go with them and go through that process.”
That warm hand-off can make all the difference, according to Gosaguio. Peer recovery coaches are also able to provide some follow-up support for after the patient has left the hospital.
“It’s just really such a magical thing to see if the connection that is able to be made between the peer recovery coach and the patient, and just to see some of the success stories that have come out of it,” she said. “We all hear about the opioid epidemic, it’s in the news so much, we all know it’s there. But there is still a lot of resistance to recognizing that it’s our community, it’s our neighbors, it’s our family members, it’s us.”