New Project to Clear Pathways to Treatment

Statistics show recovery from opioid use disorder is a difficult journey. After completion of intensive detoxification, patients are at risk of relapse and overdose. In fact, 90 percent of patients relapse within a year of discharge. While outpatient medically-assisted treatment can help reduce rates of relapse and opioid-related deaths, only a small percentage of patients engage in it. Obtaining long-term treatment can be further complicated when language and social factors are barriers. To help connect and further engage patients with life-saving addiction treatment and primary care services, the U.S. Department of Health and Human Services Office of Minority Health has awarded a $1 million grant to a promising new study at Boston Medical Center.

Project RECOVER (Referral, Engagement, Case management and Overdose preVention Education in Recovery) will employ specially-trained peer recovery coaches—people with lived experience in addiction recovery—to support individuals with an opioid use disorder during the early months of recovery. It is a model seeking to help reduce obstacles to treatment, connect and engage patients with programs offering medication for addiction treatment, assist patients in accessing preventive and specialty care, prolong involvement in continuing care and ultimately, reduce opioid-related deaths.

“A peer coach’s first point of contact will be in a detoxification setting when a patient is receiving services. He or she will help identify a patient’s barriers to care: food, housing, transportation and other social determinants of health, and will seek to link them with health care and community services that can help,” explains the study’s Principal Investigator Ricardo Cruz, MD, MPH, an attending physician in BMC’s General Internal Medicine department. “In addition, we will strive to pair minority patients with culturally and linguistically compatible coaches so they can better navigate care and prioritize what is most important in their life. The coaches will continue to provide support and assistance as patients engage in treatment over time.”

The study will follow how peer recovery coaches, overdose prevention education and the provision of kits with naloxone—a medication designed to rapidly reverse an opioid overdose—help 180 patients seeking opioid use disorder treatment. Two Boston-based opioid detoxification programs—Lahey Health Behavioral Services Boston Treatment Center and Dimock Community Health Center—have agreed to serve as partners on the project.

“What’s special about this project is the goal to help patients advocate for preventive care, testing for HIV, hepatitis B and C, evidence-based treatments and referrals to mental health services. Patients receiving substance use disorder treatment in clinics often receive isolated care that does not address the many chronic and acute medical factors that could be compounding their struggle with substance use disorder,” says Cruz.

As a whole, research on the effectiveness of peer recovery support remains in its infancy. Project RECOVER aims to gain further insight on the benefits of using a patient-centered approach to help patients engage in long-term, evidence-based treatment after completion of detoxification—a time when they are at increased risk of overdosing. Effective and replicable interventions of the study will be compiled in a Project RECOVER Toolkit with the goal to share results more broadly and help further combat the opioid crisis nationwide.