Recovery coaches help overdose survivors to avoid next incident
NEW YORK — Five months into his job at a 24-hour walkin behavioral health center on Staten Island, Tarik Arafat has a new assignment. In three weeks, he’ll be on call for a nearby hospital to counsel people who have just been revived from an opioid overdose.
In recovery from drug addiction himself, Arafat, 25, said he understands why someone in a brightly lit emergency room who uses drugs would be more comfortable talking to him than to a medical professional. “My job is to open myself up and be like a toolbox for them,” he said.
Arafat’s mission, and that of other so-called recovery coaches, is not to convince overdose survivors to get into treatment, but to offer them advice on how to get started once they’ve decided they’re ready to quit.
If they’re not interested in that moment, he’ll follow up with phone calls to see how they’re doing after they leave the hospital. He’ll also advise them on how to use drugs more safely, if that’s what they choose to do.
Nationwide, tens of thousands of opioid overdose victims have been saved over the past two decades by first responders, friends, family and bystanders who administered naloxone, an opioid overdose antidote.
But the majority of those who are rescued from near death go back to using drugs as soon as they leave the hospital, pushed by the brutal withdrawal symptoms that accompany an opioid overdose reversal.
In fact, the likelihood of a second overdose among those who survive their first is substantially higher, said Dr. Hillary Kunins, assistant commissioner for New York City’s alcohol and drug abuse agency.
To reduce those odds, New York City, Connecticut and Massachusetts are replicating a Rhode Island program that sends recovery coaches like Arafat to hospital emergency departments to meet overdose survivors and offer them support, whether it’s on the day of their ER visit or weeks or months later.
Officials in at least seven other states — California, Maine, North Carolina, Ohio, Oklahoma, Texas and Vermont — have been talking to the program’s founders over the last year about starting similar programs in their states. And New Hampshire and New Jersey have created similar programs.
And federal money under the Comprehensive Addiction and Recovery Act and the 21st Century Cures Act is available through the Substance Abuse and Mental Health Services Administration to local jurisdictions that want to start pilot recovery coach programs.
Called AnchorED, the Rhode Island program dispatches recovery coaches to the bedside of overdose survivors in every hospital in the state.
The coaches let the survivors know what resources are available to help them quit, or how they can reduce their chances of a fatal overdose, if they choose to keep using.
In the three years since it started, AnchorED’s recovery coaches have counseled more than 2,000 overdose survivors, with 87 percent of them opting to engage in some type of recovery service after being discharged from the ER, according to Michelle Harter, director of the state-funded program.
Not all of those who engage in recovery services — such as detox, spiritual guidance, medication-assisted treatment, peer counseling, job training and nutrition programs — end up quitting drugs, Harter said. “But we help them get started on a recovery pathway of their choice.”
New York City’s recovery coach program, called Relay, is slated to begin this month. It will start by employing 18 recovery coaches to be on call at hospitals in three of the city’s hardest hit communities: Richmond University Medical Center on Staten Island, Montefiore Medical Center in the Bronx, and New York-Presbyterian/Columbia University Medical Center in Washington Heights.
The plan is to set up similar programs in seven more hospitals by 2019, at an annual cost of $4.3 million. While the hope is that more people will get into treatment, the city’s primary goal is to reduce overdose deaths, Kunins said.
In addition to offering overall support, recovery coaches in New York’s program will talk to survivors about where to find drug treatment and mental health services and how to pay for them, as well as how to reduce their risk of a fatal overdose.
They’ll distribute naloxone kits, train survivors and their friends and family on how to use them, and tell them where they can get clean syringes and needles to avoid contracting HIV/AIDS and hepatitis C.
Once patients leave the hospital, the recovery coaches will follow up with daily or weekly phone calls for 90 days, or longer. But recovery coaches will hand off the work of providing services to a team of addiction specialists, health care providers and case managers.