South Florida Sun-Sentinel Palm Beach (Sunday)
Clearing a path to recovery
Peer support specialists work to give others like them a second chance
Sarah Wright stops by her peer support specialist’s hotel room-turned-office in Centennial, Colorado, several times a day.
But her visit on a morning in mid-October was one of her first with teeth.
The specialist, Donna Norton, had pushed Wright to go to the dentist years after homelessness and addiction had taken a toll on her health, down to the jawbone.
Wright was still getting used to her dentures. “I haven’t had teeth in 12 ½ , 13 years,” she said, adding that they made her feel like a horse.
A new smile was
Wright’s latest milestone as she works to rebuild her life, and Norton has been there for each step: opening a bank account, getting a job, developing a sense of her own worth.
Wright’s voice started to waver when she talked about Norton’s role in her life during the past few months. Norton wrapped her arms around Wright.
“Oh, muffin,” she said. “I’m so proud of you.”
Norton, 54, is a Harleyriding, bulldog-loving, eight-years-sober grandmother and, professionally, “a cheerleader for the people that look bad on paper.”
People like her. “If you were to look me up on paper, you wouldn’t be in this room with me,” Norton said. “You would not let me near your house.”
If she were a therapist or social worker, hugging and sharing her experiences with drugs and the law might be considered a breach of professional boundaries. But as a peer support specialist, that’s often part of the job.
Norton works for the Hornbuckle Foundation, which provides peer support to participants in the SAFER Opportunities Initiative. SAFER provides short-term shelter in the hotel for people in Arapahoe County who are homeless and have mental health or substance use disorders.
Peer support specialists are themselves in recovery and are employed to help others. As billions of dollars in opioid settlement funds roll out to states and localities, local leaders are deciding what to do with the money. Supporting and training peer specialists, whose certification requirements vary by state, are among the options.
States, counties, municipalities and tribes filed thousands of lawsuits against drug companies and wholesalers that are accused of fueling the opioid crisis.
Many of those cases were lumped together into one mega-lawsuit. Last year, four companies settled out of court, agreeing to pay $26 billion over 18 years. Participating states must follow guidelines for how the money can be spent.
In Colorado, hundreds of millions of dollars from that settlement will go to local governments and regional groups, several of which submitted plans to use some of the money for peer support services.
David Eddie, a clinical psychologist and a research scientist at the Recovery Research Institute at Massachusetts General Hospital, said peer recovery support services have “been gaining a lot of traction in recent years.”
According to the Substance Abuse and Mental Health Services Administration, “mounting evidence” shows that working with a peer specialist can result in better recovery outcomes, from greater housing stability to reduced rates of relapse and hospitalization. A report by the U.S. Government Accountability Office identified peer support services as a promising practice in treating adults with substance use disorders. In many states, peer specialists are reimbursed through Medicaid.
“They can plug a really important gap,” Eddie said. “They can do things that we as clinicians can’t do.”
They can, for example, navigate the bureaucracy of the child protective services system, about which clinicians might have little knowledge, or take someone out to coffee to build a relationship. If a person stops showing up to therapy, Eddie said, a peer support specialist “can physically go and look for somebody and bring them back to treatment — help them reengage, reduce their shame, destigmatize addiction.”
Norton has, for instance, picked up a client who called her from an alley after being discharged from a hospital stay for an overdose.
“Some people will tell you, ‘I decided I was going to get in recovery, and I never had to drink, drug or use again.’ That’s not my experience. It took me 20 years to get my first year clean and sober. And that was trying every day,” said Norton from her office.
Her office, warmed by the sunlight coming through a south-facing window and the nearly constant rotation of people plopping onto the couch, contains a shelf of essential items. There are opioid overdose reversal kits containing Narcan, tampons — Norton will “never forget” the time she got a ticket for stealing tampons from a grocery store while she was homeless — and urine analysis kits, for determining whether someone is high versus experiencing psychosis.
That October day,
Norton pivoted from nagging one person to make a doctor’s appointment, to getting someone else set up with a food pantry, to figuring out how to respond to the bank that told a third client that an account couldn’t be opened without a residential address. She also worked on lowering the defenses of a skeptical newcomer.
Some people come to Norton after being released from jail, others by word of mouth. The newcomer applied after hearing about the program in a homeless shelter.
Norton decided that sharing a little about herself was the way to go with him.
“‘My experience is jails and hospitals and institutions. I’ve got an old number,’ meaning a convict number. ‘And I have eight years drug-free,’ ” she recalled telling him.
Kyle Brewer, based in Arkansas, is the peer specialist program manager for NAADAC, the Association for Addiction Professionals (formerly the National Association for Alcoholism and Drug Abuse Counselors). Brewer, who said his life derailed after he started using prescription opioids to manage the pain from a wisdom tooth removal, said opioid settlement funds present an opportunity to support the people who work on the ground.
“When we’re working and talking and troubleshooting different approaches to solve the opioid crisis, we should have the people that have been directly affected by those issues in the room, guiding those conversations,” he said.