States turn to recovery coaches to curb opioid epidemic

Peer recovery coaches can engage overdose patients early on, and help get them into treatment.

As the opioid addiction epidemic grips the country, providers in several states are turning to peer coaching programs, where addicts in recovery meet with overdose patients who can help them enter treatment.

Rhode Island was the first state to implement such a program, according to an article from the Pew Charitable Trusts’ Stateline blog, and since then it has spread to New York, Massachusetts and Connecticut. Health officials in California, Maine, North Carolina, Ohio, Oklahoma, Texas and Vermont have also been in touch with the original program’s founders about starting similar initiatives. 

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Rhode Island’s program, AnchorED, began in July 2014 with just one coach, George O’Toole, who was on call from 8 p.m. on Fridays to 8 a.m. on Mondays, But soon hospitals were calling him on weeknights as well. Now he manages a staff of 20 coaches.

Clinical staff ask overdose patients if they want to meet with a recovery coach before bringing one in, and O’Toole estimated that only 1 in 5 actually accept the offer.

“I get that. They just overdosed. You ruined their high. They’re embarrassed, ashamed and don’t want to hear about it,” he told Stateline. “The ones who agree may already be motivated. They realize they just died and got brought back to life, and they need a plan for how that isn’t going to happen again. That’s why we’re here.”


Coaches come to the hospital and discuss potential recovery options with patients. For patients who don’t want to stop using drugs, the coaches may offer advice on how to take drugs more safely, avoiding overdoses and spreading diseases like HIV/AIDS or hepatitis. From the initial meeting, coaches follow up with the patients for 90 days or more to see how they are progressing.

RELATED: Doctors need to recognize ‘alarmingly high’ death rate for patients with opioid addiction

Patients who are addicted to opioids have high mortality rates in healthcare settings, and addiction treatment can be costly. Some states are also looking into more controversial ways to avoid overdoses, such as potential supervised injection sites, or directives that allow patients to refuse opioid prescriptions.

Other providers are looking at more stringent guidelines for prescribing opioids and alternatives to such prescriptions for pain management, but that can be a hard sell to patients, as their goals for pain management may differ from their doctor’s.

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