Center for the Study of Drugs, Alcohol, Smoking and Health, University of Michigan School of Nursing, Ann Arbor, Michigan, USA.
Home of New Vision, Ann Arbor, Michigan, USA.
Subst Abus. 2021;42(4):423-427. doi: 10.1080/08897077.2020.1847239. Epub 2020 Dec 7.
Effective interventions for overdose survivors are needed in the emergency departments (EDs). One promising model is the use of peer recovery coaches to engage with survivors in EDs, followed by partnering with community case management navigators to connect survivors to recovery support and treatment services. This paper describes the evaluation of a pilot program, the Recovery Opioid Overdose Team (ROOT), a warm hand-off system that links survivors to treatment services post-ED discharge. The ROOT program is composed of a peer recovery coach who is in long-term recovery, and a case management navigator who specializes in mental health care and provides guidance for accessing community services. After an overdose reversal, law enforcement contacts a county 24/7 Crisis Team, who then notifies ROOT. The peer recovery coach engages with the survivor in the ED, and then follow up continues with the case management navigator and the peer recovery coach for up to 90 days post-ED discharge. Retrospective chart reviews were conducted to evaluate ROOT in two Midwest EDs from September 2017 through March 2019. Of the 122 referrals, 77.0% ( = 94) of the survivors initially engaged with ROOT in the ED or in the community. The remaining 23.0% ( = 28) left the ED against medical advice or were unengaged. The majority of overdose survivors were male (63.9%; = 78), White (43.4%; = 53), had housing (80.2%; = 48), and access to transportation (48.4%; = 59). From the 122 referrals, 33.6% ( = 41) received ongoing treatment services ( = 20 outpatient, = 17 residential, = 2 detoxification facility, = 1 recovery housing, = 1 medication treatment for opioid use disorder), 2.5% ( = 3) were incarcerated, 2.5% ( = 3) died, and 61.5% ( = 75) declined services. The ROOT, a community-wide coordinated program in the EDs, shows promise in linking overdose survivors to recovery support and treatment services post-overdose.
在急诊科（EDs）需要为过量幸存者提供有效的干预措施。一种有前途的模式是使用同伴康复教练在 EDs 中与幸存者接触，然后与社区病例管理导航员合作，将幸存者与康复支持和治疗服务联系起来。本文介绍了对试点项目“恢复阿片类药物过量团队（ROOT）”的评估，该系统是一种温暖的转接系统，将幸存者与 ED 出院后的治疗服务联系起来。ROOT 项目由一名长期康复的同伴康复教练和一名专门从事心理健康护理并为获取社区服务提供指导的病例管理导航员组成。在过量逆转后，执法人员联系县 24/7 危机小组，然后由该小组通知 ROOT。同伴康复教练在 ED 中与幸存者接触，然后由病例管理导航员和同伴康复教练继续跟进，直至 ED 出院后 90 天。从 2017 年 9 月至 2019 年 3 月，对中西部两个急诊科的 ROOT 进行了回顾性图表审查。在 122 名转介者中，77.0%（=94）的幸存者最初在 ED 或社区中与 ROOT 接触。其余 23.0%（=28）未经医疗建议离开 ED 或未接触。大多数过量幸存者为男性（63.9%；=78），白人（43.4%；=53），有住房（80.2%；=48）和交通（48.4%；=59）。在 122 名转介者中，33.6%（=41）接受了持续的治疗服务（=20 名门诊，=17 名住院，=2 名戒毒所，=1 名康复住所，=1 名阿片类药物使用障碍药物治疗），2.5%（=3）被监禁，2.5%（=3）死亡，61.5%（=75）拒绝服务。ROOT 是 EDs 中一个社区范围内的协调项目，有望在阿片类药物过量后将幸存者与康复支持和治疗服务联系起来。
