Kristen Gilmore Powell1, Peter Treitler2, N Andrew Peterson3, Suzanne Borys4, Donald Hallcom5. 1. Center for Prevention Science, Prevention Technology Transfer Center, Region 2, Rutgers School of Social Work, 390 George Street, 6th Floor, New Brunswick, NJ 08901, United States. Electronic address: kgilmore@ssw.rutgers.edu. 2. Center for Prevention Science, Rutgers School of Social Work, 390 George Street, 6th Floor, New Brunswick, NJ 08901, United States. Electronic address: pt245@ssw.rutgers.edu. 3. Center for Prevention Science, Prevention Technology Transfer Center, Region 2, Rutgers School of Social Work, 390 George Street, 5th Floor, New Brunswick, NJ 08901, United States. Electronic address: andrew.peterson@ssw.rutgers.edu. 4. NJ Division of Mental Health and Addiction Services, Office of Planning, Research, Evaluation and Prevention, 222 South Warren Street, Trenton, NJ 08625-0700, United States. Electronic address: Suzanne.borys@doh.state.nj.us. 5. NJ Division of Mental Health and Addiction Services, Office of Planning, Research, Evaluation and Prevention, 222 South Warren Street, Trenton, NJ 08625-0700, United States. Electronic address: Donald.Hallcom@doh.state.nj.us.
Abstract
BACKGROUND: Fatal opioid overdose is a national public health concern in the United States and a critical problem confronting New Jersey's addiction treatment system. New Jersey developed an innovative program, the Opioid Overdose Recovery Program (OORP), to address the epidemic and the issue of low treatment admissions following a non-fatal overdose. The OORP utilizes an intervention model with peer recovery specialists (RSs) and patient navigators (PNs) to engage individuals within emergency departments (EDs) immediately following an opioid overdose reversal. The purpose of this exploratory s/tudy was to examine the process through which the OORP was implemented in its first year and determine facilitators and barriers to implementation. METHODS: Data were collected in 2016-2017, through 17 telephone interviews and focus groups with 39 participants. Participants were OORP staff and stakeholders selected through purposeful, non-random sampling. Standardized, open-ended interview guides were used. Thematic analysis was conducted to identify, analyze, and report overall patterns. RESULTS: Participants detailed stories from the field and policymakers illuminated the process of implementation. Findings revealed logistical barriers to treatment including patients' lack of insurance and cell phones, lack of immediately available detox beds, and program ineligibility for some patients due to medical conditions. The model using peers as first responders had a positive impact as their experiences with addiction enabled them to more successfully engage patients. The PNs were critical in addressing high needs for case management and referral and external partners were also important for implementation. CONCLUSIONS: Results underscore the effort needed to integrate this important model within EDs as part of a multi-level approach to address opioid misuse. The identified challenges led to statewide strategic planning and areas for further development. OORP is a promising intervention that might increase the number of individuals suffering with opioid disorders linked to peer support, treatment and recovery.
BACKGROUND: Fatal opioid overdose is a national public health concern in the United States and a critical problem confronting New Jersey's addiction treatment system. New Jersey developed an innovative program, the Opioid Overdose Recovery Program (OORP), to address the epidemic and the issue of low treatment admissions following a non-fatal overdose. The OORP utilizes an intervention model with peer recovery specialists (RSs) and patient navigators (PNs) to engage individuals within emergency departments (EDs) immediately following an opioid overdose reversal. The purpose of this exploratory s/tudy was to examine the process through which the OORP was implemented in its first year and determine facilitators and barriers to implementation. METHODS: Data were collected in 2016-2017, through 17 telephone interviews and focus groups with 39 participants. Participants were OORP staff and stakeholders selected through purposeful, non-random sampling. Standardized, open-ended interview guides were used. Thematic analysis was conducted to identify, analyze, and report overall patterns. RESULTS:Participants detailed stories from the field and policymakers illuminated the process of implementation. Findings revealed logistical barriers to treatment including patients' lack of insurance and cell phones, lack of immediately available detox beds, and program ineligibility for some patients due to medical conditions. The model using peers as first responders had a positive impact as their experiences with addiction enabled them to more successfully engage patients. The PNs were critical in addressing high needs for case management and referral and external partners were also important for implementation. CONCLUSIONS: Results underscore the effort needed to integrate this important model within EDs as part of a multi-level approach to address opioid misuse. The identified challenges led to statewide strategic planning and areas for further development. OORP is a promising intervention that might increase the number of individuals suffering with opioid disorders linked to peer support, treatment and recovery.
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