Addressing the Addiction Crisis Through Peer Recovery Support Services

Overview

Drug overdose deaths in the United States accelerated during the COVID-19 pandemic, rising nearly 30 percent in 2020 to a record 93,000 — the largest single-year increase ever recorded. Mirroring the pandemic’s disproportionate impact on communities of color, overdose deaths among Black and Hispanic populations increased at a more rapid pace than in white communities. Substance use disorders (SUD) and overdose risk are also strongly correlated with a history of involvement in the justice system. Studies show the risk of death from opioid overdose is particularly high in the period following an individual’s release from prison. To confront the overdose crisis, it is crucial to address the disparities in addiction treatment to reach as many individuals as possible with these critical services.

It’s been proven that social support from peers who have personally experienced addiction and gone through the recovery process can improve outcomes for those struggling with SUD. These survivors have a role to play in increasing the engagement of difficult-to-reach individuals, particularly within criminal justice and child welfare systems. Considered a best practice by the Substance Abuse and Mental Health Services Administration (SAMHSA), peer recovery support services (PRSS) help mitigate nationwide shortages in mental health and SUD treatment providers. Keeping up with the latest innovations and developing implementation strategies for emerging best practices can be challenging for the diverse, and often busy, organizations capable of providing PRSS. With training and technical assistance (TTA), however, they can increase their capacity and expand their PRSS offerings.

Approach

In 2017, Altarum was selected by the Bureau of Justice Assistance (BJA) to launch a national TTA center to support organizations seeking to implement or expand peer recovery programs to address opioid and other SUD for justice-involved populations. Drawing on individual subject matter expertise and decades of experience in developing PRSS programming, we have built and maintained strong relationships with over 200 grantees and partnering organizations as part of this continued work.

Using evidence-backed approaches, Altarum teaches best practices via online webinars, publications, podcasts, virtual communities of practice and consultation, and in-person training that promote peer-to-peer learning. With a focus on diversity, equity, and inclusion (DEI), we are increasing outreach to racially minoritized individuals who, research shows, have historically been stigmatized or overlooked by addiction treatment providers. We’re also active in child welfare settings, providing peer support for families with children who are struggling with addiction or are involved in the justice system. Our TTA offerings range from the dissemination of foundational practices for widespread adoption to highly individualized services based on grantee requests.

Focus Areas

Behavioral Health

Results

Here are a few of our accomplishments in 2022:

Providing targeted TTA to 18 primary and over 100 secondary grantee sites by hosting quarterly grantee and advisory board calls
Recruiting and vetting 10 new mentor sites — virtually and on-site — for the 2022-23 Peer Recovery Support Services Mentoring Initiative (PRSSMI) to match and coordinate with mentee sites across the country
Conducting intensive on-site TTA in California to improve coordination between the Orange County Health Care Agency and law enforcement as well as increase participation in a program that connects individuals leaving the county jail with medication-assisted treatment (MAT)
Continuing long-term TTA in Minnesota to implement PRSS through emergency departments statewide
Developing nearly 20 universal TTA products to disseminate to the criminal justice field, including recovery community organizations, law enforcement organizations, treatment court and jail-based settings, and re-entry programs
Developing five toolkits and corresponding Champions of Recovery videos for BJA’s 2022 Recovery Month celebration
Presenting at two national conferences: the National Association of Drug Court Professionals (NADCP) and the Cocaine, Meth & Stimulant Summit
Exhibiting at two national conferences: NAADAC, the Association for Addiction Professionals and the National Association of Peer Supporters (NAPS)

As a result of these efforts, the program’s grantee sites experienced measurable outcomes, with PRSS contributing to a more than 65 percent decrease in fatal overdoses in a six-month period at one site and leading to a fivefold increase in the number of treatment referrals between 2020 and 2022 at another. Grantees also see significant cost savings associated with improved participant outcomes due to reductions in emergency department visits and inpatient admissions.

By sharing best practices, strengthening organizational capabilities, and increasing coordination between law enforcement and community-based organizations through our technical assistance work with BJA, Altarum is helping confront the opioid, addiction, and behavioral health workforce crises by ensuring comprehensive peer recovery supports are available in more communities nationwide.