Researchers from Brown University and Rhode Island Hospital have been at the forefront of battling the opioid epidemic in Rhode Island, and a new $800,000 grant from the Laura and John Arnold Foundation will help them to keep up the fight.
With the grant, researchers will conduct the first randomized controlled trial of a peer-based recovery intervention for patients at high risk of overdose. The peer recovery support services program will be compared to the current standard of care, which is a single session with a social worker, for providing recovery support to patients who arrive in the emergency department with opioid overdoses. The team plans to begin enrolling patients in the four-year trial next week.
"Randomized controlled trials are really the gold standard for making evidence-based decisions," said Dr. Francesca Beaudoin, a principal investigator on the grant, emergency department physician at Rhode Island Hospital and Brown faculty member. "Our new trial is the first randomized controlled trial of a peer-led recovery intervention for opioid use disorders in the U.S."
Peer recovery support specialists, also known as peer recovery coaches, are people who have been in recovery from substance abuse for at least two years and have received specialized training in addiction support and referrals to treatment. Rhode Island is a national leader in developing peer-based approaches to combating the opioid overdose epidemic, said Brandon Marshall, a principal investigator on the grant and associate professor of epidemiology at Brown's School of Public Health.
"We're looking at two promising interventions: social workers, who have specific clinical training and expertise and are the standard of care, and the peer recovery support specialists, who are unique in that they bring their life experiences with addiction and follow up with the patients, often several months after discharge from the emergency department," Marshall said. "The best outcome is if both interventions do really well at increasing uptake of treatment and reducing subsequent overdoses."
Beaudoin, who also has appointments as an associate professor of emergency medicine at Brown's Warren Alpert Medical School and of health services, policy and practice at Brown's School of Public Health, is the site director for the study and will be oversee day-to-day patient recruitment and operations.
Marshall, who serves as scientific director of Prevent Overdose R.I., a drug overdose surveillance dashboard that stems from Gov. Gina Raimondo's Overdose Prevention and Intervention Task Force, will coordinate with various partners to collect and analyze the data on the intervention outcomes. These include being admitted to the emergency room with another opioid overdose within 18 months or initiating substance use disorder treatment.
"We're trying to optimize the treatment of opioid use disorders when patients come to the emergency department, especially after an overdose," Beaudoin said. "Intervening after someone has just experienced an overdose may be a critical moment in treating addiction. If patients seek out additional treatment after being released from the emergency department, that's a win. If they never have another overdose, that's really a win."
Partners involved in the peer recovery support program and the trial include the Rhode Island Department of Health; Rhode Island Department of Behavioral Healthcare, Developmental Disabilities and Hospitals; Lifespan and the Anchor Recovery Center.
"Peer recovery support programs are a vital part of our fight against the overdose epidemic in Rhode Island," said Tom Coderre, a senior advisor to Raimondo. "We hope that this randomized controlled trial confirms these programs are effective at connecting people with lifesaving resources, and anticipate the results will encourage other states to undertake similar programs."