Background: People with substance use disorders have regular contact with the emergency department (ED). Peer recovery specialists with lived experiences of substance use can provide critical linkages to substance use treatment and other services for patients who use drugs. Patient populations seen by peer recovery specialists remain largely undescribed.
Objective: This paper describes the demographics, substance use patterns, and barriers to treatment of patients seen by peer recovery specialists in an ED in Philadelphia.
Method: A review of patient records about demographics, the reason for ED visits, housing, primary drug of choice, previous treatment, treatment barriers, and urine toxicology screening results was conducted.
Results: Of 228 patients seen between December 1, 2020, and April 8, 2021, those who listed alcohol as their drug of choice (n=56, 24.6%) came to the ED primarily for withdrawal symptoms (n=19, 33.9%). Patients who listed other drug use (n=172, 75.4%) were largely seen for infection (n=57, 33.1%). Polysubstance use was prevalent in patients whose primary drugs of choice were not alcohol. Inpatient treatment was the most common previous treatment previously (n=106, 46.5%) and the most desired treatment preferred for future treatment (n=97, 42.5%). The most common barriers to treatment for patients were medical comorbidities (n=70, 30.7%) and difficulty navigating the healthcare system (n=43, 18.9%).
Conclusions: Patients consulted by peer recovery specialists had distinct demographics, substance use patterns, and perceived goals and barriers to care. These findings highlight the importance of recognizing and treating polysubstance use for people who use drugs and the critical role of peer recovery programs in navigating subsequent care.
Keywords: alcohol use disorder; emergency department; opioid use disorder; peer recovery specialist; polysubstance use; substance use disorder.
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