Emergency Department Peer Support Program and Patient Outcomes After Opioid Overdose

Area of Science:

• Public Health
• Addiction Medicine
• Health Services Research

Background:

• Patients treated for opioid overdose in emergency departments (EDs) often require addiction treatment but lack post-discharge linkage to services.
• Emergency department-based peer support programs show promise for improving treatment connections, yet robust evidence of effectiveness is limited.

Purpose of the Study:

• To evaluate the association of the Opioid Overdose Recovery Program (OORP), an ED-based peer recovery support service, with postdischarge outcomes.
• Key outcomes assessed include initiation of addiction treatment, recurrence of overdose, and utilization of acute care services.

Main Methods:

• Retrospective cohort study utilizing New Jersey Medicaid data from 2014-2020 for individuals aged 18-64 treated for nonfatal opioid overdose.
• Compared 180-day outcomes between patients treated in hospitals with OORP implementation versus those in non-OORP hospitals using an event study design.
• Primary outcome was initiation of medication for opioid use disorder (MOUD) within 60 days; secondary outcomes included psychosocial treatment, repeat overdoses, and acute care visits.

Main Results:

• OORP implementation was associated with a 45% increase in the probability of 60-day MOUD initiation (0.034 increase from a baseline of 0.075).
• The program was linked to a reduction in repeat medically treated overdoses at 4 and 5 half-year intervals post-implementation.
• Significant heterogeneity in program outcomes across facilities was observed, suggesting implementation factors influence effectiveness.

Conclusions:

• Implementation of the Opioid Overdose Recovery Program (OORP) in emergency departments is associated with improved linkage to medication for opioid use disorder (MOUD) treatment.
• The OORP demonstrated a significant reduction in repeat medically treated overdoses, highlighting its potential to mitigate harm.
• Variability in outcomes underscores the importance of successful implementation, program integration, and community-based support services for maximizing effectiveness.