Improvement in Substance Use and Quality of Life in Patients Engaged in a Peer Navigator Program for Opioid Use...

Opioid use disorder (OUD) is associated with high emergency department (ED) utilization, overdose, and unmet social needs. ED-based peer navigator (EDPN) programs may improve engagement in care and address social determinants of health, but data on their clinical and behavioral impact are limited.

To assess changes in substance use, quality of life, patient satisfaction, and healthcare utilization among patients enrolled in an EDPN program.

We conducted a retrospective review of self-reported data using the Substance Abuse and Mental Health Services Administration (SAMHSA) Government Performance and Results Act (GPRA) data collection tool from January 2021 to January 2022. Patients were enrolled during an initial ED visit and followed at 30 days, 90 days, and one year. Analyses included descriptive statistics, chi-squared tests, Fisher's exact test, Student's t-test, and Mann-Whitney U test.

Complete substance use data were available for 80 patients and quality-of-life data for 79. Opioid use decreased from 63.8% at intake to 23.4% at 6 months (p < 0.0001), and overall illegal drug use declined from 73.8% to 32.8% (p < 0.0001). Significant reductions were observed in marijuana (31.3% to 14.1%, p = 0.004), alcohol (40% to 28.1%, p = 0.047), and cocaine use (26.3% to 6.3%, p = 0.0003). Reports of criminal activity decreased from 72.2% to 32.8% (p < 0.001). ED utilization for substance-related complaints declined from 41.8% to 3.1% (p < 0.0001), and outpatient treatment engagement decreased from 81% to 18.8% (p < 0.0001). Satisfaction with living conditions, health, and relationships improved significantly.

EDPN enrollment was associated with reduced substance use, decreased healthcare utilization, and improved quality-of-life measures, supporting its role in improving outcomes for patients with OUD.