View from the Field: Maximizing the Impact of Peer Support in Emergency Rooms

November 11, 2021

Peer support workers play a critical role in supporting people with substance use disorder (SUD) in emergency rooms. After a patient survives an overdose and before they are discharged, peer workers engage in a supportive role connecting individuals with immediate, life-saving post-overdose care options including detoxification and harm reduction services as well as treatment and recovery services.

Because of their lived experiences with substance use and addiction recovery, peer workers have unique expertise that amplifies their ability to build trusting and supportive relationships with patients by sharing stories, listening, offering compassion, and help navigating next steps. As a result, when peers are part of hospital care teams, the services they provide can contribute to decreasing a patient’s length of stay, frequency of admission, and need for behavioral health services over time.  Yet, persistent stigma from other healthcare professionals, poorly defined roles, and a lack of professional support and supervision is hindering the integration of peer providers in interdisciplinary teams.

According to Dr. William Soares, Director of Harm Reduction in the Department of Emergency Medicine at Baystate Medical Center in Springfield, MA, barriers to peer support in emergency settings include a lack of understanding of their role and impact. Dr. Soares says, “Understanding that a peer coach often provides support both during and after an emergency department visit helps me to provide the best care I can to my patients with opioid use disorder.”

Some of the barriers can be addressed through trainings for hospital administrators, medical providers, emergency department staff, and peer support workers:

In addition to trainings, establishing strong working relationships between emergency room providers and peer support workers is key. The more learning experiences and opportunities for teams to collaborate and contribute, the greater the ability for everyone to learn from each other and improve patient care. For example, one important strategy is ensuring all staff are incorporated into SUD patient engagement, including in medical staff rounds, huddles, and team meetings. To build strong team environment, Rebecca Zwicker, a peer worker in Central Massachusetts says, “Emergency rooms are extremely busy. To build relationships with doctors and nurses in this environment, I have learned how to tell them what I do in 30 seconds and spent time briefly meeting them in their break rooms.”

To sum up the importance of using peer services in emergency rooms, Rebecca Zwicker says, “My job is to plant a seed, or water an already planted seed with compassion…even if someone has been in the emergency room 10 times, the 11th time might be the time when I can support them into treatment or when they are open to follow-up.”