WINSTON-SALEM, N.C. – April
18, 2018 – The numbers on drug and alcohol abuse are pretty
21 million Americans have some form of substance use disorder, according to a
2016 report by the U.S. surgeon general. That’s about the same as the
population of Florida.
federal Centers for Disease Control and Prevention says there were more than 64,000
drug overdose deaths in this country last year. That represents a 21 percent
increase over 2016, which is attributable to the opioid epidemic, and is roughly
8,000 more than the number of Americans killed in the Vietnam War.
the 88,000 alcohol-related deaths in the United States each year and you get a figure
that’s more than double the annual number of deaths from auto accidents and gun
perhaps even more staggering is that, according to different studies, only 10
percent of people with substance use disorders receive any type of treatment
for their dependency on alcohol, prescription medications and/or illicit drugs
– even if they’re patients at a hospital.
what other disease do 90 percent of the people suffering from it not get help?”
asked Laura Veach, Ph.D., professor and director of specialized counseling,
intervention and training in the surgery-trauma department at Wake Forest
Baptist Medical Center.
better treat those patients who exhibit either unmistakable and less-apparent
signs of substance abuse – regardless of the primary reason for their being at
the hospital – Wake Forest Baptist last summer filled four newly created positions.
These new hires weren’t health care practitioners with medical, nursing or
other advanced degrees but rather “civilians” with a common credential: personal
can be a good example or a horrible warning,” said Bob Richardson, a onetime
alcoholic and drug user who is one of the four certified peer support
specialists now working at Wake Forest Baptist.
real strength of peer support is the shared experience.” Richardson said. “It’s
a patient saying, ‘You won’t believe what I’ve done,’ and me saying, ‘Try me.
I’ve probably done it myself, and then some.”
support specialists are people with a history of substance use disorder or
mental illness who are in recovery and have been trained to provide personal,
experience-based guidance and assistance to others with similar problems. Their
duties can include helping individuals identify issues, articulate goals for
recovery, learn coping strategies, adopt self-help techniques and access appropriate
states have different requirements for peer support specialist certification.
North Carolina requires passing a 40-hour training course to obtain
certification, with renewal every two years subject to completion of 20 hours
of continuing education.
works in Wake Forest Baptist’s Emergency Department alongside Terry Cox, who
has dealt with personal mental health issues.
we identify the patients, Bob and Terry are able to find common ground with
them more easily than we as providers can,” said emergency medicine physician Christopher
“Crick” Watkins, D.O. “They can bridge the gap in a non-judgmental way and open
an avenue of communication to help the patients recognize that they might have
a problem, but more importantly to let them know that there is hope and
opportunity for recovery.”
that counsel doesn’t come in a one-size-fits-all package.
times I won’t even bring up the idea of substance abuse with the patient,” said
Richardson, who has done peer support since 2005. “I just say that I’m there to
support them, and they get to define that. Over the course of time I’ve gotten
pretty good at figuring out whether to go right in like a bull in a china shop
or be a little more subtle.”
support is available in the ED from 8 a.m. to 10 p.m. Monday through Friday,
with Richardson and Cox alternating shifts. But their work isn’t limited to the
confines of the hospital; they also provide follow-up support to help the
patients navigate the ins and outs of the recovery process.
peer support to emergency patients is not a new concept, though “across the
country it’s still pretty rare,” Watkins said.
is even less common with inpatients, Veach said, “but we’re changing that here.”
of Wake Forest Baptist’s peer support specialists, Alex Wilson and H.B. “Coach”
Harris, work in internal medicine inpatient wards.
combination with Alex and Coach, the physicians, addiction specialists and
counselors on our team can see more people, especially those with more serious
substance use disorders, and deal with them in a way that the majority of
hospitals just don’t,” Veach said.
and Harris also have more time to interact with patients than their counterparts
in the ED.
of the people are here for a while, so we have the chance to work with them in
multiple sessions, getting to know them, building rapport, identifying issues,
helping them in any way we can,” said Wilson, a recovering heroin and opiate
are plenty of teachable-moment opportunities,” added Harris, who said that he
“sipped, dipped, sniffed and tripped” before getting clean almost 30 years ago.
also plenty to keep the peer support specialists busy. Wake Forest Baptist
statistics indicate that about 50 percent of emergency trauma cases and about
30 percent of all admissions involve alcohol or drugs in one way or another.
Alcohol is the most common issue overall but drug-related cases are more stark
among inpatients because drugs, especially those taken intravenously, more
frequently cause or exacerbate serious conditions that require hospitalization
and often impact younger adults.
idea of having peer support at Wake Forest Baptist was introduced about four years
ago by Steve Scoggin, Psy.D., L.P.C., associate vice president of behavioral
health at the Medical Center and president of its subsidiary CareNet Inc., the
statewide counseling service.
was very impressed by how peer support fit into the health care system,” said
Scoggin, who was exposed to the practice through the College for Behavioral
Health Leadership. “I saw it as filling a gap in our care model.”
peer support program was established at Wake Forest Baptist with a grant from
the Hanley Family Foundation, a nonprofit organization that supports projects
associated with chemical dependency, alcoholism and addictive behavior
grant has two specific goals,” Watkins said. “One is to reduce recurring visits
by patients with substance use disorders, particularly alcohol. The other is to
permanently establish peer support specialists within the culture of how we
provide care here.”
the program has been in existence less than a year there are no hard data to
measure its effectiveness. But, Veach said, “We have looked at trends and what
we are seeing is that the patients who have received this type of intervention
have a lower incidence of returning to the hospital than those who haven’t.”
specialists say they have been accepted and made to feel appreciated by the
medical providers and other staff members they work with, and are usually
well-received by the patients – though not necessarily right off the bat.
of them are startled that there’s someone standing before them who’s had a similar
type life experience,” Harris said. “But once they get over that they feel a
little more settled, a little more at ease, a little more open. They lose some
of the preconceived ideas, notions, attitudes they may have had.
realize they’re not alone, and that’s a big component of the process.”