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Northeast Ohio Opioid Settlement Money To Fund Peer Recovery Coaches

MetroHealth's main campus in Cleveland. [MetroHealth System]
MetroHealth's main campus in Cleveland.

At MetroHealth Medical Center, Christopher Hall offers patients struggling with addiction something unique: common ground.

Hall is a certified peer supporter with Thrive Peer Support, an Ohio recovery organization. He’s part of a team of people at MetroHealth who have been through the rigors of addiction recovery themselves. They help patients facing addiction find treatment when it is time to leave the hospital.

“I used heroin for 15 years,” Hall said he tells patients. “I grew up with alcoholism. I know what you’re going through. And that really gets them to let their guard down and talk, and they’re usually very relieved.”

For two years at MetroHealth, Thrive’s coaches have tried to help patients find such help as outpatient care or residential treatment. The effort is funded by the county Alcohol, Drug Addiction and Mental Health Services Board. 

Now, Cuyahoga County is using $3 million in opioid settlement money to place peer supporters at Cleveland Clinic and University Hospitals emergency rooms.

“In the emergency department, 9 times out of 10, it’s detox,” Hall said. “Depending on their insurance, we can get them in somewhere usually that day.”

In Thrive’s first year at MetroHealth, peer supporters saw 1,200 patients and connected about 30 percent with treatment, according to the company. The hospital appears happy with the results so far.

“Oh, it’s phenomenal,” said Dr. Joan Papp, who oversees opioid safety for MetroHealth.

It takes a lot of time and resources to support people in treatment, Papp said. That’s time that hospital emergency departments rarely have.

“With the help of a peer supporter, somebody there to really guide you and hold your hand, and in many cases drive you directly to treatment, that is just a world of difference,” she said.

Coaches are now working with patients throughout the hospital.

They also work in the community, building relationships with people in the midst of recovery. Patricia Withrow met her peer supporter at a local treatment center in Cleveland.

“She’s a big part of my life, actually,” Withrow said. “My day—if I don’t talk to her at least once a day, I feel incomplete.”

Withrow has been sober for 17 months. When she had a recent cancer scare, she said, her supporter talked to her kids to help reassure them. That kind of stress could push someone to relapse—but Withrow has been doing well.

“It’s taught me how to have actual relationships with people that are positive,” she said. “She taught me that. She taught me to help set boundaries.”

Withrow is referring to her peer supporter, Nicole Betzner. Betzner said she tries to remove roadblocks that stand in the way of recovery, such as by driving Withrow to appointments.

“If their home environment is toxic, or relationships, or if they have barriers with food, clothing, shelter, transportation, all of those things, kind of unraveling that,” Betzner said. “But ultimately, also, helping a person recover from different traumas and issues of life.”

Over the past five years, as the opioid crisis has deepened, peer support programs have been catching on—launching in New York City, Rhode Island, Indiana and elsewhere.

While results are still coming in, hospital peer-support programs seem to be effective, according to Dr. Elizabeth Samuels, an emergency room physician and Brown University assistant professor.

“They’ve been in that person’s shoes,” Samuels said. “They know what it’s like. They treat them like a human being. They give them respect.”

For peer recovery programs to work well, she said, a wide network of treatment options should be available in the community. That includes medication-assisted treatment and accessible overdose recovery drugs like naloxone.

“There’s very high risk of repeat overdose and overdose death following an [emergency department] visit for opioid overdose,” Samuels said. “So I think for people who are setting up these types of programs, we really see that as a crucial opportunity to connect with people.”

Cuyahoga County is trying to seize that opportunity with settlement money. Meanwhile, counties around the country are still waiting for a universal opioid deal to help bring people with addiction back from the edge of crisis.

Nick Castele was a senior reporter covering politics and government for Ideastream Public Media. He worked as a reporter for Ideastream from 2012-2022.