Assertive Engagement and Harm Reduction Through Peer Coaching and Family Support

The traditional approach to treatment waits for someone to hit rock bottom before getting help. With today’s opioid epidemic and the rise of fentanyl, waiting for “rock bottom” too often means death. Additionally, substance use disorder is a chronic, relapse-prone disease, and the most important factor for predicting improvement five years after discharge from treatment is ongoing engagement. Peer coaching programs are an early intervention strategy to reach individuals and families in need and keep them engaged in the recovery process. Peer coaches use harm reduction and motivational interviewing techniques and their own lived experience – the same as the person they are coaching – as well as integration of family and community programs to deliver effective, compassionate support. Additionally, they support family members of individuals struggling with addiction, regardless of how that family member is engaged in their own recovery, by providing a baseline education on topics like substance misuse, boundary setting, and self-care. These interactions help individuals struggling with substance misuse and their family members stay engaged in the recovery journey, maintain a positive outlook, and develop new behaviors and social support that sustain accountability. A randomized clinical trial with Clemson University and the University of South Carolina School of Medicine in 2020 established the impact peer recovery programs have: At the end of the 6-month trial, participants with peer recovery coaches were retained/engaged at an 89% success rate, whereas participants randomized to treatment as usual were retained/engaged at an 11% success rate. Additionally, two years of program evaluation data through the Department of Alcohol and Other Drug Abuse Services (DAODAS) showed 98.5% of total participants successfully engaged in coaching; 60.2% of engaged participants were linked with treatment/additional recovery services during enrollment.