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There is no doubt there is a substance abuse crisis; 72,000 people in this country died of an overdose in 2017 alone, and 21.5 million people have battled a substance use disorder in their lifetimes according to the National Survey on Drug Use and Health.

Often overlooked in these grim statistics is the stigma and lack of hope those with a substance use disorder experience. “I know what it’s like to be hopeless,” says Wes Marshburn, a recovery coach with the Roanoke Rescue Mission, who is in recovery himself. “So if you have the opportunity to fill someone with hope, that’s the first step in long-term recovery.”

Peer recovery program

Marshburn is one of the first state-certified peer recovery specialists (PRS) working in Roanoke,  Virginia. The area knows the substance abuse crisis well: 49 people died from opioid overdoses in 2017 in Roanoke alone, and on average the Carilion Roanoke Memorial Hospital Emergency Department sees two overdose patients every day.

This makes the Peer Recovery Program at Carilion such an important new element in the treatment of addiction.

“The program is part of a statewide initiative which started in 2017 to formalize peer recovery specialists and make them a billable service in our Medicaid system,” says Erin Casey, who leads the Peer Recovery Specialists at Carilion. “We train people who are in recovery to assist people who are working on their own recovery journey.”

The “Hope Floor”

“For me, it was really rewarding working with other Peer Recovery Specialists,” Marshburn says. “It was a time of growing and having the opportunity to take what I’ve been through and reach the next person who is suffering from a substance use disorder.”

The training to become certified as a PRS is rigorous. “The training is a 72-hour program,” Casey explains. “Then candidates have to complete 500 hours of volunteer or employed supervised work as a peer prior to an exam. That prepares them to become certified by the Virginia Board of Counseling.”

The impact of the Peer Recovery Program has been immediate. “The floor at Roanoke Memorial where many overdose patients are treated is a medical-surgical floor,” says Casey. “They see a lot of people with endocarditis — a bacterial infection of the heart, in these cases, due to IV drug use. Staff were having a hard time with the patients leaving against medical advice (AMA) and the nursing staff were not trained to work with people with addiction. When peer recovery specialists started working on the unit almost immediately our rates of people leaving AMA dropped dramatically. Behavioral incidents did too. Staff renamed the floor the ‛Hope Floor,’ and now physicians and administrators around the hospital send patients that need hope to that floor because they know that they have this extra level of support.”

Despite these signs of hope, both Marshburn and Casey agree there’s a lot more to be done. “I’d like to see more options for people who don’t have insurance,” Marshburn says. “Free detox for people that don’t have the money to pay for it. They don’t seek help, because they don’t feel like there’s help out there.”

“I think housing is one of our biggest barriers,” adds Casey. “If you don’t have safe and secure housing, then recovery seems like a constant uphill battle.”

Still, both see progress in resources and programs — but also in reducing the shame associated with addiction. “In the peer world,” notes Casey, “we talk about stigma and shame all the time because it affects every single one of us. But we see the conversation changing. People are actually treating addiction as a disease.”

Jeff Somers, [email protected]

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