A new ER resource – recovery coaches


Melissa Killeen

In Rhode Island, more than 1,000 addicts have been brought from the edge of death due to opioid overdose, thanks to first-responders and emergency room workers using the new lifesaving drugs Narcan and Naloxone. When patients are overdosing, first-responders or ER nurses administer these new drugs, which reverse an opioid overdose. The ER staff members use it so often it’s become a verb, as in: “we Narcaned him.”

In 2015, a pilot program to train law enforcement officers to use Narcan and Naloxone prefilled syringes or nasal spray was started in the New Jersey counties of Monmouth and Ocean. It has been successful in reversing over 400 potentially fatal overdoses. Narcan kits are now available in police cars, ambulances, public transportation centers and even at your local CVS. But the growing number of overdoses has stretched the emergency room doctors and nurses to a breaking point.

When Narcan patients come to the ER, they can be angry and disorientated, when upon waking they find their high is gone. Emergency rooms are handling a lot of overdose patients, and the work can be frustrating. These patients are combative, upset, demeaning, often yelling or physically acting out. ER personnel, not trained in detox reactions, are perplexed. They are being pulled away from the people who have more medically-critical needs.

In a relatively short period of time, Naloxone and Narcan are emerging as very one-dimensional treatments. They are lifesavers, but don’t treat the real problem that brings the patient into the emergency room. Another similar one-dimensional treatment is using a defibrillator for a heart attack, it saves the life but it doesn’t treat the heart disease. Using Narcan does not treat the disease of addiction.

As a result, emergency room physicians, first-responders and treatment experts across the country say the same thing, without a mechanism to connect the overdose patients to addiction services, Narcan and Naloxone only create a revolving door in emergency rooms. Some addicts have returned from the edge of death four and five times, thanks to Narcan injections or nasal sprays.

In Rhode Island’s hospitals, and in hospitals throughout New Hampshire and New Jersey, ER doctors have called on a relatively new resource to help: the recovery coach. These coaches are not ER employees but are part of a new plan to assist ER personnel in dealing with the detoxing victims of an opioid overdose. These recovery coaches work with the detoxing patients, allowing the ER staff to continue with their tasks of treating others that come into an emergency room. These recovery coaches are peers, many of them former addicts trained to work with an overdose patient coming down from the opioid. These coaches are trained to move the patients into long-term treatment programs for their drug addiction.

“The goal of the LifelineED program is to get individuals who were Narcaned into detox and treatment,” says Sharon Chapman, program supervisor of the LifelineED program at Center for Family Services in Voorhees, NJ. “Our Recovery Coaches and Patient Navigators work with each individual to help get them into a treatment facility. It’s important for these patients to know they’re not alone, we offer support to help the patients and their families as they go through the recovery journey.”

These recovery coaches offer peer-to-peer support. There’s nothing like being approached by another recovering drug addict who can help you in your time of need, who knows exactly what you’re going through at that moment. Often, they use information and resources that the hospital staff might not have, such as a list of treatment programs, how to go through the intake process, as well as spending time to educate addicts’ families about the treatment process and how to recognize early signs of the addiction. Of course, the patient decides whether they will take part in treatment, but willingness is the strongest when the patient realizes they just have been given a new “lease on life.” Emergency staff acknowledge it’s helpful to have recovery coaches who can spend time with a patient, and can begin moving them into treatment. These coaches know the recovery terrain better than the ER nurses and physicians. Patients have the option to go to a treatment center, or if they choose to go home, they take the recovery coach’s number with them. The recovery coach or the patient navigator will follow up with them, and assists in helping the patient take the next steps towards recovery. Overdose victims are willing to let recovery coaches into their homes to talk about the program immediately after their overdose. Some need time to come to the realization that if they don’t accept the offer of treatment, there may not be another opportunity. Finding the time for a home visit is something that the ER staff could never do.

Funding for these ER Recovery Coaching programs is popping up all over the United States, since President Obama and Michael Botticelli, the Director of National Drug Control policy, have requested over $1 billion dollars to be placed into the 2017 budget to fight this growing opioid epidemic. This funding request surpasses the $400 million amount Obama signed for in the 2016 budget, which was a jump of $100 million over the 2014 budget, all in hopes of addressing this harrowing epidemic, which has ravaged communities in all corners of the U.S.

If you are interested in learning more about working in an ER room as a recovery coach, here are some resources:


Holly Fitting

Providence Center-AnchorED– 528 North Main Street, Providence, RI 02904

Phone: (401) 528-0123 / Email: hfitting@provcntr.org

Attn: Melissa Silvey

311 Route 108, Somersworth, NH 03878

Phone: (603) 516-2562 / Email: info@onevoicenh.org

Sharon Chapman, Program Supervisor

108 Somerdale Rd, Voorhees NJ 08043

Phone: (856) 428-5699 x116 / Email: lifelineED@centerffs.org



Attn.: Michael Santillo

16 Spring Street

Paterson, NJ 07501 / Phone: (973) 754-6784

  • Barnabas Health Opioid Overdose Recovery Program

1691 U.S. 9, Toms River, NJ 08754

Phone: (732) 914-3815

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