Crisis Intervention in a Local Community Emergency Department Inspires Growth of Peer Support Services.

"Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. This study was supported by the South Carolina Department of Alcohol and Other Drug Abuse Services (DAODAS) Grant."

"This data including a 98% initial engagement and 64% remaining actively engaged at one year were compelling. Initially, emergency clinicians and leadership were reluctant to integrate CPSSs into the clinical environment over concerns that patients presenting with an overdose would refuse a consultation and because of a negative perception of the CPSS’s capabilities. By the end of this intervention, team members recognized the importance of CPSSs so much so that during the COVID-19 pandemic, FAVOR CPSSs were offered vaccination within the same priority group as the rest of the ED staff. Overall, this crisis intervention provided crucial experience and intriguing preliminary data that inspired Prisma Health to initiate the following programs through both external grants and internal funding: 1) launching a network of outpatient buprenorphine treatment programs (both clinic-based and mobile units) that have capacity to see uninsured patients (HRSA:HB147075); 2) implementing Screening, Brief Intervention and Referral to Treatment (SBIRT) programs within our busiest urban and rural EDs including seven full-time CPSSs to engage patients and provide harm reduction with take-home naloxone and 3) ED-based MAT initiation (National Institutes of Health HEAL Initiative:NCT05123027, and SAMHSA:H79TI083300). Overall, while CPSSs have spread across the state in multiple EDs and other SBIRT programs their results have been mixed. This FORCE intervention did supply preliminary data for the CTN multisite “PILOT” trial (CTN-107), which is investigating two models of care using CPSSs across both short-term and long-term CPSS engagement (FORCE model). Prisma Health is one of three participating sites. Overall, this clinical intervention provided the foundation for growth of addiction-related services within our health system and provided preliminary data supporting a National Institute on Drug Abuse-sponsored nationwide clinical trial. Conflicts of Interest: By the WestJEM article submission agreement, all authors are required to disclose all affiliations, funding sources and financial or management relationships that could be perceived as potential sources of bias. No author has professional or financial relationships with any companies that are relevant to this study. This study was supported by the South Carolina Department of Alcohol and Other Drug Abuse Services (DAODAS) Grant."