Peer coaches

Beth Hanson, who is a recovery coach with the Georgia Council on Substance Abuse, talks during a staff meeting held at the Northeast Georgia Medical Center in Gainesville. With her are Ashley Stevens, Owen Dougherty, Laurisa Barthen and Avery Nix, who are all people in long-term recovery.

GAINESVILLE, Ga. – A man who introduced himself as the “drunk of Gainesville,” and who had done multiple stints in the hospital’s intensive care unit, was now 40 days sober.

Another man, who came in this spring battling a severe infection and meth addiction, had gone 135 days without using the drug.

And a former patient, who had been unreachable for months, had at last responded to a social media message to say he had just been on technology restriction as part of his treatment and he was doing well.

These were the hard-fought successes celebrated on a recent afternoon inside a small office at Northeast Georgia Medical Center, where Avery Nix and a handful of people gathered to recount the day’s events.

Nix, a 27-year-old former high school football standout, can relate. He’s been there before, literally. An opioid overdose in 2012 brought him to the same Gainesville emergency department, where his condition was so dire his parents were told he would not survive.  

“I wasn’t alive and I got brought back,” Nix said. “I can remember waking up and thinking to myself, ‘I got caught up. I did too much. Now I’m found out all over again.’ It was just mortifying.”

Three years sober, Nix is now part of an effort to try something different to curb the opioid crisis in Georgia. A team of specially trained people, who have all overcome their own harrowing addictions, has been placed inside the busy Gainesville emergency department.

The peer recovery coaches, as they are called, are bedside just hours after a patient has been stabilized. They see the patients when they are miserable and vulnerable, having just nearly lost their lives.

 “It’s probably the realest conversation they’ve had in several months,” Nix said.

‘It’s not going away’

 Statewide, Georgia has seen an alarming spike in the number of people dying from an opioid overdose, with the death toll doubling in just five years. Last year, opioids killed more than 1,000 people in Georgia.

 At the Northeast Georgia Medical Center in Gainesville, the number of opiate overdose patients coming through the emergency department rose dramatically in just one year, jumping from 281 in 2015 to 696 the following year. Last year’s data is not yet available.

 “It’s not going away. This is a reality,” said Angela Gary, who is the executive director of the non-profit hospital’s trauma and emergency services. “Choosing to sit back and not address it is just not the right thing to do.”

 Gary said it was time to do things differently. The program, which started last fall, adds a resource for following up with these patients once the crisis moment has passed.  

“From the medical standpoint, we’ve got that. That’s what we do really, really well,” she said. “The one thing that emergency departments do not do as well is really focus on the follow up. We don’t get the luxury of having that connection with them.”

It is too soon to know what impact the program is having and whether it is, for example, reducing the number of recurring patients who come to the emergency room as a result of substance abuse.

Gary, though, pointed to the number of contacts the coaches have had with patients as one positive indicator. Since January, the coaches had met with more than 1,000 patients at the three hospitals in the health care system, which includes smaller campuses in Braselton and Winder.

And the coaches, who are all in long-term recovery, have been able to reconnect with more than 60 percent of patients at least once after they have been discharged from the hospital.

The Georgia Council on Substance Abuse runs the program, called Community Connections, which is funded through a $353,000 federal grant. At full strength, the program will have eight coaches.

State lawmakers chipped in $250,000 this year to expand the program to the hospital’s neonatal intensive care unit, where the hospital treats babies born addicted to the substance their mother used while pregnant. There, the coaches work with the moms while the nursing staff focuses on the babies’ needs. 

State Sen. Renee Unterman, R-Buford, who chairs the Senate Health and Human Services Committee, said she sees the Gainesville program as a pilot. While peer recovery is not a new concept, only two groups – the council and another group in Gwinnett County – are currently doing it in Georgia emergency rooms.

Unterman said she will push for additional state funding so more peer recovery programs can be implemented in other hospitals across the state.

“They’re clamoring for it,” Unterman said. “Gainesville is not unique. Every emergency department in Georgia is facing this.”

But while opioids may have spurred the program’s creation here, it’s not the main substance that brings people into these north Georgia emergency departments. That distinction goes to alcohol.

Meth is the next most common, followed by heroin. Many of the patients are on multiple substances.

None of that matters to the coaches, though.

“As soon as they realize we’re not the police, we’re not the doctors, we’re not the mental health group – that we’re them – it’s amazing the walls that fall down so quickly,” said recovery coach Beth Hanson, who has been sober since 2013.

“They realize that we truly, truly do understand what they are going through and we are not there to judge them,” she said.

The 56-year-old said she wonders whether the program would have helped her get better sooner, had it existed years ago. Her abuse of prescription painkillers landed her in the Gainesville emergency department – twice.

Instead, it was getting caught embezzling to support her drug use that changed the former accountant’s life. She opted for drug court to avoid prison, only to realize four months into the two-year program that she really did have a problem.

“If I had not gone to jail, I would be dead,” Hanson said. “That is the God’s honest truth.”

A connection

While most of the patients are open to chatting with a coach, there are those who decline. A mom with a baby in the NICU, for example, recently scurried away before a coach could arrive.

Sometimes the patient is not all that talkative, so the coaches scan the hospital room for potential conversation starters. They quietly listen and follow along with whatever topic posed, no matter how obscure or unrelated to the crisis that nearly ended the patient’s life just hours earlier.

Some are hostile. Hanson shared an especially difficult encounter with a woman who had already threatened her co-workers.

“All I can do is love her because no one else will,” Hanson said through tears. “She thinks she is beyond hope and that she’s not able to be helped, that so much damage has been done to her body.”

But this woman is also an example of how the effort and patience can eventually pay off. In a later interview, Hanson said the woman recently contacted her – quite unexpectedly – wanting to find a long-term treatment facility.

The goal of these interactions is not necessarily to get the patient into treatment, though.

Rather, the coaches are there to make a connection. They are guided by the belief that connections to people – rather than a substance – will help lead the patients to recovery in whatever way works for them.

“If we do nothing else, we give them a hope shot,” said Neil Campbell, the council’s executive director and also a person in long-term recovery. “It’s like, ‘Here’s your shot of hope. You don’t have to live like this. There are things we can do about it and do it together.’”

It was connecting with people in long-term recovery that made the difference for Jacob Martin, who became hooked on the alcohol and Xanax that he once leaned on to navigate social settings.

The 24-year-old recovery coach described his past brushes with traditional treatment as cold and clinical. He said he sees his job as a chance to show someone who is struggling with addiction the perks of recovery, such as the mental clarity he now enjoys when he closes his eyes at night.

Either way, he’s there to listen.

“It can give someone a chance to be heard in a system that doesn’t always do a lot of hearing,” he said. 

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