Utilizing Peer Mentorship to Engage High Recidivism Substance-Abusing Patients in Treatment

Abstract

Background: Often high recidivism substance-using patients have difficulty connecting to outpatient treatment contributing to greater functioning disturbances. Approaches to address this problem frequently are staff extensive. Objective: This study evaluates the impact of peer mentorship and/or enhanced dual recovery treatment (DRT) on individuals who are inpatients, substance abusing, and have a history of high recidivism. The primary outcome is post-discharge treatment attendance. Methods: In an inpatient Veterans Administration hospital setting, 96 patients with a history of high recidivism and current and/or past diagnosis of substance use disorders were randomized to either (i) Treatment As Usual (TAU), (ii) TAU + DRT + Mentorship for Addictions Problems to Enhance Engagement to Treatment (MAP-Engage), or (iii) TAU + MAP-Engage. Results: Overall MAP-Engage was found to be comparable to the DRT + MAP-Engage and both of these conditions were significantly better than TAU alone at increasing adherence to post-discharge substance abuse, medical, and mental health outpatient appointments. Conclusion/Scientific Significance: MAP-Engage offers an alternative approach to address lack of attendance to outpatient treatment appointments post discharge that is relatively low in staff reliance.

• high recidivism
• peer mentorship
• substance use disorder
• treatment utilization
• sponsor

ACKNOWLEDGEMENTS

We dedicate this article to Bruce Rounsaville, M.D., who was a true mentor, colleague, and friend to many and a pillar in the field whose contributions are beyond measurable.

This work was supported by Veterans Integrated Service Network 3 (VISN 3). This program was given exemplary commendation by the Commission on Accreditation of Rehabilitation Facilities (CARF) for its use of peer mentors in CWT.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.