Community Health Workers (CHWs) are increasingly recognized as an integral component of multidisciplinary health care teams. A Community Health Worker is a trusted member of the community who empowers their peers through education and connections to health and social resources. CHWs coordinate with other healthcare providers to provide one-on-one care to individuals outside of a clinical setting. Although opioid use disorder is a medical condition, not all the contributing factors are medical. Poverty, unemployment, low educational status, and isolation may play an additional role in developing opioid addiction.20
Community Health Workers can support long-term recovery by addressing these social determinants to increase access to care and improve the quality of care. They provide nonjudgmental emotional support and mentoring to individuals affected by addiction. And because recovery is a team effort, involving the social network of the affected individuals is critical. Community Health Workers can talk to family members and loved ones about opioid use disorder, providing education about the disease and how to effectively navigate treatment. They can also disseminate information within the community, attending local events, meeting with local businesses and using informal networks to educate and spread information. Stigma is often cited as a reason that individuals don’t seek treatment; CHWs address stigma by actively discussing these topics in an informal and nonjudgmental manner within the community, thus normalizing the topic.
Community Health Workers can be successfully integrated into a variety of healthcare settings. In clinical settings, CHWs can receive referrals from providers to assist patients that would benefit from additional support and education. Oftentimes individuals struggling with addiction will turn to the emergency department in hospitals to receive treatments. Community Health Workers can serve in transferring individuals from these hospital settings and instead assist them with seeking sustainable treatment and ongoing risk reduction. For example, one program by Indiana University has found success by utilizing Community Health Workers to conduct outreach and support to opioid-dependent mothers and their newborns. The program, in part, aims to reduce the infant mortality rate in Indiana, which is the eighth highest in the country. In 2014, over 600 infants were born with neonatal abstinence syndrome (NAS) in Indiana. NAS develops when a mother struggles with opioid dependence during pregnancy.21
Organizations have seen success by deploying Peer Recovery Support Specialists, who are individuals that have been successful in the recovery process and help others who are experiencing similar situations. They help others stay engaged through the recovery process and extend the reach of treatment beyond the clinic. One healthcare organization analyzed the use of peer support services to address co-occurring substance use/mental health disorders for their patient population. They found that those that received peer support cost the health plan significantly less after six months compared to those that received standard case management; they also had less emergency room visits and inpatient hospitalizations.22 Although not all Community Health Workers will qualify as Peer Recovery Support Specialists, by definition they should be of the community they are serving and may share some qualities and responsibilities with Peer Recovery Support Specialists.
One unique strength of Community Health Workers is that they make a great addition to community-based organizations that are combatting addiction in their communities; they can lead supportive and educational group sessions for interested individuals and those referred by community partners.
Community Health Workers are also a strong addition to patient care teams and can positively influence outcomes for individuals with opioid use disorder. Incorporating Community Health Workers as peer support can also be economically beneficial. A study conducted by the Washington State Institute for Public Policy found a ROI of $1.25 for every $1 spent on peer-delivered substance use programs.23