{"doi":"10.1001/jamanetworkopen.2024.3614","title":"Emergency Department Peer Support Program and Patient Outcomes After Opioid Overdose","abstract":"<jats:sec id=\"ab-zoi240156-4\"><jats:title>Importance</jats:title><jats:p>Patients treated in emergency departments (EDs) for opioid overdose often need drug treatment yet are rarely linked to services after discharge. Emergency department–based peer support is a promising approach for promoting treatment linkage, but evidence of its effectiveness is lacking.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-5\"><jats:title>Objective</jats:title><jats:p>To examine the association of the Opioid Overdose Recovery Program (OORP), an ED peer recovery support service, with postdischarge addiction treatment initiation, repeat overdose, and acute care utilization.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-6\"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This intention-to-treat retrospective cohort study used 2014 to 2020 New Jersey Medicaid data for Medicaid enrollees aged 18 to 64 years who were treated for nonfatal opioid overdose from January 2015 to June 2020 at 70 New Jersey acute care hospitals. Data were analyzed from August 2022 to November 2023.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-7\"><jats:title>Exposure</jats:title><jats:p>Hospital OORP implementation.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-8\"><jats:title>Main Outcomes and Measures</jats:title><jats:p>The primary outcome was medication for opioid use disorder (MOUD) initiation within 60 days of discharge. Secondary outcomes included psychosocial treatment initiation, medically treated drug overdoses, and all-cause acute care visits after discharge. An event study design was used to compare 180-day outcomes between patients treated in OORP hospitals and those treated in non-OORP hospitals. Analyses adjusted for patient demographics, comorbidities, and prior service use and for community-level sociodemographics and drug treatment access.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-9\"><jats:title>Results</jats:title><jats:p>A total of 12 046 individuals were included in the study (62.0% male). Preimplementation outcome trends were similar for patients treated in OORP and non-OORP hospitals. Implementation of the OORP was associated with an increase of 0.034 (95% CI, 0.004-0.064) in the probability of 60-day MOUD initiation in the half-year after implementation, representing a 45% increase above the preimplementation mean probability of 0.075 (95% CI, 0.066-0.084). Program implementation was associated with fewer repeat medically treated overdoses 4 half-years (−0.086; 95% CI, −0.154 to −0.018) and 5 half-years (−0.106; 95% CI, −0.184 to −0.028) after implementation. Results differed slightly depending on the reference period used, and hospital-specific models showed substantial heterogeneity in program outcomes across facilities.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-10\"><jats:title>Conclusions and Relevance</jats:title><jats:p>In this cohort study of patients treated for opioid overdose, OORP implementation was associated with an increase in MOUD initiation and a decrease in repeat medically treated overdoses. The large variation in outcomes across hospitals suggests that treatment effects were heterogeneous and may depend on factors such as implementation success, program embeddedness, and availability of other hospital- and community-based OUD services.</jats:p></jats:sec>","journal":"JAMA Network Open","year":2024,"id":616894,"datarank":1.1910699191874667,"base_score":3.58351893845611,"endowment":3.58351893845611,"self_citation_contribution":0.5375278407684165,"citation_network_contribution":0.6535420784190503,"self_endowment_contribution":0.5375278407684165,"citer_contribution":0.6535420784190503,"corpus_percentile":null,"corpus_rank":null,"citation_count":35,"citer_count":32,"citers_with_citation_signal":20,"citers_with_endowment":20,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":322704,"name":"Stephen Crystal","orcid":"0000-0003-0366-7583","position":1,"is_corresponding":false},{"id":1590647,"name":"Joel Cantor","orcid":null,"position":2,"is_corresponding":false},{"id":1428976,"name":"Sujoy Chakravarty","orcid":"0000-0002-1321-4222","position":3,"is_corresponding":false},{"id":1590649,"name":"Anna Kline","orcid":null,"position":4,"is_corresponding":false},{"id":1590650,"name":"Cory Morton","orcid":null,"position":5,"is_corresponding":false},{"id":1590653,"name":"Kristen Gilmore Powell","orcid":null,"position":6,"is_corresponding":false},{"id":1590655,"name":"Suzanne Borys","orcid":null,"position":7,"is_corresponding":false},{"id":344707,"name":"Nina A. Cooperman","orcid":"0000-0002-2086-6042","position":8,"is_corresponding":false},{"id":1087656,"name":"Peter Treitler","orcid":"0000-0001-9360-2454","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Emergency Department Peer Support Program and Patient Outcomes After Opioid Overdose","abstract":"<jats:sec id=\"ab-zoi240156-4\"><jats:title>Importance</jats:title><jats:p>Patients treated in emergency departments (EDs) for opioid overdose often need drug treatment yet are rarely linked to services after discharge. Emergency department–based peer support is a promising approach for promoting treatment linkage, but evidence of its effectiveness is lacking.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-5\"><jats:title>Objective</jats:title><jats:p>To examine the association of the Opioid Overdose Recovery Program (OORP), an ED peer recovery support service, with postdischarge addiction treatment initiation, repeat overdose, and acute care utilization.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-6\"><jats:title>Design, Setting, and Participants</jats:title><jats:p>This intention-to-treat retrospective cohort study used 2014 to 2020 New Jersey Medicaid data for Medicaid enrollees aged 18 to 64 years who were treated for nonfatal opioid overdose from January 2015 to June 2020 at 70 New Jersey acute care hospitals. Data were analyzed from August 2022 to November 2023.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-7\"><jats:title>Exposure</jats:title><jats:p>Hospital OORP implementation.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-8\"><jats:title>Main Outcomes and Measures</jats:title><jats:p>The primary outcome was medication for opioid use disorder (MOUD) initiation within 60 days of discharge. Secondary outcomes included psychosocial treatment initiation, medically treated drug overdoses, and all-cause acute care visits after discharge. An event study design was used to compare 180-day outcomes between patients treated in OORP hospitals and those treated in non-OORP hospitals. Analyses adjusted for patient demographics, comorbidities, and prior service use and for community-level sociodemographics and drug treatment access.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-9\"><jats:title>Results</jats:title><jats:p>A total of 12 046 individuals were included in the study (62.0% male). Preimplementation outcome trends were similar for patients treated in OORP and non-OORP hospitals. Implementation of the OORP was associated with an increase of 0.034 (95% CI, 0.004-0.064) in the probability of 60-day MOUD initiation in the half-year after implementation, representing a 45% increase above the preimplementation mean probability of 0.075 (95% CI, 0.066-0.084). Program implementation was associated with fewer repeat medically treated overdoses 4 half-years (−0.086; 95% CI, −0.154 to −0.018) and 5 half-years (−0.106; 95% CI, −0.184 to −0.028) after implementation. Results differed slightly depending on the reference period used, and hospital-specific models showed substantial heterogeneity in program outcomes across facilities.</jats:p></jats:sec><jats:sec id=\"ab-zoi240156-10\"><jats:title>Conclusions and Relevance</jats:title><jats:p>In this cohort study of patients treated for opioid overdose, OORP implementation was associated with an increase in MOUD initiation and a decrease in repeat medically treated overdoses. The large variation in outcomes across hospitals suggests that treatment effects were heterogeneous and may depend on factors such as implementation success, program embeddedness, and availability of other hospital- and community-based OUD services.</jats:p></jats:sec>","is_dataset_classified":null,"base_score":3.58351893845611,"endowment":3.58351893845611,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"38526490","pmcid":"PMC10964115","openalex_id":"https://openalex.org/W4393144012","authors":[],"funders":[{"funder_name":"NCCIH NIH HHS","grant_id":"R33 AT010109","title":null},{"funder_name":"NIDA NIH HHS","grant_id":"R01 DA057568","title":null},{"funder_name":"NIDA NIH HHS","grant_id":"R01 DA047347","title":null},{"funder_name":"NCATS NIH HHS","grant_id":"UL1 TR003017","title":null}],"total_grants":4,"fwci":14.3622,"citation_percentile":0.99359727,"influential_citations":0,"citation_trend":[{"year":2024,"count":5},{"year":2025,"count":19},{"year":2026,"count":11}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2816733/treitler_2024_oi_240156_1710778597.23853.pdf","host_type":"journal"},{"url":"https://jamanetwork.com/journals/jamanetworkopen/articlepdf/2816733/treitler_2024_oi_240156_1710778597.23853.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1001/jamanetworkopen.2024.3614","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/38526490","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10964115","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC10964115","host_type":"Europe_PMC"}],"fields_of_study":["Opioid Use Disorder Treatment","HIV, Drug Use, Sexual Risk","Substance Abuse Treatment and Outcomes"],"mesh_terms":["Opiate Overdose","Aftercare","Emergency Service, Hospital","Female","Humans","Male","Opioid-Related Disorders","Patient Discharge","Retrospective Studies","United States","Cohort Studies","Drug Overdose"],"keywords":["Medicine","Medicaid","Emergency department","Opioid use disorder","Opioid overdose","Emergency medicine","Retrospective cohort study","Psychosocial","Drug overdose","Opioid","Poison control","Health care","Psychiatry","Internal medicine","(+)-Naloxone"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-03T00:16:26.704727Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}