From April 2020-2021, 100,306 parents, spouses, siblings, friends, colleagues, and neighbors in the United States died from fatal overdose—a 28.5% increase from the year prior. This dramatic increase in deaths has occurred amidst the COVID-19 pandemic, which has shut down businesses, disrupted the global economy, and damaged both individual and community well-being worldwide. This highlights something long-known within the recovery community—addiction thrives and quickly metastasizes in isolation, despair, hopelessness, disconnection, and insecurity. As Johann Hari famously states, “The opposite of addiction is not sobriety, it is human connection.”
This rapid rise of overdose deaths amidst the COVID-19 pandemic calls for urgently expanded access to biopsychosocial treatment of opioid use disorder, including medication for addiction treatment (MAT) or medication for opioid use disorder (MOUD), behavioral health access, and community supports.
As two women in long-term recovery from opioid use disorder, we recently launched the Recovery Coach Program for patients at Bicycle Health, a national organization that provides integrated medical and behavioral health treatment of opioid use disorder via telehealth. Our lived experience is the driving motivator and propelling force behind the Recovery Coach Program, and the unswerving conviction that connecting patients to positive role models, influences, and allies in the recovery community who assist in mentoring those newer to the process is the heart, soul, and foundation of the program.
The Substance Abuse and Mental Health Services Administration (SAMHSA) defines recovery as “A process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential” and also purports that people living with opioid use disorder who have access to Recovery Coaches often have better outcomes. Recovery Coaches mentor and advocate for those struggling with opioid use disorder and often use their own hope, strength, and experience to do so. Recovery Coaches are often people with lived experience in recovery, people with lived experience as a loved one, or an ally to the cause.
All Bicycle Health Recovery Coaches complete the Recovery Coach Academy, a program of the Connecticut Community for Addiction Recovery, where new coaches learn how to guide patients to set their own goals and arrive at their own decisions—a difficult skill to master, knowing that those decisions will not always align with the coach’s personal beliefs. Meeting people where they’re at is the foundation of being a successful Recovery Coach—at times, a draining process, and that’s why the Recovery Coach Academy also teaches the importance of self-care for coaches.
Our Recovery Coaches offer 20 support groups each week, and groups are offered every day of the week. Recovery Coach-led support groups occur 365 days of the year, including longer, drop-in versions on Thanksgiving, Christmas Eve, Christmas Day, New Year’s Eve, and New Year’s Day—days in which people living with opioid use disorder have a higher risk of relapse. Recovery Coach-led support groups also offer Women’s Groups, Men’s Groups, and Early Recovery Groups (for patients who identify with each respective group).
We (Shannon and Sarah) are passionate about the Recovery Coach Program, as the recovery community is what largely saved us in our own personal journeys to recovery. And these are the supports we strive to provide for our patients.
One Bicycle Health patient noted, “The support groups are amazing. I leave the meetings feeling not so alone in this process. There are actually people out there with the same issues. People that I can totally relate to. I’m more happy than I’ve been in a very long time.” This highlights the camaraderie often found within the recovery community that the Recovery Coach Program has helped to facilitate. Another patient mentioned, “I started attending support groups because I was curious about them. Everyone in our groups I now consider my family. I never expected to find such a sense of community and family in an online support group.” And another patient shared a similar sentiment: “I was looking for help with my addiction, though I had no idea I’d find a family like I have in our support groups.”
Recently, a new patient reached out in the support group channel, struggling in his first week of treatment, and a Recovery Coach replied via text message and voicemail to offer support. Feeling too ill to speak on the phone, the patient communicated with the coach via text. He was initially reluctant to open up, but the coach utilized skills learned in the Recovery Coach Academy, providing support and offering to “meet” the patient at the next support group meeting. The patient attended, and after the meeting, he texted the Recovery Coach with thanks, stating he felt so much better, and he has continued to attend support groups ever since. This one-to-one contact between Recovery Coaches and patients, particularly in early treatment, can make all the difference. Again, as two women in long-term recovery, it made all the difference for us, especially early in our own personal journeys to recovery.
William White writes, “The most obvious gifts of knowledge that recovering people can bestow on their communities are their stories—narratives that unveil the experience of addiction, stories that communicate the reality and hope of full recovery, and stories detailing their knowledge of how such recovery can be initiated and sustained.” He goes on to propose the five ideas of recovery that ought to be “inoculated” into our communities:
- Addiction recovery is a reality - it is everywhere.
- There are many paths to recovery.
- Recovery flourishes in supportive communities.
- Recovery is a voluntary process.
- Recovering and recovered people are part of the solution; recovery gives back what addiction has taken.
These five ideas of recovery are the foundation of our Recovery Coach Program, and we see the positive results daily of practicing this harm reduction lens and meeting patients where they’re at. The utilization of Recovery Coaches as positive role models, influences, and allies in the recovery process demonstrates for patients that we are indeed part of the solution, and we can and do give back what was taken from us. We are living proof that recovery is possible, and this profoundly simple but tremendously important concept is the foundation of the program.
Disclosure statement: The Editor-in-Chief of the Harvard Medical School Primary Care Review, Dr. Rebekah Rollston, also receives income from Bicycle Health, which is featured in this piece. Dr. Rollston is not a listed author on this article.
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Shannon Schwoeble is the Recovery Coach Program Manager at Bicycle Health, a national organization that provides integrated medical and behavioral health treatment of opioid use disorder via telehealth. She is a recovery advocate, mother of two, avid hiker, and lover of photography and the outdoors. Shannon prides herself on helping patients navigate the complex journey of recovery and is deeply committed to helping individuals, families, and communities impacted by addiction.
Sarah Howroyd, MSW, LCSW, is the Director of Behavioral Health at Bicycle Health, a national organization that provides integrated medical and behavioral health treatment of opioid use disorder via telehealth. She is an Adjunct Professor at the University of Kentucky Master of Social Work program and serves as the President of the Manchester, Connecticut HOPE Initiative Board of Directors, a nonprofit law enforcement community diversion program for people living with opioid use disorder, which she founded. Sarah’s expertise is often tapped at conferences, universities, and in the media, but her focus has always been to create meaningful social change and use her hope, strength, and experience to shatter the stigma surrounding addiction.