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DISCLAIMER The Addiction Technology Transfer Center Network prepared this publication under a cooperative agreement from the Substance Abuse and Mental Health Services Administration s (SAMHSA) Center for Substance Abuse Treatment (CSAT). All material appearing in the publication except that taken directly from copyrighted sources is in the public domain and may be reproduced or copied without permission from SAMHSA/CSAT or the authors. Citation of the sources is appreciated. At the time of this publication, Elinore F. McCance-Katz, M.D., Ph.D., served as the Assistant Secretary of Mental Health and Substance Use. Captain Chideha Ohuoha, M.D., M.P.H., served as the CSAT Director, and Humberto Carvalho, MPH, served as the CSAT Project Officer. The opinions expressed herein are the views of the authors and do not reflect the official position of the Department of Health and Human Services (DHHS), SAMHSA, or CSAT. No official support or endorsement of DHHS, SAMHSA, or CSAT for the opinions described in this document is intended or should be inferred. This report has not been published elsewhere, nor has it been submitted simultaneously for publication elsewhere. The work reported in this manuscript was supported by SAMHSA cooperative agreement: TI080205-01. CONTRIBUTORS Humberto M. Carvalho, MPH Public Health Advisor Project Officer Office of Management, Analysis, and Coordination - OMAC Substance Abuse and Mental Health Services Administration - SAMHSA Laurie Krom, MS Co-Director ATTC Network Coordinating Office Holly Hagle, PhD Co-Director ATTC Network Coordinating Office Maureen Fitzgerald Communications Coordinator ATTC Network Coordinating Office Great Lakes ATTC LeAnna Cates Research Assistant ATTC Network Coordinating Office REVIEWERS: Livia Davis, MSW, CSWM Vice President and Chief Learning Officer Center for Social Innovation (C4) Cheryl Gagne, ScD Senior Associate Center for Social Innovation (C4) 2 PEER SUPPORT WORKERS

INTRODUCTION The Addiction Technology Transfer Center (ATTC) Network Coordinating Office (NCO), funded by the Substance Abuse and Mental Health Services (SAMHSA), has designed three competency-based guides to raise awareness of resources available to build the capacity of the workforce to address the opioid crisis. The digital guides are relevant to psychologists, counselors, social workers, peer support workers, and other behavioral health professionals who intersect with people at risk for misuse of, or who are already misusing, opioids. Contemporary use of prescription or illicit opioids has led to the current opioid crisis in the US, where opioid overdose has increased fivefold since 1999 and where every day more than 115 people die of an opioid overdose. It is important to acknowledge the continuum of prevention, treatment, and recovery when addressing people who have, or are at risk of developing, an opioid use disorder. Therefore, we have organized the guides to align with this continuum. The methods used to develop the guides follow: Initial development and planning meeting between senior SAMHSA and ATTC NCO staff identified the need for the document and target audiences. The need was identified through an increase in requests to SAMHSA to educate the behavioral health field on understanding and addressing opioid use. Senior staff at the ATTC NCO held several exploratory meetings to review materials that are currently available on the ATTC and SAMHSA websites. In addition, senior staff identified the core competencies for each of the target audiences (psychologists and counselors, social workers, and peer support workers) to use for a crosswalk of competencies and resources. ATTC NCO senior staff conducted a crosswalk of competencies and resources through an iterative process of resource review and matching those resources to particular competencies. The identified competencies and resources were then sent out for review by subject matter experts (SMEs) from the Bringing Recovery Supports to Scale Technical Assistance Center Strategy (BRSS TACS), Council on Social Work Education (CSWE), International Certification & Reciprocity Consortium (IC&RC), and NAADAC, the Association for Addiction Professionals. ATTC NCO senior staff reviewed the SMEs recommendations and made recommended revisions. ATTC NCO senior staff conducted two rounds of review to come to consensus on the final arrangement of the crosswalk of the competencies and matching resources. It is the hope of the ATTC NCO that this digital guide will give the behavioral healthcare workforce information to be able to enhance their professional knowledge and skills so that all can have an appropriate, active role in preventing, treating, and/or supporting recovery from opioid use disorders. PEER SUPPORT WORKERS 3

QUICK GUIDE Step 1. Choose an Area of Focus There are 16 competencies listed in this interactive guide to assist Peer Support Workers providers in enhancing their professional knowledge, attitudes, and skills in preventing, treating, and supporting recovery of patients and communities with opioid use disorders. Refer to the Table of Contents to identify the competency that matches your learning or professional objectives. Step 2. Click on a Resource Icon Resources listed below each competency were selected to address the knowledge, skills, and attitudes required to meet such competency. Each has been vetted and recommended by senior staff at the ATTC Network Coordinating Office. Click on an icon to transfer you to the resource for further exploration. Resources are presented in a variety of formats to appeal to a larger audience with diverse learning styles. View the resource format key below for further clarification. RESOURCE FORMAT KEY Online Courses Training Curriculum Presentation Slides, PowerPoints Toolkit PDF Documents Bibliography Fact Sheet Mobile Apps Report Peer- Reviewed Article Webinars Movie YouTube Video Checklists Pamphlets Interactive Journals Handbooks Books/Textbooks TAP Technical Assistance Publication (TAP) Research Database Distance Educational Events Requiring Travel TIP Treatment Improvement Protocol (TIP) Chart Websites Articles Blog Posts Curriculum 4 PEER SUPPORT WORKERS

TABLE OF CONTENTS PREVENT OPIOID MISUSE Understand the role of prevention in addressing the opioid crisis... 6 Understand naloxone distribution and use as an opioid antagonist... 8 INTERVENE WITH INDIVIDUALS AT RISK FOR OPIOID USE DISORDERS Recognize signs of opioid misuse and coping strategies, including the grief process... 10 Know when to refer to a clinician or supervisor...11 Understand interactions of physical and behavioral health related to opioid misuse.... 12 Recognize potential risk factors for opioid overdose.... 13 PROVIDE SAFE, INFORMED, PERSON-CENTERED CARE FOR PEOPLE WITH OPIOID USE DISORDERS Share lived experiences of recovery and model appropriate use of personal story and self-advocacy... 14 Understand person-centered resiliency and recovery planning for all ages and stages... 15 Understand impact of trauma and responses to trauma... 16 Understand impacts of labels, stigma, and discrimination related to opioid misuse, and demonstrate cultural sensitivity and acceptance of individual experiences by using guiding principles pertinent to population served... 17 Be able to apply the following evidence-based practices to promote recovery in individuals with opioid use disorders: (a) shared decision-making; (b) motivational interviewing; (c) wellness recovery action planning... 21 UNDERSTAND YOUR ROLE Help peers to manage crises related to opioid misuse... 22 Provide information about skills related to health, wellness, and recovery and link peers to resources, services, supports, and psycho-education materials pertinent to opioid use disorders... 23 Help individuals and families recognize their natural supports... 24 Demonstrate knowledge of community resources and those specific to opioid misuse and physical health and how to navigate the benefits system... 25 Acknowledge that personal wellness is a primary responsibility... 26 PEER SUPPORT WORKERS 5