Katherine Truesdell started using meth and alcohol when she was in middle school. As an adult, she hit “rock bottom” when child protective services got involved with her children, pushing her towards sobriety.
Now, Truesdell is in long-term recovery and works as a peer specialist in Elevance Health’s (NYSE: ELV) Empower program. The program, launched in January 2023, is geared towards women between 18 and 40 who have a substance use disorder (SUD) or are at risk for developing SUD.
Elevance Health’s affiliated health plans serve more than 119 million people in the U.S.
One of the goals of Elevance’s Empower program is to combat increasing rates of neonatal abstinence syndrome (NAS) and neonatal opioid withdrawal syndrome (NOWS). These conditions occur when newborn babies experience withdrawal from substances to which they were exposed in the womb.
Peer specialists can help support women with SUD access support when pregnant or before they become pregnant to prevent these conditions.
“When it comes to recovery, there’s so much shame and so much guilt,” Truesdell told Addiction Treatment Business. “The minute somebody says, ‘I’m in long-term recovery,’ you want to talk to that person, you immediately feel the sense of ‘You get me.’ I get members daily who say, ‘I cannot believe that my health plan has peer support. This is so cool.’”
Empower’s peer specialists share information about NAS and NOWS, ask patients if they have access to the right providers and act as a sounding board to help patients talk through questions they may have for their providers.
Calls can last from 20 minutes to over an hour, but sometimes go beyond that. Truesdell recently spent three hours on the phone with a woman who was struggling with fentanyl use.
“She said, ‘I need to get into treatment, and I need to tell my mom, and I can’t do it alone,’” Truesdell said. “I stayed with her to call detox centers to make sure they took her insurance and that she could get into the program. Then we talked through, ‘How do we tell mom?’ She was 19 years old.”
The conversations serve as a much-needed link between women’s health and behavioral health. Beyond the initial phone call, an app allows women to get additional access to peer recovery support, available 24/7.
“In SUD treatment, physical health issues are overlooked when the opportunity exists to address them, such as offering family planning services,” Shawna Zabkiewicz, program manager of Empower, told ATB in an email. “Care needs to be integrated and holistic in nature. Behavioral health does not exist in a silo.”
The Empower program is one way Elevance and Carelon Behavioral Health integrate women’s health with behavioral health, offering a digital tool to help women when needed. Carelon is Elevance’s health care services arm.
“People need to have resources and community at their fingertips,” Tiffany Inglis, national medical director for women and children’s health at Carelon, told ATB. “They need to be able to have that at their fingertips when they need it and how they need it because you don’t always have a crisis between nine and five, Monday through Friday.”
One key question Truesdell asks patients is, “Do you plan to become pregnant in the next year?” Disclosing her own experience with SUD makes patients feel more comfortable, she said.
“We have that connection, that bond, which bridges that gap to say, ‘Do you plan to become pregnant in the next year?” Truesdell said. “There’s shame and guilt that comes with using, whether you use one time during your pregnancy or use the whole pregnancy. Sometimes you don’t want to talk to your provider or you need to build up that courage to have that conversation.”
SUD has other behavioral health implications, research suggests. Women with SUD have higher rates of co-occurring psychiatric disorders, including mood disorders, post-traumatic stress disorder, and eating disorders. Women are also disproportionately impacted by trauma and abuse.
Truesdell often talks to single moms who struggle with feeling alone or anxious while in recovery or patients who deal with shame related to medication-assisted treatment (MAT) and can connect them with other necessary tools.
“Members can pick their own adventure,” Inglis said. “Sometimes you need that peer recovery person. Sometimes you do need a nurse. Sometimes you need more help. Sometimes you need just that community and social support. We tried to find a program that we could develop that had all of it.”
The program currently operates in 13 states and has reached almost 6,000 women with a successful first phone call, connecting women with clinical care and offering family planning resources.
Even though Truesdell said that her job as a peer specialist can be challenging, she finds it also helps her on her own path to recovery.
“These members have these amazing stories to share with me that give me hope every single day in my own life and my own recovery,” she said.