Needham Public Health Division Peer Recovery Coach Service

Angi MacDonnell has firsthand experience of both sides of substance use and recovery. She had already been working in the town’s Public Health Division in substance-use prevention. Now, she’s taking on an additional part-time role as Needham’s first peer recovery coach, in a pilot program that began in January and runs through June.

This role is one of the ways that Needham is directing the funds from the National Opioid Settlements, which can be spent on substance-use prevention, treatment, harm reduction and recovery. 

MacDonnell sat down with the Needham Observer’s Jennifer Tirnauer recently to discuss her new role.

What is a peer recovery coach?

It’s someone who has the lived experience, who’s already been through addiction and on the other side of it. It’s basically a guide for somebody who either has a struggle with addiction or is curious about their relationship with substances.

You have lived experience?

I’ve been sober from substances and alcohol since 1995. I’ve had a lifetime of lived experience sober. I grew up in the western part of the state … had a bit of a complicated childhood. [I was] in and out of treatment centers, struggled for a while. My dad got sober in AA and that was a bit of a catalyst for me. He didn’t even say it, but I knew he wasn’t going to support my behavior anymore, and that definitely motivated my change in behavior. I had siblings who were doing better things with their lives.

What’s the difference between a peer recovery coach and a more traditional approach?

[A peer recovery coach] is a person who helps you advocate for yourself.

Addiction has been criminalized and stigmatized historically, so when you go somewhere and you’re looking for help, you launch yourself into this system where you are just surrounded by well-meaning people who are going to tell you what you should be doing to improve your life. And no adult wants to be told what they should be doing with their life.

Recovery coaching is intended to address that, and introduce people to someone to show them a path, but it’s the path that they pick. What I think someone’s life should look like doesn’t matter.

Part of the idea around recovery coaching is acknowledging that not every life skill you have [developed to support your substance use] is bad. Even if you’ve been in and out of treatment and maybe you’re being called manipulative. Are you manipulative, or have you just learned how to work the system? If you’re a person capable of working that system, you’re certainly a person capable of working the system for good. It’s really encouraging people to harness some of the skills that maybe have been causing them more pain, and turn them into skills that do good.

Is there a need for this in Needham?

Addiction does not discriminate. It hits everybody. There was a saying in AA, that you can’t be too dumb or poor to get sober, but you can definitely be too smart and too wealthy. 

Is there fentanyl in Needham?

There is fentanyl all over Massachusetts. Since the state began tracking overdose deaths, even with all the efforts that have been made in harm reduction and supports, this is the first time in the past 10 years they’ve seen the numbers go down a bit. The number in 2023 was over 2,000 people [who died] in one year in the state.

It’s super important to offer people harm reduction, so they stay alive long enough to get help. The amount of fentanyl that’s out there now, it can be someone using prescription drugs and makes one bad choice to buy something off of Snapchat.

That’s probably the most important thing we can do right now, is provide harm reduction. Narcan, a phone number you can call and someone will stay on the phone with you. The public health nurses have fentanyl test strips.

What are the misconceptions about peer recovery coaching?

That it’s therapy, which it’s not. I’m looking at your “now” and what’s going on in your life at this moment. I’m not going to go back and unpack things you did in the past. That would be something you would do with a therapist.

The other [misconception] is that I’m going to broker resources for people. If you have issues with your license or your housing, I’m not going to go back to my desk and make phone calls; that would be a social worker. My role is to help you make those phone calls yourself.

What about confidentiality?

I have people sign a consent form, and I can’t speak about peoples’ personal issues without them signing something that gives me permission. It’s the same level of confidentiality you would get speaking with a nurse or a social worker.

How much does it cost?

It’s totally free. I’m employed in youth substance-use prevention, which is half my time. The other half [for peer recovery coaching] is paid by the opioid abatement funds from the National Opioid Settlements.

Do you have to live in Needham to receive peer recovery coaching?

Live or work, and be 18 or older. If someone has an employee they are concerned about, they can offer the resource.

What’s the chance of successful recovery?

Having peer coaches decreases use of emergency services and increases length of sobriety. [Note: SAMHSA (Substance Abuse and Mental Health Services Administration) has statistics about the efficacy of peer recovery coaching.]

How would someone get in touch with you?

They can email me and we can set up a time to chat. (Email: amacdonnell@needhamma.gov)

What can parents do to protect their kids?

I think the saddest thing for me is the stories of kids today, who have grown up with less of a concern about taking medicine to manage anxiety. That’s a different paradigm for them, to take something to fall asleep, or feel better, so kids maybe make a bad choice once. They will buy one pill.

It’s super important to know what they are facing and be able to address it with them. Your kids are already seeing all this stuff if they are on social media; even if they are not on social media, they are being exposed.

Excerpt from the Needham Observer by Jennifer Tirnauer February 21, 2024

Angi MacDonnell Needham Public Health Division Peer Recovery Coach

Phone: 781-708-1752 | Email amacdonnell@needhamma.gov