The Community Addictions Recovery Specialist (CARS) Program is part of Project ECHO’s Integrated Addictions and Psychiatry (IAP) Program. The goal of the CARS Program is to expand access and improve outomes of treatment for addiction in New Mexico by training and mentoring paraprofessionals – medical assistants, community health workers, health educators and peer support specialists to provide clinical support, health education and evidence-based behavioral interventions for patients in recovery or seeking treatment for addictions, with a focus on alcohol and opiate addiction. The objective of CARS is to train and mentor Community Health Workers to provide health education, clinical support, and referrals and resources for patients in recovery or seeking treatment for addictions. The CARS Program grew out of needs identified by Project ECHO partners around New Mexico. In a survey of clinicians trained by Project ECHO to provide buprenorphine treatment for opiate-addicted patients, the following barriers to treatment were identified:
  • Clinical team not adequate to support a patient in treatment with buprenorphine (40%)
  • Concerns with lack of counseling, case management or 12 step/recovery groups in the vicinity (50%)
  • Lack of time for dealing with these patients (54%).
In the same survey, clinicians identified the following skills that would be most useful for Community Health Workers providing addictions services in their clinics:
  • Administering screening questionnaires for addictions
  • Assessing patients for treatment readiness & motivation for change
  • Performing telephone or in-person triage for patient suitability for office-based treatment of addiction to opiates or alcohol
  • Performing follow-up phone calls to support patients’ recovery efforts and assess their need for office visits.

CARS certification

CARS certification from Project ECHO requires:
  • Participation in a 2-day face-to-face training
  • Participation in weekly TeleECHO clinics for a three-month period following the training
  • Completion of required “practicum work” during the three-month period following the training.

Curriculum

CARS Training Curriculum includes:
  • Overview of Drug Use in New Mexico
  • Understanding Addiction, including current research on brain chemistry and addiction
  • Communication &amp Motivational Interviewing Skills
  • Medication-Assisted Treatments for Opiates and Alcohol
  • Psychosocial Support and Counseling
  • Mental Health Issues and Stigma
  • Harm Reduction
  • The role of the paraprofessional in addictions treatment
  • Project ECHO model – including training on use of teleconferencing equipment

Practicum

Practicum work includes:
  • Observation and/or participation in outreach, support, or clinical programs (e.g., harm reduction, suboxone education, 12-step or Smart Recovery meeting, clinic visit for drug screening and treatment).
  • Development of local referral lists for patients, including public health, counseling, and social support services.
While trained Recovery Specialists are able to work with a wide range of substance use issues, much of the program focuses on interventions for alcohol and opiate addiction.
For 3-month period following the face-to-face training: Weekly TeleECHO clinics utilize the “ECHO model,” which combines educational presentations from experts, group discussion and participant presentation of cases.