Speaking the same language: Opioid programs connect overdose victims with recovered mentors

Shame consumed Cameron Nielson as he lay curled and shaking on an emergency room bed.

Nurses shouldn’t have to rush to care for him, he thought. Other patients deserved attention more than him. This was his seventh relapse.

His mother drove him to the emergency room with severe withdrawal symptoms from opioids and Xanax last summer after his drugs were stolen from his safe, he said.

“I hated myself,” the 27-year-old Sioux Falls resident remembered.

He accepted medication from one of the nurses to stop the withdrawal symptoms. His head was clearer and he could fall asleep, but the shame remained.

Vanessa Needles entered the room after he woke up. She wasn’t a nurse, but a peer support specialist meant to connect Nielson to resources. His shame turned to embarrassment, but it soon became gratitude for the medical staff and Needles.

Needles spoke his language in a way the nurses and doctors surrounding him couldn’t. She overdosed once herself and struggled with alcohol use, eventually leading to a car crash that killed her coworker in 2017. Needles and Nielson started experimenting with drugs and alcohol around 14 years old. They’d both done things and treated their loved ones in ways they regret. He wasn’t alone.

Needles, who is seven years sober, offered Nielson grace. 

“When you’re trying to get off of it, the littlest thing makes the biggest difference,” Nielson told South Dakota Searchlight. “The most valuable thing is having someone understand what you’re going through.”

Needles is one of nine peer support specialists in eastern South Dakota with Sioux Falls-based nonprofit Emily’s Hope. Their work is part of a pilot program overseen by the state Department of Social Services and launched in January 2024 to reduce overdoses by providing “essential supports and strengthening connections” to local resources, according to a statement from the department. Rapid City-based Project Recovery piloted the program in western South Dakota.

The pilots are funded by national opioid settlement dollars, costing $346,445. The national opioid settlement was reached in 2021 to resolve opioid litigation against the country’s three largest pharmaceutical distributors and one manufacturer. More than $50 billion in settlement funds are being delivered to state and local governments from the companies accused of flooding communities with opioid painkillers even though they allegedly knew how addictive and deadly the drugs were. South Dakota is set to receive more than 78.6 million of settlement funding within the next two decades.

The department plans to continue funding the program with settlement dollars through 2029, based on a plan presented to the opioid advisory council in April.

What is the program?

The two organizations received a combined 34 referrals since the program’s launch and connected with 26 people to provide resources. Between 2016 and 2020, there were more than 2,400 drug-related hospitalizations and 684 drug-related deaths in South Dakota.

Angela Kennecke, founder and CEO of Emily’s Hope, said the organization works closely with emergency room departments for referrals. Sometimes the initial contact yields later results. One woman who ended communication with a peer support specialist last year picked communication back up this year to seek help.

“I always say a seed is planted,” Kennecke said. “Even if they don’t go into treatment immediately or they don’t go on medication and get the help they need, a seed has been planted that there is someone there to help them when they’re ready.”

Kennecke’s daughter, Emily, died of a fentanyl overdose, laced in heroin she injected. Her family was planning to enroll her into a treatment program when she died in May 2018.

Project Recovery has found most of its success working with Rapid City’s Fusion Center, which is a law enforcement task force. The clinic receives referrals based on overdose data collected by law enforcement. Kendra Joswiak, clinical practice director at Project Recovery, said her response team connected with 82% of activations, 56% of which continue to be engaged in addiction service treatments.

Needles, a 30-year-old mother of two — soon to be three — served as a peer support specialist for years in other capacities before working with Emily’s Hope to meet with overdose victims in the emergency room. She’s previously talked with people struggling with substance use on the street, and she’s shared her story with jail inmates.

The program bridges gaps in South Dakota’s behavioral health infrastructure, she said. It also destigmatizes substance use within the medical profession and in the community, and gives a sense of purpose to those in recovery.

“By helping someone stay sober, I stay sober another day,” Needles said. “I can stand in front of them and tell them that this is scary and sh—y, but that it’s going to get better.”

Peer support specialists with Emily’s Hope receive a group text when an overdose victim arrives at a Sioux Falls-area hospital. Whoever is available goes, Needles said.

Most of the time, people have already checked out of the hospital before a specialist arrives. She remembers when she overdosed a decade ago, and she left the hospital as soon as she could because she was scared. She needed to cope with her emotions, and the only way she knew how was to use again.

She and other peer support specialists will follow up with patients after they leave the hospital, dropping off bags of fentanyl test strips or medication to prevent overdose. She’ll hand them to the patient, parents or spouses — whoever she can find.

‘Everybody deserves a little bit of grace’

After Nielson was admitted to the hospital and into a treatment program through Avera Health, Needles joined him each Friday. She checks in on him to see how he’s feeling and has taken him to support meetings since he completed treatment. She sent him a coin and card when he reached three months of sobriety late last year.

Nielson is eight months sober. He’s taking a Suboxone prescription to eliminate cravings, and he feels more like himself, he said. He started reading again, hasn’t missed a day of work and spends time with his 3-year-old son each week. It’s something he couldn’t have dreamed of a decade ago.

Needles’ guidance and support reminds Nielson he’s not alone and what he’s capable of achieving.

“Besides Vanessa, I don’t have another person to talk to regularly who knows what I’m going through or is sober,” Nielson said. “It can kind of get lonely after you cut off every friend you had, since they were all part of my addiction.”

One relationship isn’t a lot, but it’s a start, Needles said. She hopes as others learn about medications for opioid use disorder and about efforts to curb overdose deaths in the state, overdose response teams will be able to reach more people.

“Everybody deserves a little bit of grace,” Needles said. “We’re all struggling one way or another.”