Written by Elizabeth Cairns, Mobilize Recovery Special Projects, and reviewed by Code Recover Peer Advisors, August 2026

The Window of Risk and Opportunity

The most critical period in a patient's recovery journey is the first 24 to 72 hours after leaving the Emergency Department. This window is when the adrenaline of the hospital visit wears off, withdrawal symptoms might fluctuate, and the reality of navigating life without opioids begins to set in. As a peer, your follow-up is critical to maintaining motivation during this period.

OUD patients are at the greatest risk of fatal overdose in the period immediately following a nonfatal overdose. (source) Maintaining connection and engagement is a significant factor in keeping patients safe.

More Than a Reminder

A follow-up call isn't just about confirming an appointment; it's about troubleshooting life. When you call a patient the day after discharge, your goal is to identify and remove any new barriers that appeared once they got home.

• Pharmacy Check: Did they actually get the medication? If not, why? (e.g., "The pharmacy said it wasn't ready," or "I didn't have the co-pay").
• Physical Check: How are they feeling on the MOUD? Are they experiencing unexpected side effects or symptoms of precipitated withdrawal?
• Emotional Check: Are they feeling overwhelmed? Sometimes just hearing a familiar, non-judgmental voice from the hospital is enough to keep them committed to their Tuesday appointment.

Navigating No-Shows

If a patient misses their first follow-up appointment, do not view it as a failure. A "no-show" is simply a sign that a barrier was too high. Reach out immediately. Was it a transportation issue? Did they lose their phone? By staying persistent and supportive, rather than punitive, you keep the door open for them to try again.

Closing the Loop

Effective follow-up also involves communicating with the receiving clinic or Recovery Community Organization (RCO). If you find out the patient didn't show up, or if they encountered a major hurdle, alert the team at the next site of care. This closed-loop communication ensures that the entire system is working together to support the individual, rather than leaving the patient to navigate multiple systems alone.