Spanish-Language Recovery Coach Supports People With Substance Use Disorder

Nickol Perez was sitting in a Lexington, Kentucky, community center for people with substance use disorder when a hometown friend from Miami called. As Spanish poured fluently from Perez’s mouth, the facility’s staff perked up. They had been looking for someone who could connect with the area’s Hispanic residents in their native language.

In recovery herself, Perez had been performing community service at the facility in the spring of 2022, but no one there knew she was bilingual. “Out of nowhere they heard me go from English to Spanish and said, ‘Whoa, we need you,’” she told The Pew Charitable Trusts.

That was how Perez started her career as a Spanish-language recovery coach. Today, she works at Voices of Hope, another Lexington-based organization that assists people in recovery from substance use disorder. Their efforts to serve the Hispanic community are funded by a grant from Pew with support from Bloomberg Philanthropies.

“One of our core values is that we want to provide recovery support to people regardless of their race, ethnicity, religion, sexual identity, whatever it may be,” said David Brumett, a program manager at Voices of Hope. “For us, being able to communicate in Spanish is just a matter of increasing access for everyone.”

Voices of Hope

According to 2021 data from the federal Substance Abuse and Mental Health Services Administration, Hispanic people in need of treatment are less likely to receive it compared with Americans on average.

Since Voices of Hope hired Perez in October 2022, she has steadily expanded the organization’s Spanish-language resources and services.

“We're changing everything up,” Perez said. “Our flyers, enrollment forms, pregnancy tests, and harm reduction materials like fentanyl test strips—we have all that material in Spanish. And if someone wants to talk, I can talk to them.”

Along with sharing a language, Perez also shares lived experiences with the people she coaches. In fact, 98% of Voices of Hope’s staff are in recovery.

“It’s nice to know that I have someone that speaks my language and can relate to the things I’m going through,” said Alejandro, a Lexington resident whom Perez coaches several times a week. “Voices of Hope is a safe place to go when I’m having a bad day and need someone to talk to.” (Asking to be identified by first name only, Alejandro shared his comments in Spanish with Perez for translation and use in this article.)

Perez said the shared experiences go a long way. “When people know that you've been through what they've been through, that helps probably more than anything,” she said. “I do a lot of outreach in the communities where I was in active use and people who knew me then tell me how much of an inspiration I am now. I never thought I'd be that person.”

As part of the Pew grant, Perez is organizing what are known as Harm Reduction Works (HRW) and Self-Management and Recovery Training (SMART) meetings in Spanish. An alternative to abstinence-only groups, HRW sessions help people reduce their substance use and limit risks of overdose and infectious disease. The SMART program, meanwhile, uses cognitive-behavioral techniques to help people change the way they think, feel, and act with respect to substance use. Both strategies bring peers together to support and learn from each other.

Voices of Hope’s participants—the term the program uses for people it supports—rely on other facilities for medical care, residential treatment, and additional services. However, research and experts on the ground caution that there are few options among those facilities for people who speak Spanish primarily. According to a Pew analysis, most of Kentucky’s opioid treatment programs provide services in English only.

“You can't find a lot of recovery houses or rehab centers that have someone who speaks Spanish,” said Perez. “And I can't be there to translate for people 24 hours a day, seven days a week.”

Still, she is researching facilities in the Lexington area and compiling a list of organizations with some capacity to serve people in Spanish so she can refer participants as needed.

“Voices of Hope is an inspiration in Lexington and truly reflects a necessity in communities across the country to meet everyone’s language needs,” said Brandee Izquierdo, director of behavioral health programs at Pew. “Equitable care requires equitable communication.”