The Peer Engagement Specialist (PES) will engage people in the emergency rooms, hospitals, and community settings in Onondaga and adjoining counties. The PES will also be involved in program development and management of CNY-PREP. The target population will be individuals who have over dosed, or who show signs of a substance use condition. The current large volume of opiate related emergency department and hospital presentations will be a primary target, but the service will be available to those with all substance use conditions including those who have been admitted to the hospital. While there is an expectation that the PES will spend a significant amount of time at the hospitals engaging with individuals who have presented with an overdose or other substance use related condition, the service provided by the PES will not be an emergent on-call response. The focus will be on an effective hand-off between the hospital social worker and the PES staff.