Perhaps more than ever before, peer workers are seen as a vital part of the solution in addressing substance use disorder as a public health crisis. In Massachusetts, opioid-related overdose deaths increased to 33.5 per 100,000 people in 2022. This is 2.5 percent higher than in 2021 and 9.1 percent higher than the pre-pandemic peak in 2016.
Peers are one important part in a continuum of substance use prevention, harm reduction, treatment, and recovery services and supports. Integrating peers throughout this entire continuum is integral to successful outreach, service engagement, and improved outcomes. For any system or program considering peer roles, it is important to understand what peer workers do and to ensure that peer support is provided using currently available best practices.
What is a peer support worker?
Peer support workers are often people who have been successful in a recovery process and leverage their lived experience in helping others through similar situations. Peers fill many roles in substance use and mental health recovery, and across different levels of care. Peer support workers can be Recovery Coaches, Peer Support Specialists, Peer Advocate, or Peer Mentors. The roles vary and are guided by the organization and setting where a peer is providing support.
Peer workers provide support through authentic mutuality. This allows for the experience to be one with no power imbalance. In this role, peers guide an individual to identify and work towards their goals, helping them to see their own expertise and strengths as a resource in their decision making. In evoking their own lived experience, peer workers inspire hope and support the recovery of a person’s whole life while motivating empowerment and self-determination.
The unique relationship between a peer and an individual with a substance use disorder is grounded in trust. The relationship is also focused on highlighting a person’s strengths while providing them with access to resources (recovery capital) and tools to achieve their long-term goals. It is rooted in a culture of hope, health, and wellness and encompasses self-actualization and social citizenship.
What support do peers provide?
Peers provide many different types of support, including:
- Emotional (empathy and concern)
- Informational (connections to information and referrals to community resources that support health and wellness)
- Instrumental (concrete supports such as housing or employment)
- Affiliational support (connections to recovery community supports, activities, and events)
SAMHSA has identified four dimensions of recovery: health, home, purpose and community. Peers support people to work on their recovery across any or all of these domains. The support of peers might include building connections, linking to services and providers, coaching, and providing resources. They also foster meaningful connections such as family, a recovery community, and other social supports. These different supports are shaped by the goals and self-determination of an individual, with a focus on their whole wellness.
A peer worker both directly supports an individual, and also becomes a support and resource for that person’s service providers. This might include physicians, clinicians, employers, educators, housing specialists, or others who are working to support the whole health and wellness of an individual. Peers can serve as a bridge to information, communication, and collaboration.
Today, peers are working in a wide variety of service settings and systems, from behavioral health and social service agencies to peer recovery support centers, community health centers, housing programs, recovery residences, hospitals and emergency departments, prisons and jails, courts, schools, faith-based and other community-based organizations. In addition to working with individuals, peers also support families and in turn, whole communities.
Is peer support effective?
There is growing evidence that individuals who are supported by peers experience (SAMHSA, 2017):
- Reduced relapse rates
- Reduced substance use
- Improved access to social supports
- Improved relationships with treatment providers
- Increased satisfaction with the overall treatment experience
- Greater housing stability
- Increased treatment retention
- Reduced re-hospitalization rates
- Decreased criminal justice involvement
The value of peers is evident in the positive impact that peers have at many levels – both in their work with individuals and in helping to transform programs to enhance recovery. As the research evidence has grown, so too has broad interest in employing peers and developing pathways for professional and career development.
For more information about peer roles, check out these resources:
Massachusetts Department of Public Health. (2023). Data brief: Opioid-related overdose deaths among Massachusetts residents. Retrieved from: https://www.mass.gov/doc/opioid-related-overdose-deaths-among-ma-residents-june-2023/download
Substance Abuse and Mental Health Services Administration (SAMHSA). (2017). Peers supporting recovery from substance use disorders. Retrieved from:https://www.samhsa.gov/sites/default/files/programs_campaigns/brss_tacs/peers-supporting-recovery-substance-use-disorders-2017.pdf
Substance Abuse and Mental Health Services Administration (SAMHSA). Recovery and Recovery Support. Retrieved from: https://www.samhsa.gov/find-help/recovery