5 - Understanding Avenues for Program Development and Evaluation for Peer Support Programs for Substance Use Recovery: Directions Identified by Peer Support Workers

Abstract Information: Since the start of the SARS-CoV-2 pandemic in the United States and the increase in fentanyl circulation, existing substance use crises have been exacerbated. Recovery community organizations have sought models of effectively engaging and linking people with Substance Use Disorders (SUDS) with harm reduction, recovery support, and resources. Substance use and recovery services across the United States may utilize the services of peer support workers (often called peer recovery coaches or specialists), people who have lived experience with substance use disorders and who consult with clients in recovery. However, very little evaluation literature exists on the effectiveness and outcomes of peer support services. Therefore, this roundtable hopes to continue the conversation regarding collaboration between peer support workers and evaluators to inform the development of programs or shape evaluation decisions related to substance use recovery. We hope to share our experiences conducting qualitative research to understand the experiences and needs of peer support workers across South Carolina. This will allow us to discuss ways to center peer support workers’ stories and embodied knowledge as a means to inform program development and evaluation decisions.

Relevance Statement: Since the start of the SARS-CoV-2 pandemic in the United States and the increase in fentanyl circulation, existing substance use crises have been exacerbated. Recovery community organizations have sought models of effectively engaging and linking people with Substance Use Disorders (SUDS) with harm reduction, recovery support, and resources. Substance use and recovery services across the United States may utilize the services of peer support workers (often called peer recovery coaches or specialists), people who have lived experience with substance use disorders and who consult with clients in recovery. However, very little evaluation literature exists on the effectiveness and outcomes of peer support services. Specific challenges to evaluating the impacts of peer support have been identified by Mathews and Weight (2021). These challenges include the many ways that effectiveness can be defined and examined across ecological levels; the lack of uniformity across peer support programming’s theories of change and related practices; and the unique positionality of peer support workers as community partners who both are implementing recovery programs and whose recovery are impacted by their roles.



This roundtable hopes to continue the conversation regarding collaboration between peer support workers and evaluators to inform the development of programs or shape evaluation decisions related to substance use recovery. First, we hope to share our experiences conducting qualitative research to understand the experiences and needs of peer support workers across South Carolina. Second, we hope to discuss peer support workers’ recommendations for current and proposed increased supports at multiple ecological levels, including self, social, organizational, and community supports. Peer support workers relayed that recognizing the risk for vicarious traumas and utilizing self-care practices were among the most critical aspects of their roles, but that some organizations integrated these as parts of trainings or day-to-day events while some did not. Challenges to their work include stress management, lack of cohesion with other recovery resources, lack of standardized trainings, and organizational misunderstandings of peer support workers’ roles and needs. Finally, given current findings about peer support workers, we hope to discuss ways to center peer support workers’ stories and embodied knowledge to bolster the effectiveness and potential impact of substance use services in the United States, and particularly under-resourced communities.