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Peer Support in Substance Use Disorder Treatment

The latest in the SAMHSA Treatment Improvement Protocol Series (TIP 64)  provides a guide for implementing peer support in substance use disorder treatment. Peer support services are nonclinical supports intended to enhance treatment and recovery among persons with substance use disorders. These services are provided by peer support workers with lived experience that enables them to provide genuine and personal empathetic support. The core values of peer support workers are inspiring hope, being authentic, treating individuals in recovery with respect, being open-minded and culturally responsive, and taking a strengths-based person-centered approach. TIP 64 identifies two key functions of peer support workers. First, peer workers provide recovery support to individuals with problematic substance use. Second, peer workers build the recovery community by connecting organizations and resources. Peer support can take many forms, including mentors, educators, advocates, outreach specialists, and resource facilitators. Implementation has occurred in a wide variety of settings, including recovery programs, community organizations, recovery community centers and residences, hospitals, and within the criminal justice system. In addition to peer support workers who connect directly with the person seeking services, family peer specialists can offer education, support, and resources to family members of someone with a substance use disorder. The different functions, roles, and settings for peer support are outlined throughout the TIP, along with key skills needed to effectively provide peer support, such as active listening, storytelling, recovery planning, group facilitation, and boundary setting.

Research has demonstrated that inclusion of peer support services leads to positive outcomes, such as increased motivation, engagement, retention, and treatment satisfaction; reduced recurrence rates; and improved social relationships. Further, peer support services support long-term recovery through community building, connection to resources, social support, and education for individuals and their families.

TIP 64 outlines key considerations for programs looking to implement peer support services including strategies for hiring and retention, examining the organizational structure and culture, and provision of training and supervision for peer workers. Additionally, this guide addresses barriers to peer support services, such as stigma, knowledge gaps, and unclear boundaries. Several key resources are included on implementing peer support services, tools for specialists and administrators, state guidelines, and resources for individuals seeking treatment and their families.

SAMHSA highlights the need to incorporate peer support services (PSS) into all programs that offer substance use disorder (SUD) services. As stated in the introduction to this document, “Any setting that offers care and support for individuals who have problematic substance use should also offer or arrange for PSS. Integrating the peer position into SUD treatment programs should supplement PSS that are offered by recovery community organizations and recovery community centers—not replace them.”

The TIP can be accessed here: TIP 64: Incorporating Peer Support Into Substance Use Disorder Treatment Services | SAMHSA Publications and Digital Products

Source: SAMHSA. (2023, June). TIP 64: Incorporating Peer Support Into Substance Use Disorder Treatment Services (Pub. No. PEP23-02-01-001). Rockville, MD: Substance Abuse and Mental Health Services Administration, US Department of Health and Human Services.