A peer recovery program at a large integrated health system improved substance use disorder (SUD) treatment outcomes and revealed key barriers and facilitators for successful implementation across medical settings.

Background

Peer recovery coaches are increasingly used in medical settings to help people with SUD engage in treatment, though in clinical settings it may be challenging to integrate peers into clinical teams. This study reports on the outcomes of a peer recovery coach program implemented across multiple clinical settings, including the emergency department at Massachusetts General Hospital (MGH) and primary care practices within the Mass General Brigham (MGB) health system.

Findings

At MGH, patients who received peer support services saw a 44% reduction in hospitalizations, a 9% decrease in emergency department visits, and a 66% increase in outpatient SUD treatment. Across the MGB system, more than half of patients who engaged with peers entered treatment and demonstrated greater adherence to buprenorphine treatment.

Program/Policy Takeaways

This study contributes to the evidence that peer support services can reduce acute care use and improve treatment engagement. Successful implementation requires intentional planning. To successfully implement a peer recovery model in emergency rooms and outpatient settings, providers can apply lessons from this study which include how to build effective peer supervision models, develop hiring guidelines that address barriers for peers with a history of incarceration, and create workflows that align with the unique nature of peer support work.