Recovery support services often provided by peers also in recovery are emerging in the United States to meet the ongoing, and often complex, needs of individuals with substance use disorder.
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For many, substance use disorders are chronic conditions with several life-impacting consequences. Even after an initial treatment episode, the risk for relapse often remains high. This risk typically persists up to 5 years after initiating abstinence.
These services are separate from informal recovery support through mutual-help organizations, like Alcoholics Anonymous. Examples include peer recovery coaching, recovery housing, recovery community organizations/centers, and collegiate recovery programs. In this study, Bassuk and colleagues conducted a systematic review of the scientific literature on recovery support services.
Study authors searched databases of scientific articles for relevant research published between 1998 and 2014. To be included, studies needed to measure outcomes (rather than simply describe an intervention), and either follow a group over time and/or compare two groups. Studies measuring a single group at one point in time (e.g., cross-sectional) were excluded, as were those with fewer than 50 participants.
The quality of each study was determined to be “strong”, “moderate”, or “weak” in terms of the rigor of its study methods using criteria outlined by the Effective Public Health Practice Project.
After a rigorous vetting process, authors determined that nine studies would be included in the review.
Links to Source Abstracts: (Bernstein, 2005), (Rowe, 2007), (Min, 2007), (Mangrum, 2008), (Ja, 2010), (Tracy, 2011), (Kamon, 2013), (Smelson, 2013).
Overall, the studies varied considerably in terms of several different characteristics. They ranged from 52 participants to 4,420, and all were focused on adults, many of which had complex clinical presentations, such as severe emotional difficulties in addition to their substance use problem or disorder. The settings where studies were conducted also varied, ranging from community-based settings to clinical ones (e.g., outpatient medical clinic).
Regarding the recovery support services themselves, some provided only a brief 1-session intervention while others tested recovery support over several months or even several years. While many evaluated substance use, this was not the case for all of the studies reviewed. Several assessed treatment utilization, recovery capital, and criminal justice status.
Despite these differences, the review showed there was a meaningful advantage for individuals who received recovery support services. Individuals who received recovery support services improved from their initial levels of substance use and also improved in comparison to those who did not receive such services.
Two randomized trials with “strong”methods were mentioned specifically:
In one, a motivational interviewing intervention delivered by a peer in recovery, added to standard outpatient treatment, promoted higher rates of abstinence compared to outpatient treatment alone.
In the second, individuals with co-occurring substance use, psychiatric disorders, and criminal justice histories who received a peer support intervention in addition to standard clinical treatment had better alcohol, but similar drug outcomes 12 months later.
This study reviewed the small, but growing scientific literature in the area of peer led recovery support services. Peer-led recovery support services are increasingly available, & are being more commonly utilized by individuals with substance use & mental health disorders.
It is critical to know whether peer-led recovery support services work, how they work, and for whom they work best.
While randomized controlled trials are not always feasible in real-world settings (e.g., because the services are readily available and even those not randomized to receive the service can easily access it), there are strategies to use sophisticated statistics that help us draw firmer conclusions even when randomization isn’t possible. Future studies may use these more sophisticated statistical approaches (e.g., propensity score matching) to improve methodological quality.
Also, because recovery is understood as an ongoing lifestyle by many, rather than an acute change process, more long-term studies are needed.
Finally, the largest potential advantage of recovery support services is that they cost very little in comparison to traditional clinical services – or perhaps cost nothing at all. Future studies should test the cost-effectiveness of these recovery support services; how much do they cost to deliver, and how much do they save the individual and society potentially through reduced abstinence, less health care utilization, and reduced harms to society.
Bassuk, E. L., Hanson, J., Greene, R. N., Richard, M., &Laudet, A. (2016). Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review. J Subst Abuse Treat, 63, 1-9. doi:10.1016/j.jsat.2016.01.003
l
For many, substance use disorders are chronic conditions with several life-impacting consequences. Even after an initial treatment episode, the risk for relapse often remains high. This risk typically persists up to 5 years after initiating abstinence.
These services are separate from informal recovery support through mutual-help organizations, like Alcoholics Anonymous. Examples include peer recovery coaching, recovery housing, recovery community organizations/centers, and collegiate recovery programs. In this study, Bassuk and colleagues conducted a systematic review of the scientific literature on recovery support services.
Study authors searched databases of scientific articles for relevant research published between 1998 and 2014. To be included, studies needed to measure outcomes (rather than simply describe an intervention), and either follow a group over time and/or compare two groups. Studies measuring a single group at one point in time (e.g., cross-sectional) were excluded, as were those with fewer than 50 participants.
The quality of each study was determined to be “strong”, “moderate”, or “weak” in terms of the rigor of its study methods using criteria outlined by the Effective Public Health Practice Project.
After a rigorous vetting process, authors determined that nine studies would be included in the review.
Links to Source Abstracts: (Bernstein, 2005), (Rowe, 2007), (Min, 2007), (Mangrum, 2008), (Ja, 2010), (Tracy, 2011), (Kamon, 2013), (Smelson, 2013).
Overall, the studies varied considerably in terms of several different characteristics. They ranged from 52 participants to 4,420, and all were focused on adults, many of which had complex clinical presentations, such as severe emotional difficulties in addition to their substance use problem or disorder. The settings where studies were conducted also varied, ranging from community-based settings to clinical ones (e.g., outpatient medical clinic).
Regarding the recovery support services themselves, some provided only a brief 1-session intervention while others tested recovery support over several months or even several years. While many evaluated substance use, this was not the case for all of the studies reviewed. Several assessed treatment utilization, recovery capital, and criminal justice status.
Despite these differences, the review showed there was a meaningful advantage for individuals who received recovery support services. Individuals who received recovery support services improved from their initial levels of substance use and also improved in comparison to those who did not receive such services.
Two randomized trials with “strong”methods were mentioned specifically:
In one, a motivational interviewing intervention delivered by a peer in recovery, added to standard outpatient treatment, promoted higher rates of abstinence compared to outpatient treatment alone.
In the second, individuals with co-occurring substance use, psychiatric disorders, and criminal justice histories who received a peer support intervention in addition to standard clinical treatment had better alcohol, but similar drug outcomes 12 months later.
This study reviewed the small, but growing scientific literature in the area of peer led recovery support services. Peer-led recovery support services are increasingly available, & are being more commonly utilized by individuals with substance use & mental health disorders.
It is critical to know whether peer-led recovery support services work, how they work, and for whom they work best.
While randomized controlled trials are not always feasible in real-world settings (e.g., because the services are readily available and even those not randomized to receive the service can easily access it), there are strategies to use sophisticated statistics that help us draw firmer conclusions even when randomization isn’t possible. Future studies may use these more sophisticated statistical approaches (e.g., propensity score matching) to improve methodological quality.
Also, because recovery is understood as an ongoing lifestyle by many, rather than an acute change process, more long-term studies are needed.
Finally, the largest potential advantage of recovery support services is that they cost very little in comparison to traditional clinical services – or perhaps cost nothing at all. Future studies should test the cost-effectiveness of these recovery support services; how much do they cost to deliver, and how much do they save the individual and society potentially through reduced abstinence, less health care utilization, and reduced harms to society.
Bassuk, E. L., Hanson, J., Greene, R. N., Richard, M., &Laudet, A. (2016). Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review. J Subst Abuse Treat, 63, 1-9. doi:10.1016/j.jsat.2016.01.003
l
For many, substance use disorders are chronic conditions with several life-impacting consequences. Even after an initial treatment episode, the risk for relapse often remains high. This risk typically persists up to 5 years after initiating abstinence.
These services are separate from informal recovery support through mutual-help organizations, like Alcoholics Anonymous. Examples include peer recovery coaching, recovery housing, recovery community organizations/centers, and collegiate recovery programs. In this study, Bassuk and colleagues conducted a systematic review of the scientific literature on recovery support services.
Study authors searched databases of scientific articles for relevant research published between 1998 and 2014. To be included, studies needed to measure outcomes (rather than simply describe an intervention), and either follow a group over time and/or compare two groups. Studies measuring a single group at one point in time (e.g., cross-sectional) were excluded, as were those with fewer than 50 participants.
The quality of each study was determined to be “strong”, “moderate”, or “weak” in terms of the rigor of its study methods using criteria outlined by the Effective Public Health Practice Project.
After a rigorous vetting process, authors determined that nine studies would be included in the review.
Links to Source Abstracts: (Bernstein, 2005), (Rowe, 2007), (Min, 2007), (Mangrum, 2008), (Ja, 2010), (Tracy, 2011), (Kamon, 2013), (Smelson, 2013).
Overall, the studies varied considerably in terms of several different characteristics. They ranged from 52 participants to 4,420, and all were focused on adults, many of which had complex clinical presentations, such as severe emotional difficulties in addition to their substance use problem or disorder. The settings where studies were conducted also varied, ranging from community-based settings to clinical ones (e.g., outpatient medical clinic).
Regarding the recovery support services themselves, some provided only a brief 1-session intervention while others tested recovery support over several months or even several years. While many evaluated substance use, this was not the case for all of the studies reviewed. Several assessed treatment utilization, recovery capital, and criminal justice status.
Despite these differences, the review showed there was a meaningful advantage for individuals who received recovery support services. Individuals who received recovery support services improved from their initial levels of substance use and also improved in comparison to those who did not receive such services.
Two randomized trials with “strong”methods were mentioned specifically:
In one, a motivational interviewing intervention delivered by a peer in recovery, added to standard outpatient treatment, promoted higher rates of abstinence compared to outpatient treatment alone.
In the second, individuals with co-occurring substance use, psychiatric disorders, and criminal justice histories who received a peer support intervention in addition to standard clinical treatment had better alcohol, but similar drug outcomes 12 months later.
This study reviewed the small, but growing scientific literature in the area of peer led recovery support services. Peer-led recovery support services are increasingly available, & are being more commonly utilized by individuals with substance use & mental health disorders.
It is critical to know whether peer-led recovery support services work, how they work, and for whom they work best.
While randomized controlled trials are not always feasible in real-world settings (e.g., because the services are readily available and even those not randomized to receive the service can easily access it), there are strategies to use sophisticated statistics that help us draw firmer conclusions even when randomization isn’t possible. Future studies may use these more sophisticated statistical approaches (e.g., propensity score matching) to improve methodological quality.
Also, because recovery is understood as an ongoing lifestyle by many, rather than an acute change process, more long-term studies are needed.
Finally, the largest potential advantage of recovery support services is that they cost very little in comparison to traditional clinical services – or perhaps cost nothing at all. Future studies should test the cost-effectiveness of these recovery support services; how much do they cost to deliver, and how much do they save the individual and society potentially through reduced abstinence, less health care utilization, and reduced harms to society.
Bassuk, E. L., Hanson, J., Greene, R. N., Richard, M., &Laudet, A. (2016). Peer-Delivered Recovery Support Services for Addictions in the United States: A Systematic Review. J Subst Abuse Treat, 63, 1-9. doi:10.1016/j.jsat.2016.01.003
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