Using Peer-Support Specialists and Digital Tools to Aid in SUD Recovery

Peer-support specialists (PSSs) are a critical part of the recovery process, both in person and even digitally. Technology has elevated the peer model and helped it to scale, going from one-on-one coaching to providing support for every phase of the process from intervention, to treatment, to ongoing recovery.

The understanding of the vital role of peer support in substance use disorder (SUD) recovery is not new. Festinger’s social comparison theory (1954) and Bandura’s social learning theory (1976) both speak to the innate human need to evaluate and improve themselves by observing and imitating the people around them. In terms of recovery, theories like these speak to the worldwide success of Twelve Step programs that function on peer support alone. An initiation into a substance-free lifestyle typically requires a community of others living in the same way who possess enough experience to demonstrate how they sustain their new sober lives.

A research study in Occupational Therapy International (Boisvert, Martin, Grosek, & Clarie, 2008) sought to provide data proving that peer-support programs reduce relapse rates by following SUD residents at a rehabilitation facility for nine months after completing treatment. This study was based on interviews, observation, a pretest and posttest, a medical outcomes study social support survey, and the volitional questionnaire.

This data was then measured in comparison to the year before the facility’s PSS program implementation. The study found that during that year, clients had a 24 percent chance of relapse, whereas those participating in the program the next year experienced a 7 percent chance of relapse (Boisvert et al., 2008). The data suggests a significant reduction in the risk of relapse, and this successful reduction was a direct result of the supportive behaviors and sense of community fostered by peer support.

An article published in the Psychiatric Rehabilitation Journal (Myrick & Del Vecchio, 2016) breaks down the integral nature of peer-support services in both private and public behavioral health systems. The article cites the ability of such services to increase access to “recovery-oriented services for people with mental and substance use disorders served by the public behavioral health care system” (Myrick & Del Vecchio, 2016). These services create an approachable program of recovery for a wide variety of clients and also provide a higher likelihood of sustained recovery.

For years, we have known that peer support has a significantly positive effect on those recovering from SUDs. Now, in 2021, it is of vital importance that recovery programs find a way to modernize this tool through the utilization of web-based technology.

A qualitative study published by the South Carolina Department of Health and Human Services explored the role of PSSs in SUD treatment. The study outlined the four types of support provided by PSSs: emotional, informational, instrumental, and affiliational (Pantridge et al., 2016). Patients working through SUD recovery require complex and differing forms of support that cannot be provided merely by behavioral health care professionals; support must come from specialists who intimately understand the intricacies of the recovery process from patients’ perspectives. This sort of unique affiliational and emotional support is most effective when coming from PSSs. With proper training and support, PSSs become an incredibly valuable resources in patients’ progression through recovery.

A 2020 study (Fallin-Bennett, Elswick, & Ashford, 2020) looked into the value of PSSs in the treatment of perinatal opioid use disorder (OUD). Perinatal OUD speaks to “someone that’s been there, lived it, seen it.” The study reviewed the personal experiences of postpartum women receiving peer-support services during their pregnancy and postpartum period. This qualitative study followed two focus groups in a private clinic that serves postpartum women suffering from OUD while parenting children under the age of five. The participants all reported that their PSSs had a “strong, positive impact on their recovery.” The study suggested that a peer-support program requires clarification of “the boundaries between peer supporters and clients” (Fallin-Bennett et al., 2020). This highlights the importance of PSSs having substantial recovery experiences of their own, as well as having proper training in the field of peer support so as to serve as more than just an empathetic ear.

Another study (Fortuna et al., 2020) regarding the utility of technology-enabled peer support for a variety of mental health and SUDs also found that the use of “peer-delivered interventions supported with technology” proved to be both effective and well accepted by patients across a number of treatment providers. This analysis spanned a total of thirty studies (including eleven randomized controlled trials) that reported on twenty-four interventions using digital peer support for patients suffering ongoing mental health crises. The findings concluded that “[d]igital peer-support interventions appear to be feasible and acceptable, with strong potential for clinical effectiveness” (Fortuna et al., 2020).

The Bottom Line

Digital peer support has the capacity to prevent SUD relapse while also serving as a crucial component of formal treatment. These technology-based services show high usage rates among engaged clients, and according to a recent national review of these digital recovery support services (D-RSS), “11 percent of US adults who have resolved a SUD [report a] lifetime engaging with at least one D-RSS” (Ashford, Bergman, Kelly, & Curtis, 2020). Digital peer support is one of the tools that can help scale access to healthy SUD recovery across the nation.

Once-a-month therapy is not enough to rescue individuals from the grips of SUDs. We need peer support along with other behavioral health services and SUD treatments. PSSs are meant to serve as frontline specialists to steer individuals in recovery towards necessary resources. This is the only scalable treatment for patients with SUDs who require around-the-clock support. The future of recovery from SUDs lies in service-enabled technology that ensures continued connection throughout recovery while leveraging the scarce resources within behavioral health treatment systems.

References

• Ashford, R. D., Bergman, B. G., Kelly, J. F., & Curtis, B. (2020). Systematic review: Digital recovery support services used to support substance use disorder recovery. Human Behavior and Emerging Technologies, 2(1), 18–32.
• Bandura, A. (1976). Social learning theory. Upper Saddle River, NJ: Prentice Hall.
• Boisvert, R. A., Martin, L. M., Grosek, M. & Clarie, A. J. (2008). Effectiveness of a peer-support community in addiction recovery: Participation as intervention. Occupational Therapy International, 15(4), 205–20.
• Fallin-Bennett, A., Elswick, A., & Ashford, K. (2020). Peer-support specialists and perinatal opioid use disorder: Someone that’s been there, lived it, seen it. Addictive Behaviors, 102, e106204.
• Festinger, L. A. (1954). A theory of social comparison processes. Human Relations, 7(2), 117–40.
• Fortuna, K. L., Naslund, J. A., LaCroix, J. M., Bianco, C. L., Brooks, J. M., Zisman-Ilani, Y., . . . & Deegan, P. (2020). Digital peer support mental health interventions for people with a lived experience of a serious mental illness: Systematic review. JMIR Mental Health, 7(4), e16460.
• Myrick, K., & Del Vecchio, P. (2016). Peer-support services in the behavioral health care workforce: State of the field. Psychiatric Rehabilitation Journal, 39(3), 197–203.
• Pantridge, C. E., Charles, V. A., DeHart, D. D., Iachini, A. L., Seay, K. D., Clone, S. & Browne, T. (2016). A qualitative study of the role of peer-support specialists in substance use disorder treatment: Examining the types of support provided. Alcoholism Treatment Quarterly, 34(3), 337–53.

Hans Morefield

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Hans Morefield is the CEO of CHESS Health, which is bringing innovative and evidence-based solutions for addiction management and behavioral health, including eIntervention, eTherapy, and eRecovery. CHESS customers, across the US and internationally, use the platform to get more patients and members into treatment, to extend treatment adherence, to reduce the rate and severity of relapses, and to use data to improve their practices.

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