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White puzzle pieces with a fair skinned hand holding one about to put the puzzle together. Below the pieces is a red background with white text that says "Peer-to-peer."

Shared Experience as a Pathway to Positive Outcomes

Certified Peer Support Shown to Play an Important Role in Addiction Recovery

To paraphrase an old proverb, it’s difficult to understand one’s struggles until you walk a mile in their shoes. For those battling the chronic disease of addiction, being able to connect with someone who has faced the same challenges may lead to a positive outcome in their recovery journey.

Portrait photo of Kenneth D. Smith

Kenneth D. Smith

In a recently released white paper, Kenneth D. Smith, an assistant professor with the University of Tennessee, Knoxville, College of Education, Health, and Human Sciences (CEHHS), and a team of researchers outlined the potential benefits of peer recovery support services in community organizations.

The white paper entitled, Unlocking the Potential of Recovery Community Organizations and Peer Recovery Support, was released by Faces and Voices of Recovery (FVR). According to the organization’s website, FVR helps over 23 million Americans recovering from addiction to alcohol and other drugs into recovery, community organizations, and networks. This includes peer-to-peer recovery support.

Smith, who is a health economist and public health practitioner, says that certified peer specialists have become a key component to help improve recovery outcomes. In fact, it is now recognized as a best practice with numerous documented positive outcomes.

“The emerging literature demonstrates that peer recovery support reduces recurrence of substance use, overdose deaths, and emergency department visits,” said Smith. “These, in turn, reduce healthcare costs, as well as costs in other systems impacted by substance use.”

It’s important to note there is a difference between a certified peer and a sponsor in a program such as Alcoholics Anonymous. It this case, peers must go through a rigorous training and certification process in order to work with those in recovery. Peer workers are not counselors, social workers, or care coordinators. However, based on past evidence they play a critical role in maximum effectiveness in the recovery process.

“Peer recovery support specialists are certified professionals who have lived experience in recovery. They are a trusted companion that supports those starting their recovery journey. It is an authentic relationship among equals based on trust—and we know that authenticity cannot happen without vulnerability,” said Smith. “When people starting recovery see that someone like them has been successful in recovery, it provides a sense of hope. This relational aspect is unique and therapeutic.”

Despite the evidence of the effectiveness of peer workers, Smith and his colleagues found that peer workers are highly undervalued. In fact, many peer workers don’t make a living wage and are often times uncompensated for positive outcomes that are difficult to measure. Smith and his colleagues go on to mention that peer workers are undervalued similarly to other occupations, such and childcare and home healthcare workers.

“Despite the professionalization of peer recovery support as an occupation, it has a profile similar to other caring occupations which, despite their importance to society, are completely undervalued,” said Smith. “Consider the lack of childcare during the pandemic and the enormous impact it had on the labor market. We need new approaches to addressing workforce development issues that arise out of complex systems.”

Smith and his colleges are using the white paper as a call to action for a number of groups, from government agencies to philanthropists, to come together to bring about transformative change in the recovery process. Continuing to leverage the importance of peer support will improve health and well-being for the greater good.

“Many people are beginning to recognize that addiction is a chronic condition that needs to move beyond an acute care model,” said Smith. “The real challenge now is to address the stigma associated with substance use and develop recovery supports in the community. The long-term goal is to change not only policies and practices but also mental models and paradigms of thinking. The white paper is a call to action to begin the hard work of systems change.”

Through its eight departments and 12 centers, the UT Knoxville College of Education, Health, and Human Sciences enhances the quality of life for all through research, outreach, and practice. Find out more at