“Running myself ragged”: stressors faced by peer workers in overdose response settings

Abstract

Background Peer workers or “peers” (workers with past or present drug use experience) are at the forefront of overdose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for peer workers but is also stressful, with lasting emotional and mental health effects. Yet, little is known about the stressors peer workers face and what interventions can be implemented to support them in their roles. Methods This project used a community-based sequential mixed-methods research design. Eight peer researcher-led focus groups (n = 31) were conducted between November 2018 and March 2019 to assess needs of peer workers. The transcripts were thematically coded and analysed using interpretative description. These results informed a survey, which was conducted (n = 50) in September 2019 to acquire quantitative data on peer workers’ perception of health, quality of life, working conditions and stressors. Frequency distributions were used to describe characteristics of participants. X2 distribution values with Yates correction were conducted to check for association between variables. Results Five themes emerged from the focus groups that point to stressors felt by peer workers: (1) financial insecurity; (2) lack of respect and recognition at work; (3) housing challenges; (4) inability to access and/or refer individuals to resources; and (5) constant exposure to death and trauma. Consistent with this, the factors that survey participants picked as one of their “top three stressors” included financial situation, work situation, and housing challenges. Conclusion Peer workers are faced with a diversity of stressors in their lives which often reflect societal stigmatization of drug use. Recognition of these systemic stressors is critical in designing interventions to ease the emotional, physical and financial burden faced by peer workers.

Organizational support for frontline harm reduction and systems navigation work among workers with living and lived experience: qualitative findings from British Columbia, Canada

“…Despite the benefits of peer-based service work, there is consistent evidence of challenges to hiring peers within organizations [ 21 ]. Peer workers face a disproportionate amount of pressure, burden, and trauma in their work, especially in overdose prevention contexts [ 17 , 20 , 22 ].…”

“…Peer workers face a disproportionate amount of pressure, burden, and trauma in their work, especially in overdose prevention contexts [17,20,22]. Studies also show that peer workers receive minimal social and emotional supports [17,[20][21][22], which may be partially attributable to their casual work arrangements [23]. Questions are being raised about the sustainability or potential burnout of the peer workforce, especially in the context of the overdose crisis in North America [21,23,24].…”

“…Studies also show that peer workers receive minimal social and emotional supports [17,[20][21][22], which may be partially attributable to their casual work arrangements [23]. Questions are being raised about the sustainability or potential burnout of the peer workforce, especially in the context of the overdose crisis in North America [21,23,24]. More research is needed that examines the role of organizations in providing support to peer workers in this context.…”

Using Intervention Mapping to Develop ‘ROSE’: An Intervention to Support Peer Workers in Overdose Response Settings

“…Peer workers indicated that their work is stressful and despite their wholehearted commitment to the job (36, 37), their lack of organizational and mental health supports to mitigate their stresses creates notable dissatisfaction. Lack of such resources often led to low morale and burnout (37).…”

Using Intervention Mapping To Develop ‘ROSE’: An Intervention To Support Peer Workers in Overdose Response Settings

“…Step 1: Needs Assessment Eight focus groups with 31 participants in total were conducted between November 2018 and March 2019; two in the Fraser region, two in Vancouver and four in Victoria. Details on recruitment of participants, interview processes, and data analysis are described in two previously-published articles (36,37).…”