Targeting the Barriers in the Substance Use Disorder Continuum of Care With Peer Recovery Support

Abstract

Substance Use Disorder (SUD) has been recognized as a chronic, relapsing disorder. However, much of existing SUD care remains based in an acute care model that focuses on clinical stabilization and discharge, failing to address the longer-term needs of people in recovery from addiction. The high rates of client’s disengagement and attrition across the continuum of care highlight the need to identify and overcome the obstacles that people face at each stage of the treatment and recovery process. Peer recovery support services (PRSS) show promise in helping people initiate, pursue, and sustain long-term recovery from substance-related problems. Based on a comprehensive review of the literature, the goal of this article is to explore the possible roles of peers along the SUD care continuum and their potential to improve engagement in care by targeting specific barriers that prevent people from successfully transitioning from one stage to the next leading eventually to full recovery. A multidimensional framework of SUD care continuum was developed based on the adapted model of opioid use disorder cascade of care and recovery stages, within which the barriers known to be associated with each stage of the continuum were matched with the existing evidence of effectiveness of specific PRSSs. With this conceptual paper, we are hoping to show how PRSSs can become a complementary and integrated part of the system of care, which is an essential step toward improving the continuity of care and health outcomes.

Characterizing the Landscape of Service Provider Needs and Gaps in Services During the Canadian Youth Polysubstance Use Health Crisis

“…The need for a continuum of care was mentioned by a large proportion of the survey respondents. For example, service provider responses highlighted what has already been noted about the inadequacies of the “acute care models” 23 (ie, reducing symptoms, clinical stabilization, and subsequent discharge). Several participants indicated the importance of developing a continuum of care with regards to the continuation of service provision and support after treatment in hospitals, acute detox, and/or withdrawal management services.…”

Relentless Stigma: A Qualitative Analysis of a Substance Use Recovery Needs Assessment

“… 29 Since not all programing is reimbursable and not all insurance plans make treatment services affordable, peer recovery support can be a vital tool for those seeking or maintaining recovery. 30 , 31 Referrals to peer recovery support from drug courts or healthcare centers is 1 way to provide free recovery based services, when appropriate. Additional ways to ensure access to treatment are needed such as providing transportation or reducing the cost of treatment services.…”

Providing peer navigation services to women with a history of opioid misuse pre- and post-release from jail: A program description

“…Although previous studies have indicated value in peer services, [6][7][8][9][10][11][12][13][14][15][16][17][18] including positioning peers in the linkage facilitator or treatment navigation role, [19][20][21] little research has focused on peer navigation specific to SUD treatment for recently incarcerated women. Findings highlight the breadth of needs reported by women in the present sample prior to release, including transportation, employment, housing, mental or physical health, and complex interpersonal relationships, all of which have been highlighted in previous research on women's reentry 16 and may pose as major barriers to engagement with OUD treatment and sustaining recovery.…”

“…Peer-based services have demonstrated promise in supporting positive health outcomes for individuals seeking recovery from substance misuse. [6][7][8] Broadly, "peers" are individuals with lived experience (e.g., incarceration, mental health issues, and/or substance misuse) working in trained/certified staff positions to address a variety of needs, including advocacy, communitybuilding, role-modeling, resource-gathering, or motivational support. 9 Through a combination of professional training and lived experience, peers can bridge communication gaps between clinicians and clients and speak with legitimacy grounded in either/both the service user or trained specialist role.…”