Mutual Help and Peer Support Models for Opioid Use Disorder Recovery

Abstract

The onset and offset of opioid use disorders involve the dynamic interplay of biological, psychological, and social processes. Most people are first exposed to substances via social mechanisms, and within this social context, opioid use is either supported and reinforced or sanctioned and prohibited. Of note, while the social factors play a powerful role in modeling and reinforcing initial opioid use, they can also play a powerful role in attracting and engaging individuals with opioid use disorder into circles of recovery that can support and sustain long-term remission. Freely standing community mutual-help organizations, such as Narcotics Anonymous and SMART Recovery, as well as more professionally formalized peer models of ``Recovery Coaching'' have grown and flourished in the United States in recent decades to address the increasing burden of disease, disability, and premature mortality relating to opioid use disorder, but the science on their effectiveness has lagged behind that in other clinical areas. This chapter describes the origin and growth of peer support models for opioid use disorder and reviews the research in these areas. The policy implications of these findings are discussed regarding the clinical and public health utility of peer support models in addressing opioid use disorders.