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Substance use/misuse is a leading public health concern in the United States. In the midst of the COVID-19 pandemic, drug-related deaths exceeded 100,000 in a 12-month period for the first time in history. There is currently an urgent need for empirical evidence to inform community leaders and policy makers on the benefits of recovery-informed approaches to SUD prevention and treatment. The peer recovery support specialist (PRSS) is a certified professional who self-identifies as being in recovery from a substance use disorder (SUD), mental illness, or co-occurring disorder and may play an important role in positively affecting outcomes for persons with SUD. However, the evidence for PRSS services is limited in part due to methods that are ill-fitted to measure the dynamic process of recovery across time and within a complex service continuum. This sequential exploratory mixed-methods study queried PRSS in five Central Appalachian states regarding their work roles and activities within the context of regional service networks also known as ‘recovery ecosystems.’ 565 Central Appalachian PRSS respondents indicate that they frequently provide emotional support in a broad array of regional service settings but have few professional advancement opportunities. PRSS also report that their role is frequently misunderstood. This study expands the existing literature providing information about training, remuneration, job satisfaction, work roles and activities within the context of existing recovery ecosystems. Inclusion of peer recovery support specialist’s perspectives improved measurement of peer service delivery and should be considered when working with this vital recovery-supporting workforce.

An examination of peer recovery support specialist work roles and activities within the recovery ecosystems of Central Appalachia