Benefits of peer support groups in the treatment of addiction

Figures & data

Table 1 Key terms and definitions related to peer support

Terms	Definitions
Peer support	The process of giving and receiving nonprofessional, nonclinical assistance from individuals with similar conditions or circumstances to achieve long-term recovery from psychiatric, alcohol, and/or other drug-related problems
Recovery	A process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential^Citation22
Peer support group	Where people in recovery voluntarily gather together to receive support and provide support by sharing knowledge, experiences, coping strategies, and offering understanding^Citation23
Peer provider (eg, certified peer specialist, peer support specialist, mentor, and recovery coach)	A person who uses his or her lived experience of recovery from mental illness and/or addiction, plus skills learned in formal training, to deliver services in behavioral health settings to promote mind–body recovery and resiliency^Citation24
Peer mentorship	Where individuals in later recovery provide nonprofessional, nonclinical assistance to individuals in earlier recovery with similar conditions or circumstances to achieve long-term recovery from psychiatric, alcohol, and/or other drug-related problems

Figure 1 Flow diagram of study selection.

Table 2 Included studies utilizing peer support groups

Authors	Design	N	Population	Findings
Armitage et al^Citation67	Pre/posttest	152	Individuals in recovery from addiction and their families	86% of participants indicated no use of alcohol or drugs in the past 30 days at the 6-month follow-up 95% of participants reported strong willingness to recommend the program to others, 89% found services helpful, and 92% found materials helpful
Boisvert et al^Citation70	Pre-/posttest	18	Individuals in addiction recovery living in permanent supportive housing	Substance use relapse rate reduced (24%–7%) for participants in the peer support community Pretest relapse rate was 85%; posttest rate was 33% for tenants returning to homelessness No differences in pre- and post-QOLR The MOS–SSS subscales revealed significant differences and moderate-to-large effect sizes (r) on the MOS–SSS subscales: emotional/informational support (P=0.005; r=0.628), tangible support (P=0.028; r=0.493), and affectionate support (P=0.027; r=0.494)
Tracy et al^Citation21	Pre-/posttest	40	Individuals with substance use disorders in an addiction treatment program	Feasibility and acceptance data in the domains of patient interest, safety, and satisfaction were promising In addition, mentees significantly reduced their alcohol use (P<0.01) and drug use (P<0.01) from baseline to termination The majority of mentors sustained abstinence Fidelity measures indicated that mentors adhered to the delivery of treatment
Tracy et al^Citation72	RCT comparing TAU + MAP-engage vs TAU + DRT + MAP-engage vs TAU	96	High recidivism veterans (mostly males) with substance use disorders initially recruited from an inpatient clinic	TAU + MAP-engage alone and TAU + DRT + MAP-engage were associated with increased adherence to post-discharge outpatient appointments for substance use treatment (P<0.05) when compared with TAU only As well as for substance use treatment, general medical, and mental health services (P<0.05 for all appointments combined) when compared with TAU only
Mangrum^Citation68	Quasi-experimental design comparing ATR and substance use treatment vs substance use treatment	4,420	Consumers with substance use disorders referred from drug courts, probation, or child protective services	Individuals who completed the program were significantly more likely to have received recovery support groups (t(1)=65.75, P<0.0001)
Purcell et al^Citation73	RCT study of peer-mentoring intervention INSPIRE vs a video discussion control group	966	HIV-positive IDU participants	Adherence rates measured at 87%, 83%, and 85% at 3 months, 6 months, and 12 months, respectively Risk behaviors decreased among randomized participants although no significant differences in conditions
Latka et al^Citation74	RCT study of peer-mentoring intervention vs a time-equivalent attention-control group	418	Individuals who are HCV-positive and IDUs	Compared with the controls, participants in the intervention group were less likely to report distributive risk behaviors at 3 months (OR =0.46; 95% CI =0.27, 0.79) and 6 months (OR =0.51; 95% CI =0.31, 0.83), a 26% relative risk reduction Peer mentoring and self-efficacy were significantly increased in the intervention group, and intervention effects were mediated through improved self-efficacy
Velasquez et al^Citation71	RCT study of both individual counseling vs peer group education/support	253	HIV-positive men who have sex with men with alcohol use disorders	Treatment effect was demonstrated over each 30-day period with regard to number of drinks consumed (OR =1.38; 95% CI =1.02, 1.86) As well as the number of heavy drinking days (OR =1.5; 95% CI =1.08, 2.10) over each 30-day period Main effect was found in the number of days in which both heavy drinking and unprotected sex occurred over each 30-day period
Marlow et al^Citation79	Pre-/posttest	13	Formerly incarcerated men on parole released from prison within the past 30 days	Findings from the assessment of psychosocial variables demonstrated significant improvement on two abstinence self-efficacy subscales, negative affect (P=0.01), and habitual craving (P=0.003) No significant differences in total scores for abstinence self-efficacy or the other measures from baseline to follow-up for the 13 participants who completed the study No significant differences in 12-step participation with regard to attendance, sponsor contact, or belief in 12-step framework
Andreas et al^Citation69	Pre-/posttest	509	Men and women in recovery from addiction who had been incarcerated, and their families and significant others	Increased self-efficacy and increased family and friend support, quality of life, and feelings of guilt and shame were demonstrated at 12 months from baseline (no data were shown) Peer and staff accessibility were valued

Abbreviations: ATR, access to recovery; CI, confidence interval; DRT, dual recovery treatment; HCV, hepatitis C virus; HIV, human immunodeficiency virus; IDU, injection drug user; INSPIRE, Intervention for Seropositive Injectors–Research and Evaluation; MAP, Mentorship for Alcohol Problem; MAP-engage, Mentorship for Addiction Problems to enhance engagement to treatment; MOS, Medical Outcomes Study; OR, odds ratio; QOLR, Quality of Life Rating; RCT, randomized controlled trial; SSS, Social Support Survey; TAU, treatment as usual.

SAMHSA [webpage on the Internet]Recovery and Recovery SupportRockville, MDSubstance Abuse and Mental Health Services Administration [updated October 5, 2015; cited February 18, 2016]. Available from: http://www.samhsa.gov/recoveryAccessed February 18, 2016

 Google Scholar

National Alliance on Mental Illness [homepage on the Internet] [cited August 2, 2015]. Available from: http://www.nami.orgAccessed August 2, 2015

 Google Scholar

INTEGRATIONSAMHSA [webpage on the Internet]SAMHSA-HRSA Center for Integrated Health SolutionsRockville, MDSubstance Abuse and Mental Health Services Administration [cited March 5, 2016]. Available from: http://www.integration.samhsa.gov/workforce/team-members/peer-providers; http://www.samhsa.gov/recoveryAccessed March 5, 2016

 Google Scholar

ArmitageEVLyonsHMooreTLRecovery association project (RAP), Portland, OregonAlcohol Treat Q201028339357

 Google Scholar

BoisvertRAMartinLMGrosekMClarieAJEffectiveness of a peer-support community in addiction recovery: participation as interventionOccup Ther Int200815420522018844242

 PubMedGoogle Scholar

TracyKBurtonMMiescherAMentorship for Alcohol Problems (MAP): a peer to peer modular intervention for outpatientsAlcohol Alcohol2012471424722045903

 PubMed Web of Science ®Google Scholar

TracyKBurtonMNichCRounsavilleBUtilizing peer mentorship to engage high recidivism substance-abusing patients in treatmentAm J Drug Alcohol Abuse201137652553121851202

 PubMed Web of Science ®Google Scholar

MangrumLFinal Evaluation Report: Creating Access to Recovery through Drug Courts. Austin, Texas Department of State Health Services. Mental Health and Substance Abuse Services DivisionAustin, TXGulf Coast Addiction Technology Transfer Center2008

 Google Scholar

PurcellDWLatkaMHMetschLRResults from a randomized controlled trial of a peer-mentoring intervention to reduce HIV transmission and increase access to care and adherence to HIV medications among HIV-seropositive injection drug usersJ Acquir Immune Defic Syndr200746suppl 2S35S4718089983

 PubMed Web of Science ®Google Scholar

LatkaMHHaganHKapadiaFA randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis CAm J Public Health200898585386118382005

 PubMed Web of Science ®Google Scholar

VelasquezMMvon SternbergKJohnsonDHGreenCCarbonariJPParsonsJTReducing sexual risk behaviors and alcohol use among HIV-positive men who have sex with men: a randomized clinical trialJ Consult Clin Psychol200977465766719634959

 PubMed Web of Science ®Google Scholar

MarlowEGrajedaWLeeYYoungEWilliamsMHillKPeer mentoring for male parolees: a CBPR pilot studyProg Community Health Partnersh2015919110025981429

 PubMedGoogle Scholar

AndreasDJaDYWilsonSPeers reach out supporting peers to embrace recovery (PROSPER): a center for substance abuse treatment recovery community services programAlcohol Treat Q2010283326338

 Google Scholar