Do Peer Recovery Specialists Improve Outcomes for Individuals with Substance Use Disorder in an Integrative Primary Care Setting? A Program Evaluation


Peer recovery specialists (PRSs) combine their personal experiences with substance use and recovery with clinical skills to support patients in treatment for or recovery from substance use. This paper provides evaluation findings from a SAMHSA-funded program that integrated a PRS team into a primary care clinic to assess the efficacy of PRS support on patients’ substance use, healthcare involvement, and criminal justice involvement. PRSs provided a range of services to patients with histories of incarceration and substance use, including facilitating support groups, providing one-on-one individualized support, and navigating services. Data were collected from PRS-supported patients at intake, discharge, and 6 months post-intake. Results revealed reductions in the percentage of patients using substances in the past 30 days, decreased number of days using alcohol, increased engagement in more medical services after program enrollment, increased school enrollment, and increased rates of employment for PRS-supported patients.

This is a preview of subscription content, log in to check access.

Access options

Buy single article

Instant unlimited access to the full article PDF.

US$ 39.95

Price includes VAT for USA

Subscribe to journal

Immediate online access to all issues from 2019. Subscription will auto renew annually.

US$ 99

This is the net price. Taxes to be calculated in checkout.


  1. Babor, T. F., McRee, B. G., Kassebaum, P. A., Grimaldi, P. L., Ahmed, K., & Bray, J. (2007). Screening, Brief Intervention, and Referral to Treatment (SBIRT) toward a public health approach to the management of substance abuse. Substance Abuse, 28, 7–30.

  2. Bandura, A., & National Institute of Mental Health. (1986). Prentice-Hall series in social learning theory Social foundations of thought and action: A social cognitive theory. Englewood Cliffs, NJ: Prentice-Hall Inc.

  3. Bassuk, E. L., Hanson, J., Greene, R. N., Richard, M., & Laudet, A. (2016). Peer-delivered recovery support services for addictions in the United States: A systematic review. Journal of Substance Abuse Treatment, 63, 1–9.

  4. Blakeman, T., Macdonald, W., Bower, P., Gately, C., & Chew-Graham, C. (2006). A qualitative study of GPs’ attitudes to self-management of chronic disease. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 56, 407–414. Retrieved April 2, 2019, from

  5. Bland, J. M., & Altman, D. G. (1995). Multiple significance tests: The Bonferroni method. BMJ, 310, 170.

  6. Blash, L., Chan, K., & Chapman, S. (2015). The peer provider workforce in behavioral health: A landscape analysis. San Francisco: UCSF Health Workforce Research Center on Long-Term Care. Retrieved April 15, 2019, from

  7. Boisvert, R. A., Martin, L. M., Grosek, M., & Clarie, A. J. (2008). Effectiveness of a peer-support community in addiction recovery: Participation as intervention. Occupational Therapy International, 15, 205–220.

  8. Brooks, A. C., Carpenedo, C. M., Fairfax-Columbo, J., Clements, N. T., Benishek, L. A., Knoblach, D., … Kirby, K. C. (2013). The RoadMAP Relapse Prevention Group Counseling Toolkit™: Counselor adherence and competence outcomes. Journal of Substance Abuse Treatment45, 356–362.

  9. Bush, K., Kivlahan, D. R., McDonell, M. B., Fihn, S. D., & Bradley, K. A. (1998). The AUDIT alcohol consumption questions (AUDIT-C): An effective brief screening test for problem drinking. Archives of Internal Medicine, 158, 1789–1795.

  10. Center for Substance Abuse Treatment. (2009). What are Peer Recovery Support Services? (HHS Publication No. SMA 09-4454). Rockville, MD: Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Retrieved from

  11. Chapman, S. A., Blash, L. K., Mayer, K., & Spetz, J. (2018). Emerging roles for peer providers in mental health and substance use disorders. American Journal of Preventive Medicine, 54, S267–S274.

  12. Cook, J. A., Copeland, M. E., Corey, L., Buffington, E., Jonikas, J. A., Curtis, L. C., … Nichols, W. H. (2010). Developing the evidence base for peer-led services: Changes among participants following Wellness Recovery Action Planning (WRAP) education in two statewide initiatives. Psychiatric Rehabilitation Journal, 34, 113.

  13. Copeland, M. E. (1997). Wellness recovery action plan. Brattleboro, VT: Peach Press. Retrieved April 15, 2019, from

  14. Darby, K., & Kinnevy, S. C. (2010). GPRA and the development of performance measures. Journal of Evidence-Based Social Work, 7, 5–14.

  15. Dasch, K., & Kendall, J. (2007). What do newly diagnosed cancer patients discuss with survivors? Delaware Medical Journal79, 489–492. Retrieved March 10, 2019, from

  16. Festinger, L. (1954). A theory of social comparison processes. Human Relations, 7, 117–140.

  17. Gryczynski, J., Schwartz, R. P., Salkever, D. S., Mitchell, S. G., & Jaffe, J. H. (2011). Patterns in admission delays to outpatient methadone treatment in the United States. Journal of Substance Abuse Treatment, 41, 431–439.

  18. IBM Corporation. (2016). IBM SPSS Statistics for Windows, Version 24.9. Armonk, NY: IBM Corp.

  19. Institute of Medicine (IOM). (2006). Improving the quality of health care for mental and substance-use conditions. Washington, DC: National Academies Press.

  20. Kocalevent, R. D., Hinz, A., & Brähler, E. (2013). Standardization of the depression screener patient health questionnaire (PHQ-9) in the general population. General Hospital Psychiatry, 35, 551–555.

  21. Laudet, A. B., & Humphreys, K. (2013). Promoting recovery in an evolving policy context: What do we know and what do we need to know about recovery support services? Journal of Substance Abuse Treatment, 45, 126–133.

  22. Löwe, B., Decker, O., Müller, S., Brähler, E., Schellberg, D., Herzog, W., & Herzberg, P. Y. (2008). Validation and standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the general population. Medical Care, 46, 266–274.

  23. Madras, B. K., Compton, W. M., Avula, D., Stegbauer, T., Stein, J. B., & Clark, H. W. (2009). Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: Comparison at intake and 6 months later. Drug and Alcohol Dependence, 99, 280–295.

  24. Napper, L. E., Fisher, D. G., Johnson, M. E., & Wood, M. M. (2010). The reliability and validity of drug users’ self reports of amphetamine use among primarily heroin and cocaine users. Addictive Behaviors, 35, 350–354.

  25. National Prevention Council. (2011). National prevention strategy. Washington, DC: U.S. Department of Health and Human Services, Office of the Surgeon General. Retrieved March 10, 2019, from

  26. Office of National Drug Control Policy (ONDCP). (2010). National drug control strategy. Washington, DC: Executive Office of the President, White House. Retrieved March 10, 2019, from

  27. Padwa, H., Urada, D., Antonini, V. P., Ober, A., Crèvecoeur-MacPhail, D. A., & Rawson, R. A. (2012). Integrating substance use disorder services with primary care: The experience in California. Journal of Psychoactive Drugs, 44, 299–306.

  28. Philadelphia Dept. of Behavioral Health and Intellectual Disabilities Services and Achara Consulting Inc. (2017). Peer Support Toolkit. Philadelphia: DBHIDS. Retrieved April 15, 2019, from

  29. Randall, M., & Ligon, K. (2014). From recidivism to recovery: The case for peer support in Texas correctional facilities. Center for Public Policy Priorities. Retrieved April 15, 2019, from

  30. Reblin, M., & Uchino, B. N. (2008). Social and emotional support and its implication for health. Current Opinion in Psychiatry, 2, 201.

  31. Reif, S., Braude, L., Lyman, D. R., Dougherty, R. H., Daniels, A. S., Ghose, S. S., … Delphin-Rittmon, M. E. (2014). Peer recovery support for individuals with substance use disorders: Assessing the evidence. Psychiatric Services, 65, 853–861.

  32. Substance Abuse and Mental Health Services Administration (SAMHSA). (2010). Recovery-Oriented Systems of Care (ROSC) Resource Guide. Substance Abuse and Mental Health Services Administration’s Partners for Recovery (PFR) Initiative. Retrieved April 15, 2019, from

  33. Substance Abuse and Mental Health Services Administration (SAMHSA). (2011). The evidence: Consumer operated services. (HHS Publication No. SMA-11-4633). Rockville, MD: Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Retrieved April 15, 2019, from

  34. Tiet, Q. Q., Leyva, Y. E., Moos, R. H., & Smith, B. (2017). Diagnostic accuracy of a two-item Drug Abuse Screening Test (DAST-2). Addictive Behaviors, 74, 112–117.

  35. Uchino, B. N. (2006). Social support and health: A review of physiological processes potentially underlying links to disease outcomes. Journal of Behavioral Medicine, 29, 377–387.

  36. VISN 1 New England MIRECC Peer Education Center & VISN 4 MIRECC Peer Resource Center. (2015). Peer Specialist Toolkit: Implementing Peer Support Services in VHA. Retrieved April 15, 2019, from

  37. Walsh, J., & Connelly, P. R. (1996). Supportive behaviors in natural support networks of people with serious mental illness. Health and Social Work, 21, 296–303.

  38. Williams, G. D., Aitken, S. S., & Malin, H. (1985). Reliability of self-reported alcohol consumption in a general population survey. Journal of Studies on Alcohol, 46, 223–227.

Download references


We would like to acknowledge the dedicated service of Virginia Vitella, Jose DeLeon, and Christina Collins. Their efforts in the service of their community and the program evaluation was of the highest compassion, caliber, and dedication.


Funding was provided by Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment (Grant No. 1H79TI026201).

Author information

Correspondence to Travis A. Cos.

Ethics declarations

Conflict of interest

Travis A. Cos, Archana Bodas LaPollo, Mara Aussendorf, Jason M. Williams, Kimberly Malayter and David S. Festinger declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Cos, T.A., LaPollo, A.B., Aussendorf, M. et al. Do Peer Recovery Specialists Improve Outcomes for Individuals with Substance Use Disorder in an Integrative Primary Care Setting? A Program Evaluation. J Clin Psychol Med Settings (2019).

Download citation


  • Peer recovery specialists
  • Evaluation
  • Integrated primary care
  • Substance use recovery