Mutual Help and Peer Support Models for Opioid Use Disorder Recovery

  • John F. KellyEmail author
  • Alexandra W. Abry
  • Nilofar Fallah-Sohy
Part of the Current Clinical Psychiatry book series (CCPSY)


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.


Opioid use disorder Opioid addiction Mutual aid Peer support Peer models Recovery Coaching Addiction Recovery 



Alcoholics Anonymous


Alcohol use disorder


Buprenorphine maintenance treatment


Cocaine Anonymous


Certified Addiction Recovery Coach


Credentialed Alcoholism and Substance Abuse Counselor


Cognitive behavioral therapy


Connecticut Community for Addiction Recovery

CMA TreatmentAdvocate

Certified Medication Assisted Treatment Advocate


Emergency departments


Electronic medical records


Group drug counseling


Individual group counseling

MARS Project

Medication Assisted Recovery Services Project


Medication-assisted treatment


Mutual-help organizations


Methadone maintenance treatment


Narcotics Anonymous

NAMA Recovery

The National Alliance for Medication-Assisted Recovery


National Institute of Drug Abuse


Office of Alcoholism and Substance Abuse Services


Opioid drug counseling


Opioid use disorder


Randomized controlled trial


Rational Emotive Behavioral Therapy


Rational Recovery


Substance Abuse and Mental Health Services Administration


Standard medical management


Secular Organization for Sobriety or Save Our Selves


Substance use disorder


Treatment as usual


Twelve-Step Facilitation


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • John F. Kelly
    • 1
    • 2
    • 3
    Email author
  • Alexandra W. Abry
    • 4
  • Nilofar Fallah-Sohy
    • 4
  1. 1.Recovery Research Institute Massachusetts General HospitalBostonUSA
  2. 2.Center for Addiction Medicine Massachusetts General HospitalBostonUSA
  3. 3.Elizabeth R. Spallin Professor of Psychiatry in Addiction Medicine, Harvard Medical SchoolBostonUSA
  4. 4.Department of Psychiatry, Massachusetts General HospitalBostonUSA

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