Theravive Home

A new study looked at peer health navigation experiences before and after prison release amount people with opioid use disorder.

“Our study looked at the experiences of participants in a specific peer navigation program that paired people with opioid use disorder exiting incarceration with peer navigators and other supports,” study author Michael Enich told us. “We were hoping to capture, in their own words, program participants’ feelings working with peers who have also experienced incarceration and/or substance use or mental health challenges. We also wanted to see what  aspects of the program these participants found to be most helpful—or aspects of the program they would change if they could.”  
 
The research team knew from other research that peer services are growing in the mental health and substance use treatment fields. They also knew that these programs have been helpful to address stigma around mental health or substance use, have improved service access for participants, and have filled gaps in services. 

“However, only a few studies have looked at peer services for people who’ve been incarcerated and have a substance use disorder, so we were excited to see what participants thought about peers using a strengths-based wellness approach in this specific context,” Enich told us.  

There are known health disparities for people in the criminal legal system. More than half of people incarcerated in state prisons have a diagnosed substance use disorder. When people return to the community, they’re at incredibly high risk of overdose and death—the risk of fatal drug overdose in the first two weeks after prison release is as much as 129 times greater than the general population. 

“We chose this study to fill the gap in understanding this, but also because we wanted to really center program participants’ perspectives,” Enich told us. “If we’re going to make programs that meaningfully address people’s needs, we need to listen to what those needs are and their experiences with those programs.”  

The team interviewed 39 adult inmates diagnosed with opioid use disorder who worked with peer support specialists before and after their release from state prison. They also interviewed 30 of those individuals a few months after their initial prison release, then analyzed their interviews for themes around their experience.  

"We found that our participants appreciated working with someone with a shared experience; they appreciated that they could use that shared experience to build a trusting relationship with someone who ‘was there for them no matter what’”, Enich told us. “This meant participants got emotional support from their peers, but also help navigating social services and treatment support in the community.” 

However, there are certain needs that remain hard to meet; policy and system barriers to recovery meant it was hard for some to access housing and employment services, and since many of these interviews were conducted in early COVID-19, it was hard for some individuals to tap into medical services.  

These results add to the growing body of work that suggests when peers are adequately supported and programs thoughtfully implemented they can be incredibly useful in helping people maintain their own wellness. 

“What surprised me most, I would say, was the diversity of experiences individuals had and just how consistently helpful they found the program, all in ways that worked for them,” Enich told us. “Peers offered so much flexible support.” 

There were five participants who were no longer enrolled in the peer program at follow up interviews, three of whom moved out of state and were no longer eligible. But for the two who were still here, both spoke positively of the program but just suggested they had other priorities or the aforementioned systemic housing problems made it difficult to stay enrolled.

Moving forward, Enich believes the study results suggest that peer programs can be incredible resources to connect participants to evidence-based treatment, help them address psychosocial needs and support long-term wellness. They also suggest further research that examines how programs can adapt to the other highlighted challenges to community integration.

“What excites me most about this work is the trust that it places in people to support each other in recovery and wellness,” Enich told us. “It shows us how valuable peer programs can be when they are implemented well, and highlights so clearly the empathy that can come from someone with the same experience as you.”