Triumphs and Challenges of Peer Recovery Work in Clinical Care

Peer Recovery Workers (PRWs) bring lived experience to clinical care, offering non-clinical support that enhances engagement and reduces stigma for individuals recovering from substance use disorders. Despite their growing presence, PRWs face systemic challenges that threaten the sustainability of their roles, including low wages, limited advancement, stigmatized experience, and lack of institutional understanding. These challenges differ from mental health peer support roles and reflect the unique demands of substance use recovery settings. This empirical phenomenological study explored the lived experiences of 12 PRWs in the United States through semi-structured interviews. Five key themes were identified: (1) respect in recovery - PRWs valued recognition but often encountered stigma and exclusion; (2) centering the consumer - Participants prioritized consumer needs, fostering trust and connection; (3) connection - Peer work fostered community and personal growth, though boundaries were sometimes difficult to maintain; (4) expertise - PRWs viewed experiential knowledge as complementary to clinical training; and (5) pay and benefits - Low wages, limited advancement, and inadequate benefits were major barriers to PRW retention. These themes indicate that PRWs find fulfillment but face structural barriers that threaten long-term sustainability. Healthcare systems must improve compensation, clarify roles, and provide institutional support to retain and empower PRWs.