"My Recovery and My Work Are Separate": Perceptions of MOUD Among Certified Peer Recovery Supporters.

Abstract

Ongoing high rates of opioid use and overdose death have prompted expansion of care options for people with substance use disorder (SUD), including medications for opioid use disorder (MOUD) and diverse forms of care linkage and support. The utilization of Certified Peer Recovery Supporters (CPRS) in the recovery field is an evidence-based practice to improve the continuum of care for SUD and has been increasingly incorporated into the recovery field. This study examines perceptions of MOUD among CPRS and how this shapes the collaborative provision of care within local treatment and recovery ecosystems. Qualitative interviews were conducted with CPRS (n=22) who were recruited via snowball sampling. Eligible participants were above 18 years old and had CPRS certification and self-reported work experience in treatment ecosystems in Dayton, OH. Interviews were transcribed and uploaded to Taguette software for coding and analysis. Select codes were analyzed using Iterative Categorization for further thematic analysis and data interpretation. All 22 participants were included in the analysis. Three key findings pertaining to perceptions of MOUD among CPRS were identified, including stigma against MOUD within treatment and recovery ecosystems, the value of MOUD as treatment and harm reduction, and structural frustrations within the health care system. Participants expressed multiple, complex viewpoints surrounding the utilization of MOUD, specifically related to treatment, work environments, and health care settings. Results indicate that while many CPRS believe MOUD to be a successful treatment, stigma and institutional mistrust remain as barriers to both collaboration with medical providers and utilization of MOUD.