Augmenting substance use treatment in the drug court: A pilot randomized trial of peer recovery support

Peer recovery specialist (PRS) support has been used to varying degrees in community substance use and mental health treatment for a number of years. Although there has been some evidence of positive PRS impacts on client outcomes, previous research has shown inconsistent findings and methodological shortcomings. Given the high prevalence of substance use disorders among people involved in the criminal justice system, and limited available treatment opportunities, PRS support could provide a cost-effective opportunity to promote positive client outcomes. Drug courts, with their focus on treatment and rehabilitation rather than punishment, are an ideal laboratory to test the impacts of PRS on substance use recurrence and recidivism.

The present study is, to our knowledge, the first experimental test of the PRS model in a justice system setting. We implemented a pilot experiment in the Philadelphia Treatment Court, randomizing 76 drug court participants to be linked to a PRS or to services as usual, and analyzed client outcomes over a nine-month follow-up period. Most participants' drug of choice was marijuana.

The results showed a reduction in rearrests and improvement in drug court engagement, but no impact on substance use recurrence or treatment engagement.

The mixed findings suggest some promise for the PRS model in the drug court setting, but the need for further research with more diverse and higher-risk drug court populations.