Emergency Department Peer Recovery Support Services for Individuals with Substance Use Disorders: A Systematic Review...

Area of Science:

• Public Health
• Addiction Medicine
• Emergency Medicine

Background:

• Individuals with substance use disorders (SUDs) frequently use emergency departments (EDs), presenting opportunities for addiction treatment linkage.
• Peer recovery support services (PRSS) leverage lived experience to support individuals with SUDs, potentially improving trust and engagement in ED settings.

Purpose of the Study:

• To systematically review comparative studies evaluating the effectiveness of ED-based PRSS for individuals with SUDs.

Main Methods:

• A systematic literature search was conducted through August 2025, retrieving 1,801 citations.
• Nine studies published between 2011 and 2025, involving 14,883 individuals, met inclusion criteria.
• Studies primarily focused on opioid use disorder, with outcomes including overdose, hospital readmission, mortality, and treatment linkage.

Main Results:

• The evidence for PRSS superiority over non-PRSS comparators in ED settings was mixed.
• Most included studies had a moderate global risk of bias.
• The review, limited to quantitative studies, did not capture the qualitative patient experience of peer support.

Conclusions:

• Current evidence on ED-based PRSS for SUDs is heterogeneous and limited by a lack of comparative studies and potential bias.
• While PRSS may enhance patient comfort and connection, clear statistical superiority is not yet demonstrated.
• Further research, including qualitative studies, is needed to fully understand the impact of PRSS in the ED setting.