Development and Testing of a Peer Recovery Support Services Intervention for Retention on Medications for Opioid Use Disorder

OBJECTIVES: This study investigated the acceptability and preliminary efficacy of a peer recovery support services (PRSS) intervention focused on enhancing retention on medication for opioid use disorder (MOUD) through a pilot RCT. METHODS: Individuals on MOUD who were newly living in a recovery residence or a long-term residential program (ie, ASAM level 3.1) were randomized to either MOUD-focused PRSS or usual care only for 24 weeks (168 d). Negative binomial and logistic regression analyses using data from 40 adults (n=20 in PRSS and n=20 in TAU) tested for group differences on the primary outcome of cumulative days of MOUD adherence and secondary outcomes of other MOUD retention metrics, opioid use and return to regular use, and intervention acceptability assessed with an investigator-created satisfaction survey. RESULTS: Results revealed no group differences on primary or secondary outcomes, with those in PRSS reporting M=126 days of MOUD adherence compared with M=127 days in TAU. Overall satisfaction levels averaged 6.71 out of a possible 7. CONCLUSIONS: The results of this study did not support our hypothesis that PRSS would enhance MOUD adherence; however, this is likely due to a ceiling effect. Participants from both groups had higher-than-expected MOUD adherence (∼75% of days). Participants who received the PRSS intervention rated it very highly, and notably, were not opposed to the integration of MOUD into PRSS. These results suggest that the PRSS intervention was acceptable and feasible, but that it should be further developed and tested for patients who face more barriers to MOUD retention.