Evaluation of peer recovery services for substance use disorder in Minnesota: Impact of peer recovery initiation on SUD treatment and recovery.

Substance use disorder (SUD) remains one of the most persistent public health challenges across the nation and in Minnesota. One intervention to help people with SUD is peer recovery services (PRS). PRS is a form on non-clinical support where trained individuals who are more established in recovery come alongside people currently in the recovery journey and provide guidance in the treatment process, help in accessing resources, and offer an empathetic ear. In combination with other services in the continuum of care, PRS seeks to reduce harm from disordered use. In 2018, Minnesota made PRS for SUD a Medicaid reimbursable service. While prior literature demonstrates promising effects of PRS for SUD, especially in treatment retention and participant experience, most studies evaluated PRS in limited settings, rather than in a large-scale implementation. Our retrospective, matched-cohort study used administrative data to estimate the impact of initiating Medicaid-reimbursable PRS for SUD on treatment, overdose, and mortality. Our results align, in some dimensions, with prior literature evaluating smaller-scale programs with positive impacts on treatment completion. We also find, however, that PRS at scale did not produce other positive outcomes that past studies have documented, particularly around overdose and inpatient treatment. This suggests that PRS follows a common challenge of implementing promising ideas at scale.