A Program of Peer-Delivered Services by and for Methadone Patients

BACKGROUND: Although methadone maintenance is the “gold standard” of opioid treatment, adherence is often limited by stigma, a highly structured clinic environment, myths about methadone treatment, distrust of the treatment system, and few opportunities for social support from other patients. In 2006 the National Alliance for Medication Assisted Recovery, a 24-year old national patient advocacy organization, used CSAT RCSP funding to create the MARS (Medication Assisted Recovery Services) program in response to these barriers. Recovery-oriented services (including a staffed drop-in space, educational and support groups and Peer Leaders recruited from the program) seek to increase knowledge about opioid dependence and methadone, decrease internalized stigma, and create opportunities for social support. All services are delivered by people (staff or Peer Leaders) who are current or former patients. MARS operates cooperatively with but autonomously from a cooperating Bronx methadone clinic. METHODS: in-depth interviews with program staff and 12 Peer Leaders, review of records, participant observation in groups and project activities identified key themes. RESULTS: Support groups designed by Peer Leaders mirrored common concerns (addiction, health, interpersonal relationships) of treatment. Peer Leaders brought strengths to group leadership: past experience in groups, the ability to create formats that accommodated literacy variations, and a desire to give and get support. They cited challenges including difficulty learning to work with others and rewards including having a place for productive activity and positive contacts with other patients. CONCLUSIONS: Peer-based services can make a unique and useful contribution to methadone treatment.