Peer Recovery Workers are Undervalued and Underpaid

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Peer recovery workers (PRWs) play a vital role in the mental health and substance use recovery landscape. They use their lived experiences of long-term recovery to form supportive, trusting relationships with individuals embarking on their recovery journeys. These workers provide an essential service, yet their compensation often falls short of what is needed to sustain a decent living. This blog will explore the critical work PRWs do, the challenges they face, and the significant findings of recent research on their wages.

The Role of Peer Recovery Workers

PRWs, often known as peer recovery coaches or peer recovery support specialists, are unique in the field of mental health and substance use recovery. Unlike traditional health professionals, PRWs share their personal recovery stories to build trust and empathy with their clients. This peer-to-peer relationship is foundational, offering a sense of mutual respect and understanding that can be deeply therapeutic.

The services provided by PRWs are diverse, including goal setting, mentoring, skill-building, advocacy, and resource sharing. These services are crucial in helping individuals navigate their recovery, promoting personal growth, self-direction, and overall wellness.

The Growing Workforce and Its Challenges

Approximately 30,000 PRWs are currently employed in the United States, with many working in community-based organizations. Despite their significant contributions, PRWs face numerous workplace challenges, including low wages, high stress, and emotional strain. A survey by the Foundation for Opioid Response Efforts (FORE) revealed that nearly a quarter of PRWs reported experiencing stress or burnout, attributed to high caseloads, long work hours, and emotional demands.

Dissecting the Wage Issue

Recent research sought to compare PRW wages to living wages across the United States. Utilizing data from a national job-posting platform and a living wage calculator, researchers found that PRW wages are significantly insufficient in many states. For single-worker households with children, the living wage exceeds PRW wages in every state.

The mean hourly wage for PRWs was found to be around $19.50, which is inadequate compared to the living wage required for basic needs like food, housing, healthcare, and transportation. This wage insufficiency impacts not only PRWs’ financial stability but also their job satisfaction and performance.

Implications for Public Health and Policy

The findings of this research have profound implications for public health and policy. Ensuring fair compensation for PRWs is not only a matter of justice but also essential for the sustainability and effectiveness of recovery services. Low wages contribute to high turnover rates and burnout, which can compromise the quality of care provided to individuals in recovery.

Recommendations for Change

To address these issues, several measures can be taken:

  1. Policy Reforms: Implementing new regulations and reimbursement policies to improve PRW wages.
  2. Organizational Accreditation: Encouraging or mandating accreditation by bodies like the Council on Accreditation of Peer Recovery Support Services (CAPRSS) to ensure quality and supportive work environments.
  3. National Social Policies: Advocating for policies that reduce the costs of childcare and housing, which would benefit all low-wage workers, including PRWs.

The Path Forward

The path forward involves a collective effort from public health researchers, practitioners, policymakers, and social activists. By advocating for fair wages and supportive work environments, we can honor the invaluable contributions of PRWs and enhance the effectiveness of recovery services.


Peer recovery workers are the unsung heroes of the mental health and substance use recovery fields. Their lived experiences and peer-to-peer relationships offer a unique and effective support system for individuals in recovery. However, to sustain their invaluable work, it is crucial to address the wage insufficiencies and workplace challenges they face. By doing so, we can ensure that PRWs continue to inspire hope and facilitate recovery for countless individuals.

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About the Author

Jonathan P. Scaccia, PhD is a clinical-community psychologist with a robust background in public health science and practice. He has led innovative evaluation and research initiatives targeting health equity, vaccine distribution, and organizational readiness. Dr. Scaccia has significantly contributed to major projects, including federal suicide prevention programs and vaccine equity strategies. He has provided expert consultation on public health improvement and evaluation for both national and international NGOs. His work, characterized by a commitment to accessible and impactful public health solutions, has been recognized with awards from the American Evaluation Association and the Society for Implementation Research Collaboration. Dr. Scaccia’s expertise in natural language processing, data analysis, and community-based research makes him a leading voice in advancing public health practices.

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