(89) Participant Perspectives of a Peer Recovery-Enhanced Jail MAT Program

Background & Introduction: The risk of fatal overdose among people released from carceral facilities is 10-40 times higher than the general population (Binswanger et al, 2013; Ranapurwala et al, 2022). Integrating peer recovery services into addiction treatment programs before and after release from carceral facilities is a promising model of care. Many peer support service interventions for people with criminal-legal system involvement show positive health and criminal-legal results in both qualitative and quantitative studies, including improved outcomes in linkage to community services, substance use, mental health, and recidivism (Treitler et al, 2025).

However, in a multistate study measuring peer support service prevalence by setting, only 1.1% of work activities occurred in jail or prison, underscoring the need to further study peer recovery services in jails and reentry settings (Hagaman et al, 2025). Our study aims to understand the impact of a new peer recovery service added to a jail’s substance treatment program.

Methods: Denver Sheriff Health Service’s medication for addiction treatment (MAT) program is operated by Denver Health, a large urban safety-net healthcare system in Denver, Colorado. Adults with alcohol or opioid use disorder are eligible. Services include case coordination, MAT with all FDA approved medications, and group and individual counseling. In October 2024, the option to receive peer recovery services became available to participants.

A trained research assistant conducted semi-structured interviews with 10 participants who reached 6 months since release from jail and received peer recovery services. Team-based reflexive thematic analysis was used to identify themes and concepts.

Results: The unifying concept that emerged was connection. Participants described being tethered to someone they could rely on and trust, which was a departure from histories of compulsive substance use and isolation. Central themes include (1) accountability, (2) hope, and (3) receiving support with resources and addressing social determinants of health. One participant stated that the peer recovery specialist made me feel “like I had something to step out to.”

Conclusion & Discussion: Participants of a jail-based MAT program that was recently enhanced with peer recovery services beginning before and continuing after release shared their appreciation for peer recovery services and described how it made a difference for them in their recovery journey. A peer recovery professional mitigates isolation, disconnection, and hopelessness experienced by people with substance use disorder with criminal-legal system involvement.

References: Binswanger IA, Blatchford PJ, Mueller SR, Stern MF. Mortality after prison release: opioid overdose and other causes of death, risk factors, and time trends from 1999 to 2009. Ann Intern Med. 2013;159(9):592-600. doi:10.7326/0003-4819-159-9-201311050-00005

Hagaman A, Warren HL, Miller R, Henderson C. Peer support service activity prevalence by setting: a nine-state survey of peer workers. Front Public Health. 2025;13:1533051. Published 2025 Mar 5. doi:10.3389/fpubh.2025.1533051

Ranapurwala SI, Figgatt MC, Remch M, et al. Opioid Overdose Deaths Among Formerly Incarcerated Persons and the General Population: North Carolina, 2000‒2018. Am J Public Health. 2022;112(2):300-303. doi:10.2105/AJPH.2021.306621

Treitler P, DiGioia-Laird V, Long B. Peer support services for individuals with health-related needs reentering the community after incarceration: a scoping review of program elements and outcomes. Health Justice. 2025;13(1):51. Published 2025 Aug 16. doi:10.1186/s40352-025-00358-0