One thing you’ll find as a thread in almost every single story of addiction recovery is this: at some point, often after years of failure, a patient will meet someone who genuinely gets them. When that counselor talks, they are speaking to the patient’s soul. They know exactly what the patient is going through. And they can help make it stop.
Substance abuse recovery is a lonely journey, and not many people make it out alone.
That knowledge and expertise in treatment is common. Every addiction counselor gets the same training and meets the same standards. So the difference isn’t in what you know. It’s about where you’ve been.
It’s really difficult for substance use disorder counselors who have not been touched by addiction themselves to connect with their patients’ struggles from a place of true knowing. But it’s something that peer counselors automatically bring to the table.
What Is a Peer Support Specialist?
The peer support specialist role represents a unique way to build on the success of addiction recovery programs. The role was created to put people who achieved sobriety and who are most familiar with the treatment process and what it takes to succeed together with patients who are currently struggling.
If you’ve gone through crisis after crisis yourself and finally come through to the other side, you have a visceral sense of connection that no other kind of SUD counselor can match.
If you still feel the pull toward your drug of choice every day but fight and win against it, you understand the resolve that is needed to help patients beat addiction.
When you have had to go through the difficulty of learning how and when to access the support and resources needed to help, you understand the frustration that people feel coming at it for the first or fiftieth time.
The Most Famous Example of Peer Support in Addiction Therapy
Maybe one of the earliest and most successful examples of peer support in a formal program of addiction support and recovery comes from the program that almost everyone has heard of: Alcoholics Anonymous.
AA traces its routes back to the 1930s, when chance meetings between individuals struggling with alcohol abuse problems in a Christian group lead to forming a mutual support group that quickly spread across the country and around the world.
While the 12 steps are well-known and often credited for the success of the program in leading people to sobriety, the more effective contribution to the process may be in the idea of sponsorship: the practice of group members who have already progressed through the steps mentoring new members in their own journey.
Sponsors aren’t official, aren’t paid anything, and rarely have any kind of training. But the simple ability to pick up a phone in the middle of the night while staring at an unopened bottle has been an invaluable support for millions of recovered alcoholics.
With the added training and integration of peer support specialists into the larger world of addiction treatment, they can be even more effective and cover even more kinds of substance use disorders.
With formal approval from state health agencies to offer that knowledge and support to other patients, peer support specialists bring their hard-won knowledge and skill to the fight against substance use disorders.
Peer Support Specialist Jobs: What Does a Peer Support Specialists Do in Addiction Therapy Programs?
Just recovering from addiction and being helpful really isn’t a job description. Because these are licensed roles in almost every state, they come with a laundry list of expected skills and limits on the kind of counseling tasks they can perform.
While those can vary from state to state, the Substance Abuse and Mental Health Services Administration (SAMHSA) has nailed down a list of 12 core competencies that peer recovery counselors are expected to demonstrate:
- Engage peers in collaborative and caring relationships
- Provide support
- Share lived experiences of recovery
- Personalize peer support
- Support recovery planning
- Link to resources, services, and supports
- Provide information about skills related to health, wellness, and recovery
- Help peers manage crises
- Value communication
- Support collaboration and teamwork
- Promote leadership and advocacy
- Promote growth and development
The main role of the peer support specialist is to be a beacon of hope… and a shoulder to lean on.
One thing peer recovery workers don’t do—and know they cannot do—is to try to do the hard parts for their patients. More than anyone, they understand that empowerment is key to the process of recovery. The most critical part can be learning how to maintain necessary boundaries while still offering the utmost compassion.
The Daily Duties in a Peer Support Specialist Job Description Come Down To Doing What Is Necessary
When it gets down to the day-to-day activities you fulfill in peer support positions, it’s a lot harder to draw clean lines around job descriptions. What it almost always comes down to is that you do what is needed to keep your patients on track to recovery.
Peer support specialists work closely with other SUD counselors as part of a larger team of support. They know better than anyone that the broader the safety net, the more likely recovery will be.
Peer specialists are the people that offer the straightest talk about addiction and recovery. Because they’ve been where the patients are, there is nowhere to hide from them.
At the same time, they have almost unlimited compassion to draw on that is borne from that experience. They can talk patients through the thorny parts of grappling with self-stigma, discrimination, isolation, and despair. All the while, they are offering a living example of what patients need most to see: proof that recovering from addiction is possible.
What Is the Difference Between Peer Support Specialists and Substance Abuse Technicians?
Although peer recovery specialists may have similar training and pay rates as substance abuse technicians, they fill a different role in the recovery process. Technicians take care of a lot of the details of implementing therapy programs designed by counselors. They may have a better understanding of the technical aspects of counseling as well as the human services support system.
Peer counselors, on the other hand, focus on using their unique position and experience to forge connections with clients. They may act more as advocates for treatment services than as direct conduits for providing those services. However, both roles can make strong connections with patients and act to support them in any way possible through the recovery process.
Peer recovery specialists and substance abuse technicians will often work together. Each of their strengths and their respective backgrounds can reinforce one another. And both work very closely with patients, learning their individual needs and challenges in a way that more senior counselors may not. That makes their contributions to the overall process of recovery equally critical.
The kind of credibility that peer support specialists build with patients often makes them the first point of contact. So they are the ones to get out in front of any crisis that comes up during therapy. They may also serve as a liaison between senior SUD counselors and patients. Their observations can be key to developing treatment plans, while it can be the way they translate those plans into terms the patient can identify with that paves the way for success in how the plan is implemented.
Where Do Peer Support Specialists Work?
Peer counselors will find positions in most of the same kinds of organizations as other substance abuse counselors. Like other counselors, it’s usually the case that the kind of patients you see and the type of treatments you offer are basically dictated by the kind of organization you’re working for… whether that’s private inpatient rehab centers, or serving prison populations, or working for social services agencies that specialize in reaching unhoused individuals.
Peer support specialists have the same range of venues for practice as other substance use disorder counselor… from out-patient settings to working right in the patient’s current home in a residential treatment center.
The biggest difference is that your specialization and employment options are basically chosen for you before you even get started. The lived experience that you bring to the job will usually define where you are most effective in supporting the recovery process. It’s exactly the gritty details of your circumstances and the kind of substances you used that makes you the most useful in counseling others.
Peer Support Specialist Salary – How Much Does a Peer Support Specialist Make?
The Bureau of Labor Statistics (BLS) doesn’t track peer support specialist salaries in with other kind of SUD counseling job data. Instead, it counts peer support jobs in with other kinds of Health Education Specialists.
This muddies the waters quite a lot when trying to pin down salary levels. So does the fact that peer support specialists may be more likely to work part-time or have other careers that provide the majority of their income.
The baseline education standard for health education specialists is a bachelor’s degree, which also puts the overall median salary of $62,860 in that area above what the typical peer support counselor is likely to make.
As a best guess at the typical salary for these jobs, then, it may be more reasonable to look at the lower ten percent of the field, which brings in $39,630 annually.
Naturally, like any other kind of job, you can expect this to vary from state-to-state and city-to-city, based on common factors like cost of living and the relative supply and demand for counselors.
First-Hand Experience Combined with Training Is the Secret to the Success of Peer Support in Substance Use Treatment
The key insight behind peer recovery programs in SUD counseling is that while you can’t teach anyone what it is like to experience addiction, you can train people who have been addicted how to provide counseling. So the training is an important part of qualifying for the job.
Because the power of your experience is the most important factor for peer counselors, the position isn’t one that requires a formal college education in any state. But that doesn’t mean you can just parachute in and start dispensing wisdom to patients, either. Every state has a set number of educational hours covering specific SUD-counseling topics that you’ll have to complete to become licensed.
That usually means a certificate program of between 40 and 100 hours on subjects such as:
- Fundamentals of Behavioral Health
- Human Services System Overview
- Screening and Client Engagement Processes
- Problems of Substance Abuse and Addiction
- Relapse Prevention
- Ethics and Professional Behavior in Substance Abuse Counseling
Peer support is powerful, but it’s also dangerous… for the support specialists themselves. Addiction is something you live with forever, and relapses are always something you have to guard against. When your daily duties involve working with people who are actively engaged in substance use, you are treading dangerously close to that risk.
In many cases, you can get this training through private educational vendors, or sometimes through state-run trainings. But it’s also possible to cover the required coursework through various community college certificate programs.
Peer Support Specialist Certification: How to Become a Peer Support Specialist
Forty-seven states have certification or registration requirements for peer recovery specialists, making it the most common kind of license available in addiction therapy today. Not all of those credentials are focused entirely on substance abuse treatment, however; in many states, the same kind of certification will cover either mental health or addiction support services. In a world that is full of co-occuring disorders, that can be important.
Some states directly license peer support professionals, while others authorize an independent professional board to provide certification—the steps in either process are similar.
The educational requirements outlined above are just the first step in getting one of those licenses.
You also usually have to pass an examination. The most commonly accepted test is the IC&RC (International Certification and Reciprocity Consortium) Peer Recovery Exam. Some states have their own unique test, but they don’t stray too far from the script: a 75 question multiple-choice exam that must be completed within two hours. It covers questions in four different domains:
- Advocacy
- Ethical Responsibility
- Mentoring and Education
- Recovery and Wellness Support
It’s also common to require peer counselors to undergo anywhere from 200 to 500 hours of directed practice with patients. This is carefully overseen by experienced clinical counselors with guidance and feedback. Some 25 or more hours are going to involve direct and specific supervision from those senior counselors, helping you adapt your own experiences and knowledge to a key piece of the formal addiction therapy process.
Building on Your Peer Recovery Credentials With National Certification
While IC&RC has a peer recovery credential, it’s offered and administered through state-level boards. Although the national organization sets minimum requirements, there is no expectation that every state board has the same standards—so your qualification can vary by where you practice.
National professional certification is different. By setting a standard that holds across the country, you can demonstrate to patients and employers that you have met the highest qualifications in education, experience, and expertise.
The only credential that currently falls into that category is the NAADAC National Certified Peer Recovery Support Specialist (NCPRSS).
National certification through NAADAC requires:
- Having a high school diploma or GED
- Be a minimum of two years into recovery from a substance use or co-occuring disorder
- Have a minimum of 200 hours of paid or volunteer work in a peer support environment
- Have undergone at least 60 contact and training hours in peer recovery support, of which 48 must include training in documentation, crisis management, screening, service planning, and other counseling skills; at least 6 hours each must be in HIV/pathogen training and in ethics
- Attest support to the NAADAC Peer Recovery Support Specialist Code of Ethics
- Receive positive references from two sources, at least one professional
- Receive a passing score on the NCPRSS examination
In a field where lived experience is a critical currency, peer support specialists are rich in the coin of the realm. Putting together their own priceless individual stories of beating addiction with tried and true psychological therapy techniques is paying big dividends in treatment. And it’s an important way for peer counselors themselves to give back to the system of therapy and recovery that delivered them to sobriety.
It’s a hard job that takes study and commitment. But there are plenty of peer support specialists who not only take it on with passion, but also who eventually go back to school for the extra education needed to become full substance use disorder counselors.
That may be the ultimate success story for anyone who was once snared in the swamp of a substance use disorder.
2023 US Bureau of Labor Statistics salary and employment figures for Health Education Specialists reflect national data, not school-specific information. Conditions in your area may vary. Data accessed April 2024.