A Pilot Randomized Controlled Trial Evaluating Peer Recovery Coaches for Addiction Recovery Among Indigenous Americans

Background: Peer recovery coaches (PRCs) have experienced addiction and are trained to help others in recovery. Indigenous American (IA) adult PRCs may fill gaps of culturally specific support in addiction.Aims: The aims were to: (1) evaluate the feasibility of implementing a PRC intervention compared to an attention control group recovering from a substance use disorder, (2) compare PRC and attention control groups on relapses and secondary outcomes, and (3) measure PRC strategies.Methods: In this feasibility trial, we recruited a total of 120 adult IAs with substance use disorders. Ninety participants were randomized to the PRC group which received support from a PRC and 30 to the attention control group which received support from a research nurse. Both groups received weekly support for 12 weeks. Participants completed surveys weekly during the 12-week intervention and then monthly for 3 months.Results: The two groups had similar quantities of alcohol consumed, days of alcohol use, and days of drug use except that the PRC group had fewer days of alcohol use in the first 3 weeks of the intervention phase (2.05 vs. 3.5 days, p = .04). "Support and advocacy" was the most common PRC intervention. PRCs were widely accepted by individuals who completed the program, receiving positive feedback from 79% of participants.Conclusion: This pilot demonstrated that racially concordant PRC services likely have high acceptability among IA populations. Future studies may draw on these findings by having trained IA coaches recruit and work with individuals in-person to assist with retention.