What Is Peer Support in Recovery? 5 Lessons From a Recovery Coach

Many people in recovery have never heard of peer support, and Wes Arnett hadn't either. He spent about five years trying to get sober before he finally got there six years ago, and he had no idea a peer support specialist or recovery coach was an option for him.

Today, Wes is the Director of Recovery Support Services and Partnerships at Recovery.com. He's a Wisconsin state certified peer support specialist, a certified parent peer support specialist, and a CCAR recovery coach professional and facilitator. He identifies as being in recovery from substance use disorder and mental health challenges, and this past January he celebrated six years of continuous sobriety.

In a recent Recovery.com continuing education session hosted by Caroline Beidler, Wes described what peer support is, what it isn't, what the research says, and how clinicians can work with peer supporters. Here are the five biggest questions the session answered.

1. What Is Peer Support in Addiction and Mental Health Recovery?

Peer supporters help others in recovery, or desiring it, by offering their ongoing support as people in recovery. Wes described that shared experience, often called "peerness," as the thing that makes peer support work. It promotes connection and inspires hope.

Peer support workers provide nonclinical, strength-based support. They're "experientially credentialed" by their own recovery. By sharing their story when it's appropriate and offering practical, real-world guidance, they help people set their own recovery goals and take concrete steps toward a life they choose.

You'll hear a lot of titles for this role: peer support specialist, peer specialist, peer recovery coach, peer advocate, and peer recovery support specialist.

It really offers a level of acceptance and understanding and validation that's not found in the other professional relationships that someone in recovery might be having.

Wes Arnett, RCPFCategory Manager of Recovery Coaching at Recovery.com

What's the Difference Between a Recovery Coach and a Peer Support Specialist?

The two roles are very similar, but Wes pointed to two differences:

• Lived experience. Every peer support worker has lived experience with substance use disorder or mental health challenges. Most recovery coaches do too, but not all. Some are advocates or family members of someone who has struggled.
• Credentialing. Most states offer state certification for peer support. Recovery coaches typically can't get state credentialing.

What Peer Support Specialists Are Not

Peer supporters aren't counselors, sponsors, or therapists. As Wes put it, they don't want to be. Their job is to complement those roles as part of a care team and stay within their own scope of practice.

One key difference from a sponsor: a sponsor usually supports a single pathway, like the 12 steps. Peer support specialists are trained on multiple pathways of recovery, including 12-step groups, SMART Recovery, faith-based programs, and medication for opioid use disorder (MOUD).

2. What Does a Peer Support Specialist Actually Do?

Wes summed up the role with a few sayings. The first is "we do with, not for." If someone needs to call a detox program or schedule a primary care appointment, a peer supporter won't make the call for them. They'll sit next to them while they make it. The same goes for finding support group meetings.

The second is "we walk alongside, not in front." Wes described a good peer relationship as a dance, not a wrestling match.

I want to walk with and support, but I can't want recovery more than they do.

Wes Arnett, RCPFCategory Manager of Recovery Coaching at Recovery.com

Peer supporters also advocate for what the person wants and needs, provide self-care education, and connect people to community resources. Wes noted that while everyone on a care team knows some local resources, peer workers usually know them in much more depth.

What Does "Meeting People Where They're At" Mean?

You hear this phrase a lot in recovery. For Wes, it means accepting someone's current situation, emotional state, and readiness for change, without imposing his own expectations or judgment. That can mean accepting that a person isn't ready, or isn't able, to stop using right now.

Where Does Peer Support Happen?

Peer support shows up in recovery community organizations, sober living homes, drug and OWI courts, child welfare agencies, shelters, primary care, behavioral health, and MOUD clinics. Hospital emergency departments are using it more, too. At his previous job with Safe Communities in Madison, Wisconsin, Wes's team was on call 24/7 to meet people in the ER after an overdose.

But most one-on-one work happened in everyday places, like coffee shops, nature walks, fast food restaurants, a pickleball court, the mall, someone's basement, plus texts and phone calls. Those settings aren't available to most other professionals, and Wes said a lot gets accomplished there.

3. What Does a Peer Support Relationship Look Like?

To show how this works, Wes shared the story of a man he called Enrique (not his real name). When they met about three years ago, Enrique was 40 and had been drinking 18 to 24 beers a night, every night, for more than eight years. He also had severe anxiety and agoraphobia. He hadn't left his parents' house in over eight years and lived in their windowless basement.

Enrique found Safe Communities through a Google search and called on his own. It took months just to build trust. Wes met him weekly, usually for about two hours.

Enrique didn't want detox or residential treatment. He wanted to try moderating his drinking. Wes didn't argue.

In my own head, might I feel like, oh my God, like with Enrique, I was like, what are you talking about moderating, man? This ain't gonna work. But I can't, I'm not going to tell that to him. That's not my job.

Wes Arnett, RCPFCategory Manager of Recovery Coaching at Recovery.com

Over the next six months, they reconnected Enrique with a therapist he hadn't seen in five years and found virtual AA and SMART Recovery meetings. Through trial and error, Enrique decided moderation wasn't working and chose to try abstinence. He added an AODA (alcohol and other drug abuse) counselor and asked Wes to join his appointments. The counselor was surprised at first, then invited Wes back once a month for about a year.

With input from Enrique's therapist, Wes helped with exposure work, like walking to the end of the driveway, then the corner, then around the block, then three blocks to Wendy's, and eventually to a nature preserve and the mall.

Wes was clear that peer support alone didn't get Enrique there. A therapist, an AODA counselor, a primary care physician, and a peer supporter worked as a team.

4. Does Peer Support Improve Recovery Outcomes?

Wes said both quantitative and qualitative evidence show peer support lowers the overall cost of mental health services by reducing rehospitalizations and inpatient days while increasing outpatient care. It's also linked to better quality of life, more engagement with services, and better self-management. He noted that more research is still needed.

Highlights he shared:

• 2022 Journal of Osteopathic Medicine study. This study tested a peer recovery coaching model for high-risk men entering residential treatment. The researchers noted that racially minoritized communities are disproportionately affected by substance use disorders and that traditional inpatient programs have had inconsistent results there. Men paired with a recovery coach had higher abstinence rates, more housing stability, and lower depression and anxiety scores.¹
• Massachusetts General Hospital. In a study of nearly 1,200 patients, hospitalizations dropped and outpatient visits rose in the six months after patients first met with a recovery coach. Patients taking buprenorphine were also more likely to stay engaged in treatment and abstain from opioids in months when they had contact with a coach.²
• Peer Bridger model. This program pairs people leaving inpatient psychiatric care with a peer supporter. Data from New York and Wisconsin showed fewer inpatient stays, fewer inpatient days, and more outpatient visits.³
• Cost savings. Recovery Innovations in Arizona saw a 56% drop in hospital readmissions. Pierce County, Washington, calculated almost $2 million in savings from fewer involuntary hospitalizations. Tennessee saw a 90% decrease in acute inpatient days, and Wisconsin saw a 71% decrease.³

Wes stressed the financial numbers because they're what governments and insurers pay attention to when deciding what to cover.

How Many People Use Peer Support?

According to National Survey on Drug Use and Health (NSDUH) data Wes presented, less than 1% of people with a diagnosed substance use disorder received peer support from 2022 to 2024.

The 2025 data showed an increase of more than 300%. Wes believes the jump reflects growing awareness, but he sees the low numbers as a big opportunity.

Imagine if we were able to move that needle to 5% or 10%. And that really, like, that gives me hope.

Wes Arnett, RCPFCategory Manager of Recovery Coaching at Recovery.com

Is Peer Support Covered by Medicaid?

Increasingly, yes. As of 2024, 48 states and the District of Columbia reimbursed for peer support through Medicaid in some form, and 41 states covered both mental health and substance use disorder peer support. Vermont and South Dakota were the only states that didn't reimburse for either.⁴ Wes noted that Vermont is expected to add coverage in 2026.

Certification has expanded too. Forty-eight states and DC certify both mental health and substance use disorder peer support. Hawaii certifies mental health peer support only, and South Dakota doesn't offer certification for either.⁴

5. How Can Clinicians Integrate Peer Support Into Their Practice?

Wes's first piece of advice was simple: know that peer support exists, that it's effective, and that it's an option you can offer. Many clients have never heard of it.

His second was to be open to collaboration. When Enrique's AODA counselor invited Wes into sessions, it became a strong working relationship that helped Enrique more than either could alone.

The Bottom Line

Peer support works because it's built on shared experience, not clinical authority. Peer supporters do things with people, not for them, and they let each person define what recovery means for them.

The research points to fewer hospital stays, more outpatient engagement, and lower costs, and Medicaid coverage and state certification now reach nearly every state.

Yet very few people with a substance use disorder use peer support, mostly because they don't know it exists. For behavioral health professionals, the takeaway is to know peer support is an option, offer it, and treat peer supporters as part of the care team.

Wes also pointed to two free resources:

• Recovery coaching search. Recovery.com lists over 600 organizations across the U.S. that provide peer support or recovery coaching. Search by location here.
• Meeting finder. Wes built a centralized meeting finder here with about 150,000 in-person and virtual meetings across all 50 states. It covers 15 support groups, including AA, NA, SMART Recovery, Recovery Dharma, White Bison, Celebrate Recovery, CoDA, and Overeaters Anonymous, and you can filter by group, day, and time.

And for referring professionals, create an account on Recovery.com/Pro to start making custom referral lists and sending them to patients with one click.