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

Attrition was high, and the authors could not determine why participants withdrew, so the results may be affected by attrition bias. The study changed from local in-person recruitment to national distance-only contact because of pandemic restrictions, which may have altered engagement and outcomes. Participants were allowed to receive counseling, medication management, substance treatment services, or any other care, so any difference cannot be attributed to peer recovery coaching alone. The intervention was a pilot feasibility trial with unequal allocation and many self-reported outcomes, so it cannot establish effectiveness. Peer recovery coaches used varying combinations of support, role modeling, facilitating change, and recovery plan strategies, and the study could not separate which strategies mattered. Participants who needed acute detoxification or were in inpatient or intensive outpatient programs were excluded, so findings may not apply to those needing more intensive care. Most outcome comparisons were not significant, and the early drinking-day difference did not persist through later intervention or follow-up.

The authors declared no potential conflicts of interest.

Do not conclude that peer recovery coaching prevents relapse in Indigenous adults. The trial found no significant differences in alcohol or drug use during the last three weekly surveys or follow-up, and participants could also receive counseling, medication management, substance treatment services, or any other care.