ROSE: A peer-led intervention to support peer workers in overdose response settings in British Columbia

Background: Peer workers, i.e. people with lived/living experience of substance use, are at the forefront of harm reduction efforts in BC. Their work is stressful, with lasting mental health effects. With the increase in illicit drug overdose deaths during COVID-19, peer workers have been particularly instrumental in supporting people who use substances. Despite their important work, peer workers lack resources and mental health supports from their organizations. The Peer2Peer project aims to identify, implement and evaluate interventions for peer workers in overdose response settings.

Methods: Eight peer-led focus groups (n=31) were conducted and transcripts were thematically analyzed. An intervention model was designed and implemented at the pilot sites. Surveys were conducted both prior to implementation and one year after implementation (n=50) to evaluate the impact of the intervention.

Results: Three major support needs arose and led to an intervention model 'ROSE'; R- Recognition, O-Organizational support, S-Skill development, and E-for Everyone. Each component consists of multiple strategies that were implemented at the pilot sites. The evaluation results indicate that peer workers are feeling more recognized for their work, have more trusting relationships with their colleagues, and feel a greater sense of satisfaction from their work since the implementation of the ROSE Model.

Conclusion: The ROSE Model holds much promise in improving the working conditions for peer workers in overdose response settings and consists of many practical strategies which can be implemented by organizations across the world to support peer workers during the ongoing opioid crisis.