Background: Peer recovery workers (PRWs) are individuals with lived experience of substance use who provide support to others in recovery. Roles, settings, and certifications of PRWs have expanded in health care, but little is known about the work experiences of this workforce. Aim: This review synthesizes U.S.-based research on the first-hand work experiences of PRWs. Methods: A systematized literature review was conducted using five databases. Articles were included if they centered on the work experiences of U.S.-based PRWs whose primary professional identity is grounded in lived experience. Nine peer-reviewed articles met the inclusion criteria and were analyzed using thematic synthesis. Results: PRWs described their work as deeply meaningful but marked by role ambiguity, low pay, and systemic misunderstanding. Themes included role identity and responsibility, stress and burnout, support needs, and boundary challenges. While many PRWs reported job satisfaction and a sense of purpose, they also expressed frustration with unclear expectations, inadequate compensation, and limited organizational support. Peer support was found to be both a source of resilience and a potential stressor when boundaries were not respected. Conclusions: PRWs play a vital role in recovery-oriented systems of care yet face structural barriers that threaten workforce sustainability. Clearer role definitions, equitable compensation, and recovery-informed workplace policies are needed to support and retain PRWs. Future research should explore policy and organizational strategies that align with the values of peer-led recovery.
Woody et al. (2026) studied this question.