Researchers working in global health are proposing peer-delivered health interventions as a solution to address massive gaps in substance use and mental health care access in the United States. Only one in five people with substance use challenges receive services, with even lower numbers for those seeking opioid use disorder treatment—a disparity that is further exacerbated in rural areas.
According to researchers Jessica Magidson and Emily Mendenhall, who have studied these issues globally, community members trained as peers can deliver patient-centered, evidence-based care while leveraging their own lived experiences. Magidson observed in South Africa how peers can be trained in approaches to support mental health and substance use challenges typically reserved for psychiatrists or psychologists in the U.S., and found in subsequent work in Washington, D.C., Baltimore, Detroit, and rural Maryland that patients often prefer care from peer providers. These interventions can weave in lived experiences to help patients feel supported and understood in healthcare settings that may feel unwelcoming.
The research team developed “Khanya,” a peer intervention tested in South Africa to support people with HIV and substance use challenges. The approach, developed through years of community feedback from patients and providers, improved participants’ ability to take HIV medications on time and in some cases reduced alcohol use. Patients described a preference for meeting with someone with shared experiences who has “walked in their shoes” to support recovery.
The same team is now applying the Khanya approach in Washington and Baltimore, testing how peer support can help patients starting new long-acting medications for HIV treatment. Early findings show it can help patients stay more engaged in opioid use disorder treatment. A parallel evaluation is underway in rural Maryland, where mobile treatment units operate outside of churches. This “task shifting” model, which trains less specialized health care workers to take on specific responsibilities within a care team under supervision, has been the backbone of scaling biomedical interventions such as HIV treatment globally.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.usatoday.com/story/life/health-wellness/2025/09/05/global-health-opioid-addiction-crisis/85864885007/