\u201cRunning myself ragged\u201d: stressors faced by peer workers in overdose response settings

Zahra Mamdani,Jennifer Conway-Brown,Jane A Buxton,Fred Cameron,Sophie Mckenzie,Amy Howell,Tracy Scott,Ryan Seguin,Peter Woodrow,Bernadette Pauly,Denice Edwards

doi:10.1186/s12954-020-00449-1

Zahra Mamdani, Jennifer Conway-Brown + Show 9 more

Open Access

https://doi.org/10.1186/s12954-020-00449-1

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Abstract

BackgroundPeer workers or “peers” (workers with past or present drug use experience) are at the forefront of overdose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD). Working in overdose response settings has benefits for peer workers but is also stressful, with lasting emotional and mental health effects. Yet, little is known about the stressors peer workers face and what interventions can be implemented to support them in their roles.MethodsThis project used a community-based sequential mixed-methods research design. Eight peer researcher-led focus groups (n = 31) were conducted between November 2018 and March 2019 to assess needs of peer workers. The transcripts were thematically coded and analysed using interpretative description. These results informed a survey, which was conducted (n = 50) in September 2019 to acquire quantitative data on peer workers’ perception of health, quality of life, working conditions and stressors. Frequency distributions were used to describe characteristics of participants. X2 distribution values with Yates correction were conducted to check for association between variables.ResultsFive themes emerged from the focus groups that point to stressors felt by peer workers: (1) financial insecurity; (2) lack of respect and recognition at work; (3) housing challenges; (4) inability to access and/or refer individuals to resources; and (5) constant exposure to death and trauma. Consistent with this, the factors that survey participants picked as one of their “top three stressors” included financial situation, work situation, and housing challenges.ConclusionPeer workers are faced with a diversity of stressors in their lives which often reflect societal stigmatization of drug use. Recognition of these systemic stressors is critical in designing interventions to ease the emotional, physical and financial burden faced by peer workers.

Highlights

IntroductionPeer workers or “peers” (workers with past or present drug use experience) are at the forefront of over‐ dose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD)
Peer workers or “peers” are at the forefront of over‐ dose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD)
Stressors and challenges faced by peer workers Several sub-themes of stressors and challenges in peer work were identified by focus group participants

Summary

Introduction

Peer workers or “peers” (workers with past or present drug use experience) are at the forefront of over‐ dose response initiatives, and their role is essential in creating safe spaces for people who use drugs (PWUD). Peer workers inform and lead nimble and effective overdose response and prevention services for people who use drugs (PWUD) [11,12,13,14] within overdose response settings.1 These include stand-alone supervised consumption sites and overdose prevention services (OPSs), as well as services in shelter and housing agencies. The advent of COVID-19 has led to reduced hours and closure of several OPSs [15, 16] This has further increased the importance of peer workers who are involved in a variety of roles, including peerwitnessing onsite, outreach services, mobile overdose response, delivery and collection of harm reduction supplies, advocacy, and referrals to services such as housing agencies [17]

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