Why peer overdose response workers deserve more

Five years into the public health emergency, the emotional and psychological burden carried by those responding to overdoses becomes heavier with each day.

Overdose responders with lived experience are especially susceptible to burnout, according to Michelle Olding, a community-based researcher at the BC Centre on Substance Use. She’s been interviewing peer response workers at overdose prevention sites in Vancouver to better understand their experiences. Her latest study, "And we just have to keep going": Task shifting and the production of burnout among overdose response workers with lived experience, explores the inequality experienced by peer workers compared to others in the same role.

“Working in a peer role is unique because the overlap of professional and personal lives brings other stressors,” Olding explains. “You can't really check out from your work at the end of the day, because issues that might arise in the workplace carry into your personal life.”

Laura Shaver, a peer advocacy navigator with BCCSU, agrees. “The role of a peer worker is probably one of the most energy-demanding jobs you can think of. Our lived experience is invaluable, and without us the programs can’t go on. Yet, the word ‘peer’ has become stigmatized and we’re not treated fairly.”

Peer overdose response workers shared with Olding that they felt constant stress as a result of economic insecurity, unpaid work, and constant pressure to keep their friends, family, and community alive during an overdose crisis.

Shaver agrees that quality of working conditions, compensation, and benefits that peer workers receive directly affects the success of overdose prevention sites. Turnover amongst peer workers would be reduced, and the quality of health and safety would be improved by accessing better healthcare, stable housing, food security, and other essential needs.

“If peers are compensated in the same way as ‘staff,’ then we wouldn’t worry about falling asleep at work because we had no where to go the night before. Or we could better navigate our work hours if we don’t have to go stand in food lines.”

These pressures are a result of failed systems, argues Olding. The criminalization and stigmatization of drug use results in a significantly reduced paycheck compared to those whose roles are not defined by their drug use. She stresses that these roles are often undervalued compared to similar other frontline jobs.

“Even in harm reduction spaces, research shows that peer workers may be treated with more suspicion because they're seen as a ‘drug-user,’” Olding elaborates. “This is where we see the stigma around drug use shape how we value and organize work.”

While many peer roles offer low barrier and flexible part-time and casual positions, they need to be better compensated with a living wage and work benefits. Removing the power dynamic in the overdose prevention site setting could lead to more lives being saved and quality of life improving overall across people who use drugs.

“People coming in to use the services respect the site and feel respected when they see themselves represented in these roles,” shares Shaver. “It makes them feel empowered that people like them design the programs and keep the place open.”

Olding is now investigating how roles and responsibilities within harm reduction services are evolving with the pandemic. She predicts that peer work will become more essential in bringing innovative services directly to people in order to reduce crowding in confined harm reduction spaces. The key to the success of these peer-led outreach initiatives, she says, is understanding what these trust-based relationships and interventions mean to someone’s life.

“Peer overdose response workers do more than stop overdoses.”


WATCH: "Inequity Faced by Peers/Experiential Workers in the Workplace" a short film by BCCDC's Peer2Peer Project

Michelle Olding is a Research Assistant at the BC Centre on Substance Use and a doctoral student in the Interdisciplinary Studies Graduate Program at the University of British Columbia. Read more of her research here.

Laura Shaver is a Peer Advocacy Navigator with BCCSU and member of the BC Association of People on Methadone (BCAPOM) and Vancouver Area Network of Drug Users (VANDU).

Photo: The front entrance to the Molson Overdose Prevention Site (MOPS) in Vancouver, BC. Credit: Jade Boyd.
Note: “Peer” is a widely-used term to refer to people who draw on their lived experiences of drug use to inform their work. The term is preferred by some, and seen as limiting by others. It is important to recognize that the way this term has been applied in these spaces can have problematic elements and that there are inequities within the workplace.