Date of Award

5-10-2026

Date Published

June 2026

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Sociology

Advisor(s)

Gretchen Purser

Keywords

CRPA;poverty;recovery peers;SUD;SUD treatment

Subject Categories

Social and Behavioral Sciences | Sociology

Abstract

This dissertation examines the remaking of the recovery industry via the rise of Certified Recovery Peer Advocates (CRPA), or recovery peers, and the conditions that enable and constrain their labor. Peer Based Support Services (PBSS) was professionally recognized in the substance use disorder (SUD) treatment field starting in the early twenty-first century through federal grants for the underinsured and the ability to submit services for Medicaid/Medicare insurance repayments. As a result, CRPAs are especially present in low-income communities, dispatched to serve people seeking recovery from SUD with a mandate to “have conversations about change.” Drawing from in-depth interviews, participant observation at a CRPA training, four months of participant observation at a community recovery drop-in center, and archival research, this study shows that recovery peers’ efforts to enact their essential functions are largely constrained by forces outside of their control. Using Pugh’s (2024) framework of connective labor, this study exemplifies how unrelenting poverty can preclude connection between providers and clients. I argue that the placement of CRPAs on the frontlines of impoverished people seeking recovery is an effort to pacify the crisis clients endure battling poverty and addiction, symbolizing society’s enduring indifference towards the poor and people struggling with SUD.

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Open Access

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