Abstract
INTRODUCTION: The USA is facing a substance use workforce crisis, due in part to a shortage of providers. Substance use peer workers (PWs) fill a critical gap in the care continuum and are a growing sector of the workforce. In their daily work of providing non-clinical services to highly vulnerable people who use drugs, PWs are repeatedly exposed to stress, trauma and loss, which can adversely affect their well-being and recovery. This review aims to synthesise available evidence on PWs' experiences working in the field, its impact on their recovery and their occupational support needs. METHODS AND ANALYSIS: We will conduct a qualitative systematic review using the PRISMA flow diagram to illustrate article identification and screening. We will search six databases (Academic Search Complete, APA PsycInfo, CINAHL, MEDLINE, SocINDEX, PubMed) for English-language peer-reviewed scientific literature published between January 1, 2000, and August 13, 2025. Eligible articles must primarily focus on PWs' perspectives and experiences related to working in the field and the impact of this work on their recovery. Article screening and data extraction will be conducted independently by two trained research assistants and supervised by a third researcher who will resolve any disagreements. We will use a thematic synthesis approach to synthesise findings of included articles and report synthesised findings in accordance with Enhancing Transparency in Reporting the Synthesis of Qualitative Findings guidelines. We will assess article quality using the CASP Qualitative Checklist and assess our confidence in individual review findings using the GRADE-CERQual approach. ETHICS AND DISSEMINATION: Ethics approval is not required, as the research only involves published work. Findings will be disseminated via peer-reviewed publication, conference presentations and online via social media. PROSPERO REGISTRATION NUMBER: CRD420251105491.