Enhancing care in alcohol-associated liver disease through peer support for alcohol use disorder

Abstract

Alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) are interconnected conditions that contribute significantly to global morbidity and mortality. Despite advances in medical management, care for individuals with AUD and ALD remains suboptimal due to persistent gaps in psychosocial support, stigma, and limited integration between behavioral health care including AUD treatment services and hepatology. Peer support, emotional, informational, and practical assistance provided by individuals with lived experience, has emerged as a promising, though underutilized, strategy to address these challenges. This review examines the evolving role of peer and patient support programs, including community-based groups such as Alcoholics Anonymous and SMART Recovery, structured interventions for transplant candidates, and the integration of peer navigators within medical settings. Evidence suggests that peer support fosters recovery by enhancing engagement, reducing isolation, and promoting self-efficacy. Technological innovations, including virtual platforms and mobile apps, are extending the reach of peer support, particularly in rural or underserved populations. In addition, culturally tailored and demographically specific models are increasingly being adopted to address the diverse needs of patients. However, several challenges persist, including variability in peer training, inconsistent oversight, and limited research specific to ALD populations. To maximize the impact of peer support, future efforts must focus on integrating these programs into clinical care, ensuring sustainable funding, and evaluating outcomes using standardized metrics. Peer support represents a critical opportunity to enhance the recovery experience for individuals with AUD and ALD by addressing the emotional and social dimensions of care often overlooked in traditional medical settings.