Coproduction in the Treatment of Substance Use Disorder and Its Relationship to Clinics' Service Output Patterns.

Health, social, and human service providers seek diverse ways to engage service users in the service production process. This approach to engagement with users is known as "coproduction." In addition to conventional user-provider coproduction (i.e., patient-centered care), providers attending to stigmatized and marginalized groups may hire staff who share life experiences with user groups. These providers are known as "user representatives," and their service provision is known as "peer coproduction." Using nationally representative data from substance use disorder treatment clinics in the United States, I investigate how clinics' use of patient-centered care and peer coproduction mechanisms is associated with organizational service availability and utilization patterns. Results demonstrate the potential and limitations of the two coproduction mechanisms in substance use disorder treatment. This study is a critical examination of working conditions and the impact of user-engagement mechanisms and calls for a more empowered work environment in human service organizations.