Peer recovery coaches (PRCs) are increasingly playing a role in helping patients with substance use disorders engage with treatment. PRCs can support and motivate patients in meeting their self-defined recovery goals, engaging in addiction treatment, navigating the health care system, and overcoming barriers to recovery. This support increases patient engagement and is cost-effective. Little has been written about integrating PRCs in health care settings. In this column, the authors describe the implementation of a PRC program with 23 coaches serving 5,662 participants in diverse clinical settings. The authors discuss key facilitators and barriers and opportunities for further research.