Recovery Capital Research Articles

Barriers and facilitators to recovery among college students without access to a collegiate recovery program

Background Undergraduate students pursuing substance use recovery face multiple barriers, including widespread substance use on campus, stigma, and limited support. A small number of campuses have collegiate recovery programs to support students. Most students in recovery lack access to such programming, and little research has explored their experiences. Methods This study, framed by the recovery capital perspective, utilized thematic analysis to illuminate students’ experiences in recovery without a collegiate recovery program on a Midwestern US campus. Seventeen students participated in semi-structured interviews. We sought to understand the barriers to recovery these students faced and how students overcame them. Results Barriers exemplified limited or negative recovery capital. Students described substance use and mental health challenges, being overwhelmed with responsibilities, feeling isolated, and negative twelve-step group experiences. Students gained personal recovery capital by mobilizing personal strengths, coping, and self-care strategies. To build family/social capital, they engaged various supports (e.g. mutual aid or activist groups). Community capital was limited to campus counseling services or supportive professors. Notably, not all students chose abstinence. Conclusion This study augments the literature about how students in recovery overcome barriers without a collegiate recovery program. Universities should offer services to accommodate the range of recovery preferences and experiences.

중독회복자의 심리적 고통과 삶의 질 관계에서 회복자본의 매개효과

The aim of this study was to explore the level of quality of life among individuals in addiction recovery and to examine whether psychological distress affects the quality of life and recovery capital has a mediating effect on this relationship. To do this, original data from the ‘Stigma Perceived by Individuals with Addiction Study’ conducted by the Korea Addicts Right Center in 2023 were used. Recovering individuals who used community addiction organizations and facilities for alcohol, drug, and gambling problems participated in a self-report survey both online and offline. Using SPSS PROCESS macro, mediation analysis was conducted with a sample of 226 recovering addicts. First, the level of quality of life among recovering individuals was found to be low. Second, psychological distress had a direct effect on the quality of life among recovering individuals. Third, recovery capital had a mediating effect on the relationship between psychological distress and quality of life. Based on these findings, suggestions were made to alleviate psychological distress and enhance recovery capital to improve the quality of life for individual in addiction recovery.

Changes in Recovery Capital Among Patients Receiving Buprenorphine Treatment for Opioid Use Disorder in a Telehealth Setting.

Medications for the treatment of opioid use disorder (MOUD) such as buprenorphine are the most effective treatment available for OUD; yet, beyond drug testing results and retention in care, systematically measured clinical outcomes have proven elusive. There is growing interest in integrating systematic monitoring of patient-reported outcomes and measurement-based care as strategies to improve patients' success in treatment. We analyzed changes in recovery capital assessed via the Brief Assessment of Recovery Capital (BARC-10) from baseline to 30-120 days post-intake among patients initiating buprenorphine treatment from May to October 2023 at Ophelia, a telehealth MOUD provider, who were retained for ≥90 days. Differences in baseline characteristics were assessed between patients with and without high "remission-predictive" baseline scores (≥47) using chi-squared and t-tests. Changes in scores from baseline to follow-up were assessed using paired t-tests. In all, 791 patients initiated treatment during the study period, 742 (93.8%) of whom had a baseline BARC-10 score, 542 (73.0%) of whom were retained in treatment for ≥90 days, and 477 of whom (88.0%) had a follow-up BARC-10 score and represent the analysis sample. Older patients, those not requiring buprenorphine induction, and those not using heroin or fentanyl at intake were more likely to have remission-predictive baseline BARC-10 scores (P < .05). Patients with remission-predictive baseline scores (n = 257) had a mean increase of 1.4 (SD = 5.9) from 52.7 (SD = 4.1) (P < .001), and 234 (91%) sustained remission-predictive scores throughout the assessment period. Patients without remission-predictive baseline scores (n = 220) had a mean increase of 9.2 (SD = 8.2) from 38.4 (SD = 6.6) (P < .001), and 129 (59.0%) achieved a remission-predictive score at follow-up. Most patients had increased or sustained already high levels of recovery capital, an established predictor of sustained remission. Further research is required to better understand variability across patients and how it may relate to long-term outcomes.

A randomized controlled trial of a virtual community-based mental health and substance use program in the Philippines

Purpose This study aims to evaluate the delivery of a virtual community-based mental health and substance use program for Filipino drug users during the COVID-19 pandemic. Design/methodology/approach It used a randomized control longitudinal design with data collected prior to the program and every two months for 10 months. The programs focused on building recovery skills, life skills and family modules. Program length ranged from a brief intervention of three sessions to 24 sessions depending on whether clients were low risk, moderate risk or those arrested for drug use. Findings Results revealed significant improvements in recovery skills of participants in the treatment group compared to those in the control group. Mental health illness symptoms decreased for both control and treatment groups; however, no differences were found in recovery capital and cravings. Research limitations/implications The lack of significant changes in certain variables, such as recovery capital, requires more data to understand the barriers to enable greater recovery. The study was limited to virtual delivery of rehabilitation services conducted during the COVID-19 pandemic. Future studies may wish to compare modalities of online and onsite delivery to enable a comparison of effectiveness. Practical implications Results suggest the feasibility of virtual delivery of mental health and substance use treatment implemented by trained paraprofessionals. However, it also highlights the necessity to build the capacity of service providers and address connectivity challenges. Social implications Stigma and discrimination prevent people who use drugs from seeking treatment. Virtual delivery of mental health and substance use treatment can provide a platform where people can seek help while maintaining some privacy. Originality/value The study provides evidence from under-represented populations – persons who use drugs in the Philippines.

The Role of Addiction Treatment in Building Recovery Capital: Findings From 2022 Life in Recovery Survey in Flanders, Belgium

Introduction: This paper examines life experiences before and during addiction recovery in a large sample of treated and untreated persons in Flanders (Belgium). Methods: A total of 343 participants in recovery from alcohol and/or illicit drug problems (≥3 months) completed the 2022 ‘Life in Recovery’ survey online. Participants were categorized into four groups based on their engagement with treatment services: (1) unassisted recovery, (2) mutual aid support only, (3) formal treatment only, and (4) formal treatment and mutual aid support. The questionnaire was supplemented with open-ended questions about facilitators and barriers to recovery. Findings: Group comparisons revealed significant differences in the severity of dependence and living conditions (recovery strengths and barriers, SABRS) during addiction between those in recovery without treatment and the treatment groups. However, similarities in strengths, barriers, and quality of life during recovery were observed across all groups. Differences in barriers during recovery were attributed to variations in initial conditions rather than treatment engagement. The complementary qualitative analysis revealed that the four clusters experienced similar factors as facilitating and hindering recovery. Discussion: These findings suggest that while various pathways can lead to recovery, those involving formal treatment and mutual aid support may be particularly valuable for individuals facing greater initial barriers and fewer strengths during addiction, highlighting treatment as an important but not universally necessary source of recovery capital.

Recovery capital profiles among a heterogeneous sample of individuals in recovery from alcohol problems.

Recovery capital (RC) is a framework for conceptualizing the resources individuals use to support alcohol and other drug recovery across social, physical, human, and cultural domains. The goal of this study was to identify subgroups of individuals in recovery with distinct combinations of RC across domains and characteristics of individuals with unique RC patterns. Latent profile analyses investigated patterns in both within-domain amount and variability of RC across each of the four domains using the Multidimensional Inventory of Recovery Capital, a theoretically and psychometrically sound RC measure. The sample included U.S. participants closely reflecting 2020 Census demographics (n = 482, 49% female, 38% racial/ethnic minority, Mage = 42.57) identifying as having resolved a prior problem with alcohol (alone or with other drugs). Latent profile analyses distinguished four RC profiles: Low/Inconsistent (23%), Moderate/Consistent (43%), Moderate/Inconsistent (12%), and High/Consistent (22%). Females and individuals who were unemployed, nonabstinent, and had greater alcohol problem severity were more likely to belong to the Low/Inconsistent profile. Individuals in unassisted recovery were more likely to belong to the Moderate/Inconsistent profile. Older age and more time in recovery were associated with High/Consistent profile membership. Race/ethnicity was not associated with profile membership. These person-oriented analyses elucidate complex patterns of resources that individuals utilize during recovery and individual characteristics underpinning differences across RC patterns. The empirically derived subgroups in this heterogeneous sample highlight multiple combinations of resources that individuals leverage to achieve recovery and indicate characteristics of individuals who may need greater amounts and/or consistency of RC to continue sustaining recovery. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Moving Beyond Referrals: Addressing Multilevel Barriers to Substance Use Treatment Engagement Through Police-Led Recovery Management Check-Ups.

The opioid epidemic in the United States (US) has prompted innovative responses from law enforcement agencies including specialized units to refer overdose survivors to substance use treatment following an overdose. However, traditional law enforcement outreach does not address the multilevel barriers to treatment engagement that lead to repeat overdose-related calls for service. The current evaluation explored the process components and outcomes of a Comprehensive Opioid Abuse Program (COAP) initiative within a local law enforcement agency in the Southeast US. COAP funding supported a police-led recovery management team (RMT) to connect overdose survivors to substance use treatment. The RMT also utilized recovery management check-ups (RMCs) to provide sustained support to enhance substance use treatment engagement beyond the initial treatment referral. A mixed-methods approach was employed to examine participant demographic, substance use, mental health, treatment, and criminal justice characteristics (N = 65) and explore perceptions of programmatic strengths and potential areas for improvement (N = 15). The quantitative and qualitative analyses were informed by the Recovery Capital Model. Quantitative analysis revealed that the RMT connected many participants with various support services, notably including housing assistance and health insurance. Qualitative findings highlight program effectiveness in improving social, community, and personal recovery capital. These findings contribute to expanding research on police-led post-overdose initiatives and suggest that police-led RMCs can address multilevel barriers to treatment engagement and minimize law enforcement stigma.

Predictors of Recovery Capital in Alcoholics Anonymous Members

ABSTRACT Alcoholics Anonymous (AA) is a mutual aid program where social processes help individuals maintain recovery. This study aimed to gain insight into attachment characteristics that support the social processes in AA. AA member participants (N = 113), from a publicly available data set, were examined to identify predictors of increased recovery capital (RC), utilizing the independent variables of attachment anxiety, attachment avoidance, and self-esteem. Results from a multiple linear regression revealed a positive, strong, significant relationship between RC and self-esteem; a negative, moderate, significant relationship between RC and attachment avoidance; and no significant relationship between RC and attachment anxiety.

The day-level effects of recovery community center attendance on indicators of recovery wellbeing and risk

BackgroundRecovery community centers (RCCs) are a relatively new resource in the recovery support landscape aimed at building their members' recovery capital. In recent years, interest in the value of RCCs has grown, however, no studies have used within-person methods to consider how RCCs may impact the day-to-day lives of their attendees. Using within-person data drawn from members of RCCs, this study examined how visiting RCCs was associated with several same-day indicators of recovery wellbeing and risk: daily sense of meaningfulness, recovery identity, negative affect, and positive affect. MethodsParticipants were 94 visitors of six RCCs in western Pennsylvania. Daily diary methods collected 10 nightly reports of daily RCC attendance and end-of-day meaningfulness, recovery identity, negative affect, and positive affect. Multilevel modeling accounted for nesting in the intensive longitudinal data. In independent models, the study regressed meaningfulness, recovery identity, negative affect, and positive affect onto day- and person-level RCC attendance. ResultsWithin-person associations between RCC attendance and meaningfulness (b = 6.96, SE = 1.66, p < .001), recovery identity (b = 4.75, SE = 1.08, p < .001), and PA (b = 3.82, SE = 1.45, p < .01) were significant, although NA was not (b = −2.41, SE = 1.34, n.s.). All day- by person-level RCC attendance interactions (in preliminary models) and between-person associations were non-significant across recovery outcomes. ConclusionsThe results indicated that on days participants visited RCCs, they reported significantly higher levels of meaningfulness, recovery identity, and positive affect, although negative affect levels did not significantly differ. Also, those who attended RCCs more frequently did not generally report different levels of recovery wellbeing and risk. Taken together, results suggest visiting RCCs works on a daily basis to support interpersonal processes related to positive recovery outcomes. That RCC visits do not appear to reduce negative affect suggests that additional programs may be needed to address negative affect. The within-person design provided insight into the dynamic processes that contribute to the intrapersonal states that support recovery and a practical approach to examining whether and how RCCs might support recovery. By using individuals as their own controls, the study design provided strong counterfactual inference.

Recovery Capital and Community Integration Among a Sample of Formerly Incarcerated Adults: A Pilot Study

This study investigated the impact of recovery capital (RC) on community integration (CI) among a sample of adults formerly incarcerated. A sample of 78 participants who identified as being in recovery from substance use disorder and having been previously incarcerated completed a survey asking about their RC and CI. Results of a hierarchical regression model investigating the relationship between RC and CI revealed a significant model, accounting for 27% of the variance in CI. Results provide support for considering aspects of RC, particularly social support, when facilitating reentry and reintegration for individuals who have experienced incarceration. Results also reveal that people who identified as multiracial reported significantly lower levels of CI.

Exploring cultural dynamics of Black Asian Minority Ethnic (BAME) women in addiction recovery: a comparison of three women from different ethnic backgrounds

Background The existing recovery capital (RC) literature primarily focuses on white males. This study aims to fill this gap by exploring addiction recovery among three culturally diverse UK women, utilizing CHIME-D (Connectedness, Hope/Optimism, Identity, Meaning, Empowerment, and Difficulties) and RC frameworks. It seeks to compare their recovery paths, combining quantitative data with lived experiences, and barriers specific to women in recovery. Methods The article will deploy a case study design involving a mixed methods approach to explore recovery pathways and resulting RC, based on in-depth interviews and recovery capital assessments with three women from white, black and Asian ethnic backgrounds. Results While one of the three participants, reports very strong and positive RC on the REC-CAP, the other two are at a much earlier stage in their journey. In contrast to the white female participant, who lacks personal RC and has significant barriers around ongoing substance use, the Black and Asian Minority Ethnic (BAME) participants report cultural challenges and difficulties engaging with mainstream services. Conclusion Recovery is a personal and individualized journey, but one that is predicated on social support, belonging and access to cultural and community resources. For BAME participants, accessing and engaging with appropriate peer support is essential in building RC and fulfilling the requirements of CHIME.

Stress Exposure and PTSD in a Cross-Sectional Residential Substance Use Treatment Sample.

Aim 1 of this cross-sectional, observational study with people in residential treatment for substance use disorders (SUDs) was to document stress exposure. Aim 2 was to assess potential sociodemographic and health differences based on probable posttraumatic stress disorder (PTSD) status. Aim 3 was to assess relative contributions of Diagnostic and Statistical Manual (DSM)-congruent versus DSM-incongruent stressors (Criterion A vs non-Criterion A) to mental and physical health. We hypothesized that both types of stressors would significantly contribute to impairment across indicators and that DSM-congruent stressor exposure would be more strongly associated with impairment than DSM-incongruent exposure. We assessed exposure to DSM-congruent traumatic stressors and DSM-incongruent life stressors, PTSD and depressive symptoms, emotion regulation difficulties, substance use recovery capital, and physical/mental health-related quality of life among 136 people in residential SUD treatment who were 64% men, 36% women; 49% white, 41% Black, 11% multiracial/another race; 18% lesbian, gay, or bisexual (LGB+); mean age = 39.82 (standard deviation = 12.24) years. Participants reported experiencing a mean of 9.76 (SD = 6.11) DSM-congruent events. Those with probable PTSD were younger and more likely to be LGB+ than those without probable PTSD (P < .05). Experiencing higher numbers of DSM-congruent events was associated with more severe PTSD and depressive symptoms, emotion regulation difficulties, and lower physical health-related quality of life (P < .05). DSM-incongruent stressor exposure was not independently associated with any indicators. Recovery capital was not associated with either type of stress exposure. Stressful event exposure among people in residential SUD treatment is very high. Those who are younger or LGB+ in residential SUD treatment may be at greater risk of developing PTSD. DSM-congruent stressors are more consistently associated with mental health indicators than are DSM-incongruent stressors. Prioritizing treatment targets and identifying implementable treatment strategies can be challenging with this complex population.

The Relationship Between Problem Gambling, Adult Attachment, Difficulty in Emotion Regulation, and Recovery Capital: A Study of Lottery Gamblers in Chinese Mainland

The Relationship Between Problem Gambling, Adult Attachment, Difficulty in Emotion Regulation, and Recovery Capital: A Study of Lottery Gamblers in Chinese Mainland

Lift Yourself Up: The Short-Term Associations Between Strength Training and Mood States and the Longer Term Development of Physical Capital and "Grit" Among People Recovering From Substance Use Disorders.

Mind Body Connect is a charity that delivers community-based physical exercise (PE) classes to people in recovery from substance use disorders. This study aimed to identify the contribution that strength training played in the development of positive short- and long-term psychological attributes for people recovering from substance use disorders by assessing (a) the short-term associations between participation in group exercise classes (N = 43, t = 2,940) and (b) the prospective long-term association between strength development and individuals' self-assessed level of "grit" among participants for whom strength training became a habitual activity (N = 13, median 8 weeks supported training). Participants completed demographic, Profile of Mood States-Adapted Short Form, and Short Grit Scale questionnaires before and after each strength training session over a period of 45 noncompulsory training sessions between February 2020 and March 2021. Weekly training logs recording the weight lifted were normalized into a measure of physical capital development. Short-term associations were tested using multilevel regression models predicting change in mean Grit score with interactions for gender; long-term associations were assessed through the use of latent growth models. We found that training sessions were associated with weak to moderate reductions ( = -0.112 to -0.533) in many negative mood states but elevated fatigue ( = 1.071, = 0.397). Latent growth in recorded strength was strongly associated with latent growth in self-assessed grit ( = 0.674). The findings suggest that PE classes and supported long-term strength training may assist with the development of recovery capital.

Her village: experiences of drug-involved women in a female-only aftercare program in the Philippines

PurposeWomen are exposed to vulnerabilities that can lead to drug use or hinder recovery. However, there is a dearth of studies on recovery programs for women. This study aims to add to the literature by examining the feasibility of a women-only aftercare program for recovering users in the Philippines.Design/methodology/approachThe study used a mixed-method design with pre and post-program surveys used to measure changes in participants’ recovery capital. Focused group discussions elicited participants’ context, their reactions, perceived outcomes and suggestions on the program.FindingsWomen in the program shared narratives of pain, trauma and abuse before treatment. Participants reported significant improvements in personal, community and family recovery capital dimensions. The program enabled personal growth in the form of new knowledge, skills and self-confidence. The women-only program also provided a safe space for women, to receive support from other women, community members and family. However, the women continue to face continuing challenges related to stigma and discrimination and a lack of livelihood opportunities.Research limitations/implicationsA limitation of the study was its small sample size and the lack of a control group. Another limitation was the variability in treatment received by the women, which could have affected overall outcomes. Future studies using a randomized control trial and longitudinal designs may provide more robust conclusions on the effectiveness of the program.Practical implicationsGiven punitive contexts, gender-sensitive and trauma-informed programs and services for women involved in drug use could potentially mitigate the abuse, stigma and vulnerabilities they experience.Originality/valueThis study contributes to the sparse literature on women-only aftercare, particularly in countries that criminalize drug use.

203 Assessing social determinants of health and psychosocial factors critical to sustaining recovery among pregnant and parenting women with opioid use disorder

OBJECTIVES/GOALS: This study explored personal recovery support, including social determinants of health and psychosocial needs to understand factors for sustaining recovery among parenting and pregnant women with opioid use disorder. METHODS/STUDY POPULATION: This study used a mixed method quantitative/qualitative design and recruited women from residential/transitional facilities in an urban area. We used the Accountable Health Communities Health-Related Social Needs tool to assess social determinants of health factors, level of physical activity, family/community support, and mental health (stress). Through focus groups, we interviewed women to describe challenges to recovery and to resources including access to providers, housing, childcare, and food assistance from lived experiences. RESULTS/ANTICIPATED RESULTS: Survey analysis showed social determinants of health factors such as food and transportation were partially mitigated by residential living; however, parenting and pregnant women with opioid use disorder remained concerned about housing and finances; and encountered low levels of physical activity and significant stress. Preliminary results from the focus groups revealed a theme of positive recovery and retention experiences from residential living. DISCUSSION/SIGNIFICANCE: Evidence from studies suggests focused interventions for recovering women to reduce relapse risk factors and adverse maternal outcomes. Opportunities for improving personal recovery capital are accessible in residential facilities, however, further exploration of unmet social determinants of health factors are needed for recovery retention.

Peer navigation: a pilot study to improve recovery capital for alcohol and other drug telephone helpline callers

Background People with alcohol and other drug (AOD) use problems face multiple barriers to care. Peer navigation may overcome known barriers to care. This pilot study explored the impact of peer navigation integrated into an AOD telephone helpline. Methods Helpline callers (n = 34; 21 male, 12 female, 1 non-binary; mean age 41.3 years) were connected to a peer worker for 6 weekly phone sessions. Linear mixed models were performed to assess change in recovery capital, self-efficacy, and substance use post-intervention and 3-months follow-up. A descriptive approach was used to analyse qualitative data. Results Participants attended a mean of 4.2 sessions (range 0 to 8). Analyses showed significant improvements in recovery capital (B = 2.56, p <.001) and self-efficacy (B = 0.18, p =.015) at exit and follow-up respectively. Participants showed significant reductions in substance use at follow-up. Qualitative analysis indicated participants described unique benefits related to working with a peer, including help to access resources and support. Conclusion Peer navigation via an AOD helpline has potential to support callers to improve recovery-related outcomes. More research is needed to assess the efficacy of peer programs in helping overcome barriers to accessing care.

“Recovery is about change, so you have to change everything”: Exploring the evolution of recovery capital among women in substance use disorder treatment

Recovery capital is a framework in addiction research aiming to understand substance use disorder recovery holistically by considering individuals' access to resources across the four domains of human, physical, social, and community capital. Each domain is opposed by negative capital. The underrepresentation of women's experiences in substance use research and the limited understanding of substance use treatment's effect on recovery capital limits our understanding of how treatment programs can support women in developing and maintaining recovery capital. This secondary qualitative analysis of data collected from the RENEW study explores the experiences of n = 19 women enrolled in substance use disorder treatment in Connecticut at baseline. Interviews occurred at two time points three months apart between February 2020 and April 2021 and discussed participants' experiences with treatment and the resources they have access to early in recovery. Thematic analysis identified four main themes related to recovery capital development. First, the direct effects of treatment, defined as clinical pathways to recovery capital, promoted resource growth primarily in the domains of human and physical capital. Second, non-clinical pathways, including indirect effects of treatment, facilitated maintenance of treatment-related improvements in human, social, and community capital. Third, interactions between domains promoted recovery capital resource growth across domains. Finally, goals and expectations for treatment motivated resource development across study time points. This study's findings have important implications for operationalization of the recovery capital framework and highlight the importance of more robust integration of non-clinical interventions to improve the experiences of women in treatment for substance use disorders.

Identifying components of recovery capital that support substance use disorder treatment completion

PurposeIndividuals who do not complete substance use disorder treatment (SUDT) have similar outcomes to the untreated. Recovery capital (RC) is the collection of one’s resources that contribute to the initiation and maintenance of sobriety. The aim of this paper was to identify individual measures of RC that are associated with SUDT completion. MethodsRC data for 69 residents from a men’s recovery center was obtained from questionnaires administered to residents at intake and after SUDT graduation or dismissal. Participant data was divided into two groups, Graduates (n = 39, age 35.87±10.83) and Non-Graduates (n = 30, age 34.35±14.44), and retrospectively analyzed to compare RC between groups at various points during SUDT and which RC measures are associated with SUDT completion. ResultsAt baseline all participants reported limited RC and there was no significant difference in RC between groups. At graduation, Graduates reported significantly more RC in all measures when compared to baseline and Non-Graduates at dismissal. Non-Graduates reported a significant increase in Checking and Savings at dismissal but no other measure. ConclusionBaseline levels of RC in both groups were limited and not significantly different which limited the capacity of the study to identify measures of RC associated with SUDT completion. A lack of RC at onset of SUDT did not preclude SUDT completion and obtaining RC during SUDT was associated with completion as only Graduates reported increases in RC. Future study designs should include participants with variable amounts of RC when entering SUDT.

The development of a recovery coaching training curriculum to facilitate linkage to and increase retention on medications for opioid use disorder.

Medication treatment for opioid use disorder (MOUD) decreases opioid overdose risk and is the standard of care for persons with opioid use disorder (OUD). Recovery coach (RC)-led programs and associated training curriculums to improve outcomes around MOUD are limited. We describe our comprehensive training curriculum including instruction and pedagogy for novel RC-led MOUD linkage and retention programs and report on its feasibility. The Kentucky HEALing (Helping to End Addiction Long-termSM) Communities Study (HCS) created the Linkage and Retention RC Programs with a local recovery community organization, Voices of Hope-Lexington. RCs worked to reduce participant barriers to entering or continuing MOUD, destigmatize and educate on MOUD and harm reduction (e.g., safe injection practices), increase recovery capital, and provide opioid overdose education with naloxone distribution (OEND). An extensive hybrid (in-person and online, both synchronous and asynchronous), inclusive learning-focused curriculum to support the programs (e.g., motivational interviewing sessions, role plays, MOUD competency assessment, etc.,) was created to ensure RCs developed the necessary skills and could demonstrate competency before deployment in the field. The curriculum, pedagogy, learning environment, and numbers of RCs trained and community venues receiving a trained RC are reported, along with interviews from three RCs about the training program experience. The curriculum provides approximately 150 h of training to RCs. From December 2020 to February 2023, 93 RCs and 16 supervisors completed the training program; two were unable to pass a final competency check. RCs were deployed at 45 agencies in eight Kentucky HCS counties. Most agencies (72%) sustained RC services after the study period ended through other funding sources. RCs interviewed reported that the training helped them better explain and dispel myths around MOUD. Our novel training and MOUD programs met a current unmet need for the RC workforce and for community agencies. We were able to train and deploy RCs successfully in these new programs aimed at saving lives through improving MOUD linkage and retention. This paper addresses a need to enhance the training requirements around MOUD for peer support specialists.