International Overdose Awareness Day: Bridging Gaps in Overdose Recovery Care

With International Overdose Awareness Day being recognized today, August 31, new research underscores persistent disparities in access to recovery resources and points toward strategies that could help address them.¹ Despite the effectiveness of medications for opioid use disorder (MOUD), which are widely recognized as the gold standard for treatment, many individuals—particularly Black Americans—continue to face barriers in sustaining recovery.

Research reveals significant health care disparities in overdose recovery resources, emphasizing the need for better connections between opioid treatment programs and recovery centers. | Image credit: Jayadiudara - stock.adobe.com

A recent study published in Frontiers in Public Health examined how directors of opioid treatment programs (OTPs) engage with recovery community centers (RCCs), peer-led organizations that provide non-clinical support ranging from mutual help groups and overdose prevention education to housing, childcare, and employment assistance. These centers are designed to complement clinical care and strengthen “recovery capital,” or the social and community resources that support long-term recovery.

These gaps in linkage take on particular urgency in light of racial disparities in overdose mortality. The opioid epidemic has claimed more than 107,000 lives in the United States in 2022 alone, with synthetic opioids such as fentanyl driving record overdose deaths, and the COVID-19 pandemic widened existing disparities.² Black Americans in particular have experienced disproportionately high increases in overdose mortality, with recent data showing death rates surpassing those of White Americans for the first time since national tracking began.³

Medications for opioid use disorder (MOUD)—including methadone, buprenorphine, and naltrexone—remain the gold standard of treatment, yet retention in care is limited, with nearly half of patients discontinuing within the first year.¹ OTPs, which are the main entry point to MOUD in the US, are encouraged by federal guidance to connect patients with RCCs, peer-led organizations designed to provide long-term recovery support and strengthen social networks.

However, little is known about whether OTP directors were aware of RCCs, how often they referred patients to them, and what barriers might prevent collaboration. To address this gap, researchers conducted a national survey and interviews with OTP directors serving predominantly Black communities, aiming to better understand current practices and opportunities to strengthen linkages that could reduce overdose deaths and advance health equity.

The study focused on OTPs located near RCCs serving predominantly Black communities, defined as ZIP codes where at least 25% of residents were Black. Researchers surveyed 15 OTP directors and interviewed 5 to better understand referral practices, awareness of RCCs, and barriers to collaboration. On average, surveyed OTPs served about 370 patients weekly, most of whom were between the ages of 25 and 59 years. The majority were White (68%), while 23% of OTPs were Black and 15% were Hispanic. About two-thirds of OTPs were men.

Despite federal guidance encouraging OTPs to connect patients to RCCs, there remain gaps in practice, the study found. Only 40% of OTP directors knew that an RCC was located nearby (defined as less than 10 miles away). Although nearly all directors referred patients to long-established mutual help groups such as Alcoholics Anonymous and Narcotics Anonymous, only two-thirds reported referring to RCCs.

The most common barrier to RCC referral was the lack of knowledge about RCCs (47%), followed by concern of RCC effectiveness in supporting patients who’ve recovered from an overdose (33%) and logistical challenges such as staff capacity and transportation (33%). Also, some OTPs expressed concerns with RCCs discouraging the use of MOUDs (40%).

The study limitations included a small sample size and a low survey response rate, which may limit generalizability. However, the findings align with other evidence that knowledge gaps, stigma, and structural barriers hinder access to recovery supports. Importantly, every OTP director surveyed agreed that routine referrals to RCCs made sense and would be valuable for patients. Interviewees offered practical suggestions to strengthen linkages, including in-person introductions between OTP and RCC staff, accessible transportation options, and clearer communication about services and costs.

As organizations mark International Overdose Awareness Day, the research highlights an urgent need to move beyond clinical treatment alone. Addressing disparities in overdose recovery care requires building stronger networks that connect medical treatment with community-based supports.

References

1. Hoeppner BB, Williamson AC, Nicoll C, et al. The linkage between opioid treatment programs and recovery community centers: results of a survey of OTP directors. Front Public Health. 2025;13:1532374. doi:10.3389/fpubh.2025.1532374

2. CDC. Increase in fatal drug overdoses across the United States driven by synthetic opioids before and during the COVID-19 pandemic. CDC Health Alert Network. Published December 17, 2020. Accessed August 27, 2025. https://emergency.cdc.gov/han/2020/han00438.asp

3. Furr-Holden, D, Milam, AJ, Wang, L, and Sadler, R. African Americans now outpace whites in opioid-involved overdose deaths: a comparison of temporal trends from 1999 to 2018. Addiction. 2021;116(3):677-683. doi:10.1111/add.15233