Community Resources & Recovery Supports

The social determinants of health are the social, physical, and economic conditions in which people live. Social determinants of health can play a critical role in patients’ short- and long-term health outcomes, including functioning, quality of life, and risk factors.³

Healthy People 2030 groups social determinants into five categories³:

1. Economic stability (e.g., employment, food insecurity, housing instability, poverty);
2. Education access and quality (e.g., early childhood education and development, enrollment in higher education, graduation from high school, literacy);
3. Social and community context (e.g., social cohesion and support, discrimination, incarceration rates);
4. Health care access and quality (e.g., access to health care, health literacy); and
5. Neighborhood and built environment (e.g., prevalence of crime and violence, environmental quality, housing).

A true patient-centered, holistic approach to recovery will identify patients’ needs related to their social determinants of health and incorporate services that address those needs into the treatment plan. For example, if patients are unemployed and living in poverty, providers might consider connecting them with supported employment services to help them find a job.

The recovery supports available will vary based on the local community. Overall, these resources may be more limited in rural or poor areas. Medication-assisted treatment (MAT) programs should maintain a list of all potentially helpful community-based recovery support services and organizations that may help meet patients’ complex needs. Ideally, they might engage and develop partnerships with these community organizations. They can educate patients and their families about these available recovery supports. If patients need and are interested in these services, the treatment plan should reflect this interest and include strategies to actively connect them.

Mutual Aid or Self-Help Groups. These groups are often the most widely available type of recovery support, even in rural areas. They allow individuals in treatment or recovery to learn from the experiences of others and form connections for emotional support.⁴ Some of these groups, such as Alcoholics Anonymous, Narcotics Anonymous, and SMART Recovery, are based on a 12-step program. Some support groups are specifically designed for family members of those with substance use disorders.

It is worth noting that, historically, some of these groups did not welcome individuals taking medications to treat substance use disorders, as they did not consider this option to be true “abstinence.” While attitudes may be shifting and some MAT-specific 12-step groups are forming, providers should listen to patient feedback and experiences with these groups and encourage attendance at those that will offer patients the best support. In some cases, patients may not want to be extremely vocal about their MAT.

Recovery Coaches and Peer Support Workers. These are lay members of the recovery team. They may be paid or voluntary positions. A variety of titles are used, including recovery coaches and peer support workers. People in recovery often serve in these roles. They draw on their own lived experience with substance use disorders to help instill hope and offer emotional support to others.⁴ They also model positive behaviors and help individuals in recovery develop needed life skills, such as how to build social relationships and how to structure free time. They might also serve a navigation role, connecting individuals with substance use disorders to needed community services and addressing any barriers that might interfere with their recovery.⁴

Case Management. These services can help establish the stability in a patient’s life needed for recovery.² Case management includes helping patients get access to food, housing, income support, legal aid, transportation, and employment. A safe, stable living environment may be key to recovery. Therefore, community-based organizations may help connect individuals with substance use disorders to affordable housing or offer substance-free housing options.

For example, a local community may have recovery housing or sober living homes.⁴ Living in recovery-supportive homes can help patients draw on mutual support from other residents in a substance-free environment. Learn more about the importance of finding and keeping housing.

Similarly, finding a job can help individuals with opioid use disorder by giving them meaning or purpose in life and financial stability. Organizations or agencies that provide supported employment or vocational rehabilitation services can help people find job training, apply for jobs, and obtain accommodations to help maintain employment. Learn more about the importance of meaningful work in recovery.

Mobile or Web-Based Applications. Providers in rural communities or other areas that lack available recovery supports should also consider the use of mobile or web-based applications. These apps can help provide support whenever and wherever patients need it. For example, in 2016, SAMHSA held a challenge to develop free, recovery-focused support apps for patients with opioid use disorder receiving outpatient MAT. The winners included apps called: FlexDek for MAT, rePear, and Recopia.