BACKGROUND: Recovery from opioid use disorder (OUD) is multi-component, combining medications for opioid use disorder (MOUD) with psychosocial supports such as counseling and mutual aid. Treatment access remains challenging in the U.S. Southeast; Alabama exemplifies the rural, under-resourced Deep South, where limited infrastructure shapes access to care. This study explored how individuals with OUD in Alabama describe and experience recovery during MOUD treatment.
METHODS: We conducted 26 semi-structured telephone interviews (June to September 2024) with individuals who self-reported struggling with OUD and were currently or previously in treatment. Participants were recruited through MOUD clinic sites across Alabama. Interviews were analyzed using deductive thematic analysis.
RESULTS: Participants were mostly women (n = 18, 69%) and White (n = 20, 77%). Three themes emerged: (1) Recovery as an ongoing process of rebuilding a ‘normal life,’ including restoring stability, relationships, and purpose; (2) Logistical challenges, including affording care, locating Medicaid-accepting programs, treatment delays, and transportation; and (3) Recovery supported by social support, including family, peers, clinic staff, workplaces, and the legal system.
CONCLUSIONS: Recovery was a long-term rebuilding process shaped by logistical challenges and strengthened by social support. Improving affordability, reducing delays, and addressing transportation may enhance engagement in under-resourced settings and comparable regions internationally.
Exploring recovery experiences and challenges among individuals with opioid use disorder in the U.S. Deep South
Drugs: Education, Prevention and Policy [Epub 2026 Aug 15]. doi: 10.1080/09687637.2026.2716010.