5th Edition of Addiction World Conference 2026

Abstract

Background & Objective:

Medications for Opioid Use Disorder (MOUD) are evidence-based treatment therapies available to persons with an opioid use disorder (OUD) that facilitate recovery and reduce opioid-related deaths¹. In a 2025 study of outcomes of recovery housing residents on MOUD, the authors concluded that “research was urgently needed to establish an evidence base on recovery housing for those prescribed MOUD².” There is a dearth of research on persons living in recovery houses while prescribed an MOUD by type of MOUD. We assessed recovery capital growth among persons with OUD using MOUD by type (buprenorphine vs. other [naltrexone or methadone]) who utilized a voucher-based recovery support program in Kentucky. This voucher-based program helps pay for recovery support services (RSSs), including recovery housing, transportation supports, and basic needs.

Methods:

We conducted a logistic regression analysis (mixed effects model and a random effects logit model) of persons with an OUD who participated in a voucher-based RSS program (n=371) assessing their recovery capital outcomes (stable housing, employment, return to substance use, and Brief Assessment of Recovery Capital [BARC]-10) by MOUD type at four timepoints. The four timepoints were: 1) 0 months; 2) Discharge (~3-6 months); 3) 3 months post-discharge (~5-8 months); and 4) 12 months. Vouchers up to a $2,000 limit were available to persons with an OUD who participated for accessing recovery housing, basic needs, and transportation support. We assessed interactions between each timepoint and recovery house utilization, transportation support utilization, and basic need utilization. Demographics examined included race; gender at birth; months in recovery; concurrent alcohol use disorder, stimulant use disorder, or mental health disorder; and probation/parole status.  

Results: 

Approximately one-half of the persons with an OUD selected recovery housing regardless of the MOUD type. There was no significant difference between persons prescribed buprenorphine vs. those not on any type of MOUD for any of the recovery outcomes. In contrast, there was a significant difference in recovery outcomes between persons prescribed other types of MOUD (naltrexone or methadone) and those not on any MOUD. Persons prescribed other MOUD types had a lower BARC-10 score (p<0.05), and were less likely to be employed (p<0.05) or to live in stable housing (p<0.05). Being female, being older, and having more months in recovery (p<0.05) were all associated with being stably housed. Having a concurrent mental health diagnosis was associated with an elevated return to use (p<0.05), while being on probation/parole was associated with a lower return to use (p<0.05). Being on probation/parole was also associated with a higher BARC-10 score. 

Conclusions & Discussion:

Persons prescribed naltrexone or methadone who participated in a voucher-based recovery support service program reported lower recovery capital outcomes over time compared to persons with an OUD not on any type of MOUD. Buprenorphine prescribing may be a useful therapy for persons in a voucher-based recovery support service program that includes recovery housing. The results of this study may have broad implications in the type of MOUD that should be recommended in recovery housing. Further research is needed to explore why those on methadone or naltrexone had lower recovery capital such as medication dosing or other variables that could be included in the statistical model.