Increasing numbers of opioid overdoses were observed during the COVID-19 pandemic, likely reflecting the pandemic’s multiple effects on this already vulnerable population. People in recovery from opioid use disorder (OUD) reported disproportionate psychosocial distress and isolation, as well as significant disruptions in access to treatment, including peer support, during the COVID-19 pandemic. These negative outcomes were especially acute for rural, low-income, and minority populations in recovery from OUD.

Peer support was a key component of many evidence-based OUD recovery programs. It improved recovery capital, treatment engagement, perceived social support, and reduced psychosocial distress, particularly when used in conjunction with other evidence-based treatments such as medication for opioid use disorder (MOUD).

The project involved a randomized controlled trial of a novel mobile peer support app platform among a national sample of 1,300 patients in recovery from opioid use disorders (OUDs) as an adjunct to usual care during COVID-19. The researchers’ previously piloted online-only recruitment and follow-up strategy—melding patient-reported outcomes with administrative datasets—enabled strategic recruitment of often-excluded participants from across the United States, including those facing the highest barriers to treatment.

The mobile app-based peer support intervention, provided as an individual-level enhancement of existing treatment and recovery programs, allowed individuals in OUD recovery to access a tailored, anonymous, peer-moderated support group 24/7. The app was augmented with natural language processing tools capable of automatically flagging critical or clinically relevant content, thereby creating a scalable system to keep groups safe and constructive. Participants were followed for six months through both self-report and administrative outcomes.