The Landscape of Recovery Support Services Implementation in Local Jurisdictions of Maryland

Background and Purpose: With the number of drug-related fatalities exceeding 110,000 individuals in the United States in 2021, Maryland (MD) ranks in the top ten states in drug-related fatalities. Recovery support services (RSS) are essential in providing support to individuals with opioid use disorder (OUD) by helping them enter and remain in treatments that use medications for OUD and facilitating long-term recovery. Prior research supports the positive effects of RSS on health outcomes and health service utilization. The importance of RSS has prompted the authors of this study to conduct a study that investigated the implementation of RSS across local jurisdictions in Maryland.

Methods: This study employed key informant interviews and reviewed state and online RSS documents to examine the implementation of RSS in each jurisdiction in MD. An online survey was developed after having consulted with state officials from the Maryland Department of Health (MDH) and field experts and distributed to key stakeholders from twenty-four local jurisdictions. Written documentations provided by MDH were reviewed, and online searches were conducted to supplement the interview findings. RSS state funding in 2022 was also examined to capture resource disparities among jurisdictions.

Results: All jurisdictions participated in the survey and interview. Ten services were evaluated: recovery community center (RCC), wellness recovery center (WRC), support groups, care coordination/case management, recovery housing, homeless shelters, Medicaid transportation, harm reduction, and peer support services. While all jurisdictions had at least one provider offering support groups, care coordination, MA transportation, harm reduction services, and peer support services, significant disparities existed in the provision of RCC, WRC, recovery housing, homeless shelters, and supported employment services among the twenty-four jurisdictions. Baltimore City, Calvert, Carroll, Cecil, Frederick, Harford, Montgomery, St. Mary’s, Washington, and Wicomico counties had all ten RSS available; however, Caroline, Garrett, Queen Anne’s, and Somerset counties had two or fewer RSS available. Counties with fewer RSS are located in Eastern Shore and Western Maryland. Additionally, the average RSS budget per person in Maryland in 2022 was $2.54, with Anne Arundel, Baltimore County, Frederick, Harford, Montgomery, and PG counties having lower RSS budgets than the state average per person They are among the top 8 most populous counties in MD.

Conclusions and Implications: This study identified significant disparities in RSS implementation and state funding across local jurisdictions in Maryland. Rural jurisdictions had fewer RSS available, and populous counties had less state RSS funding per person. The findings of this study offer direction to policymakers and state administrators on implementing RSS and distributing resources across local jurisdictions in MD. Additionally, the study’s findings serve as a reference guide for individuals with OUD and their loved ones seeking resources for recovery.