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As one key recovery support, access to quality recovery housing can make or break a person’s likelihood of long-term success. Specific to opioid use disorders, recovery residence operators need guidance to implement cultural and operational changes that support medication-assisted recovery. While different levels of recovery residences have varying structures, staffing, services, and supports, the information and considerations in this brief are helpful to all residences seeking to support medication-assisted pathways to recovery. Currently, there is no definitive research that matches the level of a recovery residence with its ability to support residents using medication in their recovery.