Purpose of Review <p>We review recent investigations of environmental factors that may positively or negatively influence individual opioid use, and treatment outcomes.</p> Recent Findings <p>We explore key studies on the effects of secondary exposure to opioids, social network strength, and clinic proximity on opioid mortality and treatment engagement. Evidence supports reducing secondary opioid exposure, minimizing geographic barriers and leveraging social supports to improve treatment adherence and lower overdose risk. We also review literature on associations between opioid mortality and housing stability, neighborhood safety and overall law enforcement presence. This work underscores that an individual’s recovery environment is shaped by a breadth of cultural and systemic factors.</p> Summary <p>As the opioid epidemic continues to exacerbate public and individual health in evolving ways, there is a growing need to characterize environmental facilitators and barriers to recovery. We argue that, through focused conversations and counseling, these environmental factors can and should be directly explored with patients.</p>