Within a mid-Atlantic state, opioid use disorder-related deaths remain high. In 2018, there were 2,087 opioid-overdose deaths in a mid-Atlantic state, a rate of 33.7 deaths per 100,000, higher than the national rate of 20.7 deaths per 100,000 (NIDA, 2020). In addition, this state is ranked number one for opioid overdoses of non-Hispanic Blacks (Substance Abuse and Mental Health Services Administration (SAMHSA), 2020). This state has a comprehensive program designed to address this epidemic. Research highlights that, while comprehensive programs are important strategies to address the opioid crisis and decrease opioid related Social Security Disability Insurance (SSDI) applications (Harris et al., 2019; Schiltenwolf et al., 2014; Cutler et al., 2017; Maestas and Sherry, 2021; and Wu et al. 2021), responses should also vary to address the racial differences (SAMHSA, 2020). Therefore, this research explores whether there are disparities in opioid treatment, referral services, and discharge by race, economic, and other social factors. The project has two parts 1) a comprehensive literature review to understand what is known regarding racial differences in opioid use treatment and opioid overdose response and 2) analyses of administrative and survey data on MD-SOR program clients linked to contextual economic and social indicators from the American Community Survey to generate descriptive statistics, visualizations, and text analysis of notes in records of individuals receiving treatment to explore disparities in opioid treatment and opioid overdose response.