What stands in the way of cooperation between clinicians and community stakeholders responding to the opioid epidemic, and how can these obstacles be overcome? This project has two aims: first, to describe the barriers to institutional collaboration among those responding to the opioid epidemic; and second, to create policy recommendations for effective collaboration in efforts to stem the opioid epidemic. In partnership with a consortium in southern Appalachia, the project will offer practical resources for clinicians and communities struggling with the opioid epidemic across the nation.