BACKGROUND: Extended-release naltrexone (XR-NTX, Vivitrol OBJECTIVES: Using a triangulation of perspectives, this study examined concordance between the social network themes that emerged from qualitative interviews with clinicians and POUD social network findings. METHODS: Audio-recorded qualitative interviews were conducted with all clinicians ( RESULTS: Three themes related to POUDs' social network barriers of XR-NTX emerged from the clinician interviews: (1) networks with limited knowledge of XR-NTX, (2) homophily in networks, and (3) limited support networks. From the perspective of the POUD, knowledge of XR-NTX was nonexistent within their networks, aligning with the clinician theme. Homophily was prevalent in some attributes (e.g., employment), but only 31.8% of POUD networks had used drugs, providing mixed support for this theme. In concordance with clinicians, POUDs received high levels of emotional support, but lacked instrumental, financial, and treatment support from networks. CONCLUSIONS: The network characteristics of Appalachian POUDs recently released from prison create challenges associated with recovery, which may be addressed through network and educational interventions.