Medically underserved rural communities struggle to meet challenging needs in response to the opioid crisis. The purpose of this study was to measure any benefit of an occupational therapy (OT) intervention group with participants in an addiction recovery program. Supervised OT graduate students implemented a five-week program at a faith-based non-profit organization in a small metro community. A weekly time management occupational-based intervention group based on the Action Over Inertia (AOI) manualized protocol focuses on motivating and providing strategies to successfully reintegrate individuals into the community by using meaningful activity and positively influencing levels of occupational balance and engagement (Krupa et al., 2003). Outcome measures included self-report of time use, occupational balance, occupational engagement, and goal identification, satisfaction, and performance. The need to effectively treat individuals with SUD is a public health priority. Results demonstrated positive outcomes with self-rating of time management, self-management skills, frequency of engaging in meaningful activities, and performance and satisfaction in meeting individual goals. This research adds to the limited evidence base in the OT literature for interdisciplinary treatment of this population using a manualized occupation-based intervention.