Researchers found that integrating addiction treatment into primary care training clinics may be a promising strategy for addressing substance use disorders.
For the millions of Americans who never make it to a specialty rehab center, this model could represent a significant shift in how and where addiction treatment is delivered.
The Addiction Treatment Gap in Numbers
The scale of the problem is hard to overstate. Data from the 2024 National Survey on Drug Use and Health indicate that approximately 48.4 million Americans aged 12 years and older, or 16.8% of the population, were affected by a substance use disorder. Yet fewer than 1 in 4 individuals received treatment for alcohol and drug abuse.
That gap exists partly because specialty rehab centers aren’t accessible to everyone. Cost, transportation, stigma and waitlists all play a role. But a less-discussed barrier is physician preparedness.
Lead author Michael Binder, MD, an adjunct associate professor of medicine and physician with UC Health, noted that although only a small percentage of people with substance use disorders receive treatment, many internal medicine residents report having limited practical experience in addiction care.
How the Integrated Clinic Works
The research team launched a structured, clinic-based training experience in 2023 within a UC resident primary care practice. The model brought together attending physicians, clinical pharmacists, addiction fellows and internal medicine residents to function as a unified care team.
During the clinic’s first 15 weeks, the team recorded 73 patient visits, with opioid use disorder and alcohol use disorder among the most common diagnoses.
Opioid use disorder treatment often centers on medications like buprenorphine, an FDA-approved medication used in medication-assisted treatment (MAT) that reduces cravings and withdrawal.
Having residents practice initiating and adjusting these medications under supervision is a meaningful step toward normalizing MAT in everyday primary care settings.
Physician Confidence Rose Significantly
Researchers surveyed participating residents before and after their rotation. Results from 11 of the 18 residents showed marked improvements in confidence when diagnosing SUDs, interpreting urine drug tests, initiating and adjusting buprenorphine for opioid use disorder, and providing harm-reduction counseling.
Chief physician resident Ellen Jochum described the experience as transformative. Before rotating through the clinic, her training had been mostly theoretical and limited to inpatient settings.
She emphasized that the hands-on training, outpatient substance use treatment experience, and patient counseling opportunities helped build confidence in delivering evidence-based addiction treatment and connecting patients with community support resources.
“I am going to be starting as a primary care physician this summer, and I am so grateful I have this training,” she said.
Reducing Stigma Through Normalization
One underappreciated benefit of this integrated model is what it communicates to patients. Unlike specialty addiction centers, this clinic operates within a standard internal medicine practice, making addiction treatment more accessible and reducing stigma for patients.
As Dr. Binder put it, patients can receive care for substance use disorders in the same place they manage diabetes or hypertension, a framing that treats addiction as a medical condition rather than a moral failing. That shift in setting can meaningfully reduce barriers to engagement for people who might resist or delay entering a standalone rehab program.
What This Means for Treatment Seekers
The research team hopes the model can be adapted by other academic medical centers seeking to expand access to evidence-based addiction treatment and improve physician training.
If widely adopted, patients in cities with academic medical centers may eventually find addiction treatment available through their regular primary care provider, with no separate referral required.
For people currently researching their options, this research underscores the importance of asking providers directly about their experience with SUD treatment, mediation assisted treatment and harm reduction.
Exploring Treatment Options
If you or someone you care about is navigating a substance use disorder, understanding what level of care is appropriate, from outpatient support through a primary care provider to residential rehab, is a critical first step.
- Compare rehab centers in your area that offer integrated medical and behavioral care
- Ask about insurance coverage for addiction treatment, including MAT programs
- Look for facilities that employ physicians trained in addiction medicine or have addiction-certified staff
- Verify that evidence-based therapies, including harm reduction counseling, are part of the treatment approach
Rehab.com’s directory lists thousands of verified treatment centers across the nation. Call
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