Integrating Substance Use Disorder Services into Primary and Other Care Settings
Medications for opioid use disorder are among evidence-based treatments
As a healthcare practitioner, you can significantly contribute to increasing access to lifesaving services for your patients, improving their health, enhancing their quality of life, and helping them achieve recovery from substance use disorders (SUD).
Whether you are a new or experienced practitioner in a setting such as primary care, family practice, private practice, community health center, pharmacy, counseling, or social work, this web resource offers a wealth of tools and information about integrating SUD treatment and recovery services into your practice.
In order to provide essential SUD treatment and recovery services for those in need, practitioners can play a key role by integrating evidence-based services into their practices.
Many people have a trusted healthcare practitioner who is foundational to their health, providing clinical services and counsel over a lifetime. Research shows that:
- People living with SUD report a greater willingness to enter treatment in a primary care setting than a specialty care setting.
- Individuals with SUD often access the healthcare system for other reasons, including acute health problems like chronic illness, injury, or overdose, as well as chronic health conditions such as HIV/AIDS, heart disease, or depression.
- Office-based opioid treatment (OBOT) is effective for a substantial proportion of patients (50–80 percent), and patients are typically highly satisfied with the services they receive.
According to SAMHSA’s 2024 National Survey on Drug Use and Health, about 1 in 6 Americans ages 12 and older reported having an SUD in the last year. In addition, an estimated 4.8 million people had an opioid use disorder (OUD), and 27.9 people had an alcohol use disorder (AUD).
Increasing access to SUD treatment and recovery services is critical, including patients with an OUD. So is reducing the impact of stigma and unconscious bias about SUD, increasing practitioners’ knowledge about SUD treatment, and helping them to be comfortable and willing to provide services. The fact is you are probably already treating patients in your practice who would benefit from these essential services.
The Agency for Health Care Research and Quality (AHRQ) Integration Academy’s Medications for Opioid Use Disorder Playbook, is a practical guide for providing Food and Drug Administration (FDA)-approved medications for opioid use disorder (MOUD) and immediate care for patients with opioid use disorder (OUD) in primary care and other ambulatory care settings.
This interactive, web-based product has the latest guidance, tools, resources, tips, and examples that address key aspects of MOUD implementation. The Playbook will help you find your own path for implementation by applying knowledge about successful approaches and navigating possible barriers.
What Practitioners Need to Know
Your practice does not have to directly provide all of the additional supports for you to offer treatment and recovery services in your practice. There are many organizations in your community to which you can refer people. Talk with your patient about their care, so together you can make informed decisions about what is best for their needs, just as you would when treating a patient with any other chronic disease.
There are various pathways to recovery. The use of MOUD including methadone, buprenorphine, and naltrexone, is just one component of an evidence-based care plan that includes additional patient-centered supports such as counseling and behavioral therapies, and medical and social services to best meet the needs of the individual.
Buprenorphine and naltrexone can be prescribed in a variety of care settings, while methadone is available only through opioid treatment programs (OTPs). Naltrexone is also approved to treat AUD. These medications relieve withdrawal symptoms and psychological cravings, reduce risk of overdose, and help patient retention in treatment.
Buprenorphine offers several benefits to people with OUD and to others for whom treatment in an OTP is not appropriate or is less convenient. The 2023 elimination of the DATA Waiver (X-Waiver) enables practitioners, and pharmacists in some states, to prescribe buprenorphine in a variety of care settings. This opens the door for more practitioners to integrate this care into their practices, to help those in need and increase access to lifesaving treatment.
The use of medications for SUD treatment is effective, and available for practitioners to use in their practices, yet according to the 2024 National Survey on Drug Use and Health, of the 4.8 million people with an OUD, only 17 percent (or 818,000 individuals) received medications for their OUD in the past year. Of the 27.9 million people with an AUD, only 0.5 percent (or 1.3 million individuals) received medication for AUD (MAUD).
Benefits of MOUD
Medications for OUD such as buprenorphine:
- Reduce cravings to use opioids
- Reduce risk of relapse
- Reduce illicit opioid use
- Reduce or relieve withdrawal symptoms
- Reduce risk of opioid overdose death
- Increase treatment retention
- Produce better treatment outcomes
- Lead to lower healthcare usage and costs
- Can be taken on a short and long-term basis
Practitioner-Specific Information
For information, resources, and training specific to physicians, physician assistants/associates, nurse practitioners, pharmacists, counselors, social workers, and peer support workers visit the individual practitioner pages.
MOUD Integration Resources
PCSS-MOUD
Care Models
- Integrated Models for Behavioral Health and Primary Care
- Integrating MOUD and Primary Care: Outcomes of a Multicenter Learning Collaborative
- SAMHSA Advisory: Low-Barrier Models of Care for Substance Use Disorders
Strengthening the Behavioral Health Workforce
In November 2024, SAMHSA launched the Behavioral Health Career Navigator to assist current and aspiring behavioral health professionals in identifying state-specific requirements for various careers in the field. The Behavioral Health Career Navigator provides a comprehensive resource for understanding education, credentialing, licensing, and renewal processes across states. It also supports existing professionals exploring relocation by detailing credential reciprocity.
Additional SAMHSA Supports
Practitioners with general information and training questions can contact SAMHSA’s Provider Support Team at providersupport@samhsa.hhs.gov or by calling 1-866-287-2728.
Practitioner Champion Initiative
You can help to expand access to MOUD and create a greater awareness of the effectiveness of these medications. However, barriers to increasing availability of MOUD remain, including stigma and hesitation from practitioners to integrate it into their practice.
SAMHSA’s Practitioner Champion Initiative is a program to highlight the integration of MOUD services for physicians, physician assistants/associates, nurse practitioners, and pharmacists and other practitioners who are currently working in the field. The initiative helps practitioners understand the benefits of MOUD treatment and overcome barriers, providing actionable, evidence-based guidance and best practices from peers who have successfully included MOUD services into their practices. It also serves as a community of experts where experienced practitioners can help spread the word and influence other providers around them.
Practitioner Champion Videos
Learn from Practitioner Champions who have integrated SUD and MOUD services into their practices for years on how they integrated, the benefits, and dispelling stigma within their practice.