Embedding addiction treatment in a resident primary care clinic increased confidence in SUD diagnosis, medication use, and harm-reduction counseling.
Embedding
“In traditional training, addiction care is often taught in theory rather than practice,” lead author Michael Binder, MD, adjunct associate professor of medicine, said in a press release. “We wanted to create a model where treating substance use disorders is integrated into everyday primary care, because that’s where many patients already are.”2
Key Facts
The report describes development of a structured addiction medicine clinic integrated into a resident ambulatory practice beginning in 2023. The clinical team included attending physicians, clinical pharmacists, addiction fellows, medical assistants, and internal medicine residents. Investigators evaluated the clinic’s first 15 weeks using patient care metrics and resident education outcomes.¹
During that initial period, the clinic recorded 73 patient visits. Opioid use disorder (OUD) and
The findings address a persistent mismatch between disease prevalence and treatment access. Based on the 2024 National Survey on Drug Use and Health, approximately 48.4 million Americans aged 12 years or older had an SUD, representing about 16.8% of that population, while fewer than 1 in 4 received addiction treatment.3 Primary care practices are often where patients with SUDs already receive care for other chronic conditions, but many clinicians report limited supervised outpatient experience with medications and counseling approaches used in addiction treatment.
The integrated model is notable because it places addiction care within routine internal medicine training rather than in a separate specialty setting. That structure may help normalize SUD treatment alongside diabetes, hypertension, and other chronic disease management. It may also reduce logistical and stigma-related barriers for patients who might not seek care at a specialty addiction center.
The medication focus is clinically relevant.
For residency programs, the Cincinnati experience suggests that hands-on exposure may be more effective than didactic teaching alone for building clinical readiness. The outcome measured, however, was confidence rather than independent competency or patient-centered outcomes. The evaluation was also small, single center, and short term, with paired survey data from 11 residents. The summary did not report quantitative changes in medication initiation rates, treatment retention, substance use outcomes, overdose events, or longer-term practice patterns after graduation.
Ellen Jochum, chief physician resident who practiced in the clinic, said the experience helped translate classroom learning into outpatient primary care. “I feel much more prepared because of my experiences and now feel comfortable starting treatment for patients with a substance use disorder, knowing resources available to them,” she said in the press release.2
Next steps identified by the research team include assessing whether this type of rotation affects patient outcomes over time and whether residents continue providing addiction treatment after training. For other academic medical centers, the study offers an implementation example, but replication will require attention to faculty expertise, pharmacy support, workflow design, and sustained access to community recovery resources.
References
