Bringing Addiction Treatment to Primary Care Settings

Nearly one in five Americans will face substance use disorder in their lifetime, yet the majority will never receive treatment. In 2024 alone, more than 80,000 people in the United States died from drug overdoses. Among young people between the ages of 15 and 44, overdose is now the third leading cause of death, behind firearm-related deaths and motor vehicle collisions. 

Despite this urgent need, access to treatment remains limited. Many people living with addiction will never be connected with a specialty treatment program. But nearly everyone sees a primary care clinician at some point in their lives. This makes primary care settings powerful and underused entry points for addiction medicine. 

Recognizing this opportunity, Zach Sartor, Lance Kelley, and Ryan Laschober from Waco Family Medicine in Texas, with guidance from Johns Hopkins Bloomberg School of Public Health Associate Professor Alene Kennedy-Hendricks, utilized a Network of Practice Grant from the Bloomberg American Health Initiative to strengthen the role of primary care in addressing substance use.  

Their project focused on making it easier for primary care systems to integrate addiction treatment into routine care. To achieve this, the team developed a Primary Care Addiction Medicine Implementation Toolkit, designed to help health systems overcome common barriers such as limited training, structural constraints, and uncertainty about primary care’s role in addiction medicine. 

To ensure the recommendations included the patient perspective, the team conducted qualitative interviews with patients, gathering stories that underscored the unique value of receiving addiction care in a trusted primary care setting. Many interviewees noted that primary care clinics offered a more compassionate, less stigmatizing environment compared to specialty treatment programs.  

The research team also created a policy brief tailored to Texas policymakers, advocating for expanded access to medications for addiction treatment, like buprenorphine, through primary care. This brief is already informing conversations with state leaders ahead of the 2025 legislative session. 

The Waco Family Medicine team shared their findings at the 55th Annual American Society of Addiction Medicine Conference in April of 2024 and are engaging with organizations like the Texas Medical Association and Texas Medicaid. These efforts have opened new doors for collaboration and policy change. 

This project is not just about one clinic in Waco. It is about building a scalable model that can strengthen community health centers nationwide—many of which serve populations most affected by inequities in addiction treatment access. By equipping primary care providers with tools, policy support, and patient-centered insights, this work is laying the groundwork for a future where addiction treatment is not siloed but seamlessly woven into the healthcare system.