Integrating Substance Use Disorder Services with Primary Care: The Experience in California

Abstract

Integrating substance use disorder (SUD) services with primary care (PC) can improve access to SUD services for the 20.9 million Americans who need SUD treatment but do not receive it, and help prevent the onset of SUDs among the 68 million Americans who use psychoactive substances in a risky manner. We lay out the reasons for integrating SUD and PC services and then explore the models used and the experiences of providers as they have begun SUD/PC integration in California.

Keywords:

• behavioral health integration
• behavioral health integration (California)
• health policy
• primary care
• substance use disorder treatment

Notes

1. Two rural California counties provide SUD services under one shared system, so there are only 57 county SUD administrators in the state even though there are 58 counties.

2. Other promising and highly innovative SUD/PC integration models—such as San Francisco's Office-Based Opiate Treatment program (Hersh, Little & Gleghorn 2011)—are being implemented in California as well. However, the three models discussed here are the most common ones being used throughout the state.