At the University of Cincinnati, resident physicians are learning to treat addiction the way they treat any other chronic disease—right alongside the patient managing diabetes in the next exam room. In 2023, researchers there launched an integrated addiction clinic within a standard internal medicine practice, embedding substance use disorder treatment into everyday primary care. The results are quietly revolutionary: physicians who had never prescribed buprenorphine or counseled patients on harm reduction suddenly felt confident doing both, and patients found addiction care in a place where stigma tends to dissolve.
The need for this shift is urgent and vast. According to the 2024 National Survey on Drug Use and Health, approximately 48.4 million Americans aged 12 and older experience substance use disorders—nearly one in six people. Yet fewer than one in four of those individuals ever receive treatment. The gap isn't just a shortage of addiction specialists; it's a shortage of primary care physicians trained and confident enough to help. Many internal medicine residents, as lead researcher Michael Binder, MD, notes, receive addiction training mostly in theory rather than hands-on practice.
The University of Cincinnati team—led by attending physicians Binder and Carolyn Chan, MD, alongside clinical pharmacists Marisa Brizzi, PharmD, and Bailey Francis, PharmD, addiction fellows Ross Lawson, MD, and Aastha Singh, MD, and medical assistant supervisor Shantel Voelker—created a structured, clinic-based training experience to change that. During the first 15 weeks of operation, the clinic recorded 73 patient visits, with opioid use disorder and alcohol use disorder among the most common diagnoses. The team treated real patients and monitored real learning outcomes.
Eleven of the 18 participating residents completed pre- and post-rotation surveys. The improvements were striking: residents showed marked gains in confidence diagnosing substance use disorders, interpreting urine drug tests, initiating and adjusting medications like buprenorphine for opioid use disorder, and providing harm-reduction counseling. For many of these physicians, it was their first time actually prescribing these medications or having these conversations with patients. After just a few weeks of integrated practice, confidence soared.
What makes this model different from traditional addiction medicine training is its location. By operating within a standard internal medicine clinic rather than a specialty center, the approach normalizes addiction treatment. Patients receive care for substance use disorders in the same space where they manage diabetes or hypertension. The messaging is simple but powerful: this is healthcare, not stigma. Barriers drop. Engagement improves.
The research, published in Academic Medicine, represents an early but promising step. The team is already thinking beyond Cincinnati. They hope other academic medical centers will adapt the model to expand access to evidence-based addiction treatment and equip more primary care physicians with the skills and confidence to treat this epidemic. Binder emphasizes that future work will examine long-term patient outcomes and how these experiences shape physician practice years after residency ends.
The path forward is clear: if we want fewer Americans to suffer from untreated substance use disorders, we need more clinicians prepared to help. Embedding addiction care into primary care training, one clinic at a time, is how that happens.