Treatment for substance use disorder: Opportunities and challenges under the Affordable Care Act.

Addiction is a chronic brain disease with consequences that remain problematic years after discontinuation of use. Despite this, treatment models focus on acute interventions and are carved out from the main health care system. The Patient Protection and Affordable Care Act (2010) brings the opportunity to change the way substance use disorder (SUD) is treated in the United States. The treatment of SUD must adapt to a chronic care model offered in an integrated care system that screens for at-risk patients and includes services needed to prevent relapses. The partnering of the health care system with substance abuse treatment programs could dramatically expand the benefits of prevention and treatment of SUD. Screening, Brief Intervention, and Referral to Treatment (SBIRT), the subject of National Drug Abuse Treatment Clinical Trials Network protocols CTN-0047 (SMART-ED) and CTN-0057-Ot (SBIRT-PC), is cited as an effective strategy in identifying and intervening drug problems in emergency departments and primary care and improving health outcomes. Expanding roles of health information technology and nonphysician workforces, such as social workers, are essential to the success of a chronic care model.

This article by the Director of the Center for the Clinical Trials Network (CCTN, Dr. Tai) and the Director of the National Institute on Drug Abuse (NIDA, Dr. Volkow) is part of a special issue of the journal Social Work in Public Health about “The Role of Social Work in the Prevention and Treatment of Substance Use Disorders” that includes a number of articles about the National Drug Abuse Treatment Clinical Trials Network (CTN). See [*URL*] for more information about the issue.

Related protocols: CTN-0047, CTN-0057-Ot