What role can primary care play in helping people with substance use disorders find treatment and recovery?
In this episode of Beyond Substance, Dean Babcock speaks with Dr. Maria Robles about integrating substance use disorder treatment into primary care, including medication, behavioral health support, peer recovery services, and coordinated care. Dr. Robles is a dual board-certified physician specializing in internal medicine and addiction medicine. She provides primary care and substance use disorder treatment in the outpatient setting. She also developed and currently runs an inpatient addiction medicine consult service. Dr. Robles has a passion for teaching and works with the Indiana University School of Medicine Internal Medicine program and with the Medical School. She provides lectures and develops curriculum. Dr. Robles strives to have a patient-centered approach which allows her to connect with patients who are at all stages of recovery.
Then, Jodi Miller shares the story of Sam Ferling, a nurse who hid an opioid addiction while continuing to work and raise her children. Now in recovery, Sam brings her lived experience into her work with patients, using it to strengthen empathy, trust, and advocacy.
Together, the conversations explore what can happen when health care professionals listen closely, respond without judgment, and make treatment available when someone is ready for help.
A Look at the Numbers:Primary care is often the first point of contact for most health concerns. However, it is not consistently used to screen, diagnose, or monitor SUD—even though SUD is a chronic, long‐lasting condition similar to asthma or high blood pressure. Similar to other chronic conditions, SUD can require ongoing management. Understanding the scale of this issue and recognizing the need for ongoing monitoring helps explain why integrating SUD treatment into primary care could make a meaningful difference.
SUD affects millions of Americans. According to the 2024 National Survey on Drug Use and Health, over 48 million Americans aged 12 and older had a substance use disorder. This includes nearly 28 million people with alcohol use disorder and 28 million with a drug use disorder. These conditions often occur together, as about one in six people experienced both alcohol and drug use disorders at the same time.
The survey also found that access to treatment for SUD remains limited. It estimated that of those who needed treatment in 2024, only 23 percent received it. Among adolescents, the gap was even greater: 93 percent of teens aged 12 to 17 with an SUD did not receive treatment.
Despite the need for care, many people with SUD faced significant barriers to treatment. In 2024, 45 percent of people with SUD reported they didn’t seek care because they thought it would be too expensive, and almost 40 percent reported they didn’t know where to go or how to get treatment.
Primary care can play a key role in reducing barriers to SUD treatment. This is particularly true in rural areas, where long travel distances make it harder for people to reach specialty care. As of 2025, only 14 percent of behavioral health treatment facilities
in the U.S. were in rural communities, with less than half of them specializing in
substance use treatment.
Primary care is especially critical during transitions, such as when someone leaves residential treatment and returns home. During this time, individuals often lose contact with counselors or case managers, increasing the risk that early symptoms go unnoticed. When primary care is integrated into the system, it provides consistent follow-up where recurrence can be identified early and reconnection to services is more accessible.
Integrating substance use disorder screening, diagnosis, and medication treatment into routine primary care visits can strengthen early diagnosis, ensure continuous patient support, and expand access to treatment by providing these services directly within the primary care system people are already relying on.
Episode Hashtags#BeyondSubstance, #RecoveryIsPossible, #SubstanceUseDisorder, #AddictionRecovery, #PrimaryCare, #AddictionMedicine, #OpioidUseDisorder, #LivedExperience, #Healthcare, #Nursing, #RecoverySupport, #Buprenorphine, #MOUD, #MentalHealth, #ShawnPNeal, #AdvoCast
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Podcast Information:- Hosted by: Dean Babcock & Jodi Miller
- "A Look at the Numbers" Host: Allie Martin
- Executive Producer: Shawn P Neal
- Produced and Mixed at AdvoCast Leadership Advisory's Studio236
Beyond Substance explores substance use prevention, treatment, recovery, public health, and the people working to build healthier communities through informed conversations and evidence-based perspectives.
Topics:Substance Use, Recovery, Prevention, Public Health, Mental Health, Community Health, Healthcare, Education
Hashtags:#BeyondSubstance #SubstanceUse #Recovery #RecoveryMatters #Prevention #PublicHealth #MentalHealth #CommunityHealth #Healthcare #HealthEducation