More Than Medication: Partnering for Better Opioid Treatment in Primary Care
- jameliahand
- 5 days ago
- 6 min read
Updated: 4 days ago
By Jamelia Hand MHS CADC CODP I
In 2004, I was leading a medical stabilization program at a hospital. Our job was to admit patients experiencing intoxication or withdrawal, usually for a brief 2–3 day stay, assuming they didn’t have other co-occurring conditions. During that time, my team would work quickly to find a treatment provider who could support their recovery long-term. Even though I wasn’t delivering clinical services at that time, I was a certified substance use counselor and I cared deeply about what happened to patients once they left our care.
But the truth is, many of them came back. Month after month.
I knew their names. I knew their stories. I saw the revolving door up close and it worried me. Not only because it was a sign that we weren’t solving the problem, but because it placed a heavy and expensive burden on an already overwhelmed hospital system. We needed new solutions. Ones that didn’t end when a patient was discharged.
Take Darius, for example. He was a familiar face at our hospital. A well-known member of the community, Darius led his church choir and had a beautiful singing voice. His routine was almost like clockwork, he would admit himself on Thursday and make sure he was discharged in time for Sunday service. He was kind, respectful, and very open with us. He didn’t want to keep using drugs. He just didn’t know how to stop. Darius, like many others, needed a different type of support. Not just detox. Continuity. Care. A plan.
So I started going out into the community. Office-Based Opioid Treatment (OBOT) was still relatively new. At the time, very few providers in Illinois were treating opioid use disorder with buprenorphine, and even fewer were willing to treat up to the full SAMHSA/CSAT cap of 30 patients for their first year. Only five. Five providers who were ACTIVELY treating across the state.
I’d introduce myself to them as a counselor providing free education on substance use disorders. I’d ask to speak with them about reducing treatment barriers for patients. Barriers like addiction counseling as anadjunct to medication, lack of transportation, rigid appointment times, stigma, or the need for daily clinic visits. I wasn’t selling anything. I was trying to build something. I believed that if we created real partnerships between the medical and behavioral health community, we could begin to break the cycle.
That’s when I met Dr. Dora Dixie.
She worked out of the county hospital and one of its satellite clinics. The first time I visited her, she only had a few minutes, but she used every one of them to make me feel welcome. We talked about our roles, our families, about patients, and about the future of addiction treatment. I told her about the patients I was supporting. Many of them were working or trying to get back to work. They wanted flexibility to go on family vacations. They wanted to “feel less like an addict” as Darius once said. They didn’t want to be tied to a clinic every day. Dr. Dixie got it. We were aligned.
Over time, I referred hundreds of patients to her, and we stayed in contact. Each week she made time for an update, and i’d share additional resources like housing, transportation, childcare, or food assistance. We didn’t just make referrals. We helped people get their lives back.
Later, I took a position with the manufacturers of Suboxone. Even then, I brought that same counselor heart with me. I used my new platform to educate, support, and expand the number of providers treating with buprenorphine. And I continued helping my father at home, who was also struggling with opioid dependence. But that’s another story.
This one is about what counselors and physicians can accomplish together.
Enter Dr. Elias Rivera
A gentleman I will refer to as “Dr. Rivera” was a family physician on the South Side of Chicago who started treating patients with buprenorphine after losing a cousin to overdose. He was also in recovery. When I first met him, he had just begun prescribing and wasn’t sure what to expect. We met for coffee, and I brought along some patient education materials and talked to him about how counselors could serve as a lifeline for both the provider and the patient.
He admitted something I’ll never forget, “I know how to manage the medication, but I don’t always know what to say when the tears start.”
That’s when the partnership became clear. Dr. Rivera needed someone he could call when a patient was falling apart emotionally or navigating trauma. I made myself available, introduced him to peer support groups, and helped him set up a process to work with local counselors and case managers. Within a few months, he told me his practice had become one of the most fulfilling parts of his career.
He also started calling me just to check in on patients, on programming, and even on my father. That kind of compassion matters.
Why Addiction Counselors Matter in Primary Care
Many counselors don’t realize the role they can play in expanding access to medication-assisted treatment (MAT). You don’t need a medical license to make a difference. You have clinical insight, experience with recovery planning, and a deep understanding of the social drivers that affect your clients’ success. Your voice matters.
Here are some actions counselors can take this week:
• Visit a doctor’s office (or 2) in your area: You don’t need an appointment. Introduce yourself and ask if you can leave information about services.
• Try this opener:
“Hi, my name is [Your Name], and I often refer patients to your clinic. I’d love to speak with Dr. [Physician’s Name] to talk about how we can strengthen our partnership.”
• Offer to present at local primary care meetings or hospital in-services on substance use, engagement strategies, or harm reduction.
• Bring data or stories: Share success stories of patients who’ve benefited from integrated care.
• Help problem-solve: Ask physicians what their biggest challenges are in treating patients with OUD and offer real, actionable support.
• Stay in touch: Send a follow-up email or call every few weeks with updates and encouragement.
Ways Physicians and Their Team Can Strengthen Collaboration
Physicians also have an important role to play. Consider:
• Reaching out to local counseling agencies and ask to meet with a counselor or clinical director. Or, host an open house at your clinic and invite them to see where you treat patients.
• Including counselors in patient care plans or warm handoffs, especially when someone is starting buprenorphine for the first time.
• Referring patients to multiple support services, not just MAT, many will need help with housing, job readiness, or child custody.
• Asking questions and staying curious about the emotional, cultural, and social context of your patient’s addiction.
• Taking a moment to check in with your community partners not just for updates, but for encouragement.
Physicians like Dr. Dixie and Dr. Rivera understood this. They didn’t just treat symptoms. They helped people rebuild their lives. And they reminded me that when we work together, we’re not just creating access, we’re creating hope.
Final Thoughts and a Call to Action
Partnerships between physicians and counselors aren’t just a nice idea. They’re necessary. People are falling through the cracks every day, not because they don’t want help, but because the system makes it hard to get what they need.
So here’s what you can do this week:
• Counselors: Pick one provider you’ve referred to before and check in. See how they’re doing. Ask how you can support them. Offer a resource.
• Physicians: Reach out to a counselor or treatment agency in your area. Invite them to share insight or explore collaboration.
• Both: Think of one patient who could benefit from a stronger connection between your services, and take one step to close that gap.
At Vantage Clinical Consulting, we help bridge those gaps every day. Whether it’s technical assistance, staff training, or helping communities launch new programs, we bring lived experience, real-world tools, and decades of systems knowledge to the table. Let’s build together.
We all have a role. We all have responsibility. Let’s make next week better than the last, for us and for the people we serve.
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