Organizing Publicly Funded Substance Use Disorder Treatment in the United States: Moving Toward a Service System Approach

Howard Padwa, Darren Urada, Patrick Gauthier, Traci Rieckmann, Brian Hurley, Desirée Crèvecouer-MacPhail, Richard A. Rawson

Research output: Contribution to journalArticlepeer-review

16 Scopus citations


Historically, publicly funded substance use disorder (SUD) treatment services in the United States have been disorganized and inefficient. By reconfiguring and linking services to create systems of care—services, structures, and processes that are purposively interconnected to treat SUD systematically—health systems can transform discrete service components into cohesive service systems that comprehensively and efficiently treat SUDs. In this article we: (1) articulate the potential benefits of organizing publicly funded SUD services into systems of care; (2) review basic principles underlying theories of SUD system organization; (3) describe the mix and configuration of services needed to create comprehensive, integrated systems of publicly funded SUD care; (4) elucidate how patients can flow through systems of SUD services in a clinically sound and cost-efficient manner, and; (5) propose eight steps that can be taken to create systems of care by identifying and leveraging the strengths, assets, and capacities of SUD service providers already operating within their health care systems. In July 2015, the Centers for Medicare and Medicaid Services (CMS) announced opportunities for states to redesign their Medicaid-funded SUD service systems. This paper provides considerations for SUD system design and development.

Original languageEnglish (US)
Pages (from-to)9-18
Number of pages10
JournalJournal of Substance Abuse Treatment
StatePublished - Oct 1 2016


  • Medicaid
  • Organized delivery systems
  • Public policy
  • Substance use disorder services

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health


Dive into the research topics of 'Organizing Publicly Funded Substance Use Disorder Treatment in the United States: Moving Toward a Service System Approach'. Together they form a unique fingerprint.

Cite this