It sounds radical, but what if substance use isn’t a disorder but a survival strategy for coping with trauma, poverty, or pain? The real issue isn’t in the brain or body but what’s happened to and around them. Recovery doesn’t require another diagnosis, but rather understanding, support, and meeting people where they are. Are we ready to have that conversation?

The contemporary behavioral healthcare model, while well-intentioned, is fundamentally limited by outdated methodologies and technologies. The sporadic nature of in-office and televisits, coupled with rudimentary follow-up mechanisms, creates a discontinuous care experience that fails to capture the nuanced, day-to-day realities of patients’ lives. Aaron Reichlin, MD, leads efforts to revolutionize mental health service delivery.

Substance use disorder (SUD) recovery is a complex, lifelong process requiring coordinated support across health care, social services, and community systems. Unlike other chronic conditions, SUD is episodic and has uniquely high stakes due to the lethality of the current drug supply. The lethality of today’s drug supply means that a gap in care or a recurrence of symptoms can quickly become fatal.