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Development and Implementation of a Substance Use Disorder eConsult.
Journal of Addiction Medicine
|December 17, 2025
Summary
A new substance use disorder (SUD) eConsult service successfully connected primary care providers with addiction specialists, improving medication management for conditions like alcohol and opioid use disorder.
Area of Science:
- Addiction Medicine
- Digital Health
- Implementation Science
Background:
- Substance use disorder (SUD) presents significant challenges for primary care.
- Integrating specialized addiction expertise into primary care settings is crucial for effective patient management.
- eConsult platforms offer a potential solution for bridging this gap.
Purpose of the Study:
- To evaluate the types of SUDs addressed, medications recommended, and implementation of a novel SUD eConsult service.
- To identify facilitators and barriers to program implementation using the Practical, Robust Implementation and Sustainability (PRISM) model.
Main Methods:
- Retrospective analysis of 103 SUD eConsults from December 2020 to September 2024.
- Application of the PRISM model to assess contextual factors influencing program implementation.
Main Results:
- Alcohol and opioid use disorders were the most common reasons for eConsults.
- New pharmacotherapy was recommended in 65.1% of cases, with 58.2% of patients receiving prescriptions.
- Facilitators included existing infrastructure and specialist availability; barriers included clinician hesitancy and stigma.
Conclusions:
- The SUD eConsult program effectively extended addiction medicine expertise to primary care.
- The service supported pharmacotherapy initiation and management for patients with substance use disorders.
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