There is a longstanding challenge in addiction care: we have treatment and recovery support services that work, yet many individuals will never receive them. Individuals with substance use disorder must overcome many financial and logistical barriers to accessing treatment, such as finding a provider, stigma, and navigating a fragmented behavioral health care system (McGovern et al., 2013; Louie et al., 2021). Even when individuals overcome these challenges, the chances that they will receive services backed by science — such as contingency management, medication for opioid use disorder, or cognitive behavior therapy — is low. Effective services often fail to reach addiction care settings, which contributes our nation’s ongoing substance use crisis (Ducharme et al., 2024; McGovern et al., 2025).
