Despite the high prevalence of substance use disorders among hospitalized patients, hospital-based addiction care across the U.S. remains inconsistent, a Cedars-Sinai behavioral health leader told Becker’s.
“What’s not variable is the prevalence of alcohol and substance use disorders in hospitals,” Itai Danovitch, MD, chairman of the department of psychiatry and behavioral neurosciences at the Los Angeles-based health system, said. “About 1 in 10 patients that present to the ED and/or the hospital have a substance use disorder.”
Substance use disorders often compound patients’ medical conditions rather than exist alongside them.
“Frequently the substance use disorder is exacerbating, amplifying, complicating or causing their medical problems. It’s really significant,” Dr. Danovitch said. “The failure to address the substance use disorder while addressing other health issues or in other medical problems is a major failure and opportunity. There’s a big need there.”
While the prevalence is consistent, hospital response is not, he said. Urban academic medical centers are often well resourced, but many nonacademic rural and critical access hospitals have limited or no dedicated addiction services.
One of the biggest pain points is ensuring patients are connected to care after discharge, Dr. Danovitch said. Cedars-Sinai’s nearly 1,000-bed hospital handled more than 130,000 emergency visits in 2025. It created a nonclinical role to help bridge that gap.
“We have a substance use navigator whose role is dedicated to helping connect patients who can be discharged from the ED in need of substance use services after they leave,” Dr. Danovitch said.
Bridge programs also play a key role in smoothing the transition from hospital to outpatient care, reducing the number of patients who fall through the cracks.
Barriers to hospital-based addiction care include stigma, limited resources and workforce strain.
“Some hospitals have outdated procedures and protocols and some don’t even have the FDA-approved medications to treat substance use disorder on their formulary,” Dr. Danovitch said. “It’s really incumbent on us in hospitals to address addiction like the disease that it is, and to address it like other chronic diseases that have acute manifestations or exacerbations.”
