Mini Mindset: Substance Use Disorder — Opening the Door to Better Care

You don’t have to work in addiction medicine to care for patients with substance use disorders. Substance use shows up across healthcare—from psychiatry and primary care to emergency medicine, pediatrics, and hospital settings—and it often intersects with anxiety, insomnia, trauma, depression, chronic pain, and relationship stress. In this Mini Mindset episode, Jessica Spissinger and Mercedes Dodge break down practical ways clinicians can recognize substance use disorder, reduce stigma, and feel more confident starting the conversation. In this episode, we discuss: • Why shifting from “Why won’t you stop?” to “What is this substance doing for you?” can change the clinical encounter • The 4 Cs of substance use disorder: control, craving, compulsion, and consequences • How SBIRT can help clinicians screen, intervene, and connect patients with treatment • Using motivational interviewing to move from judgment to curiosity • Evidence-based treatment options for alcohol and opioid use disorders • Harm reduction and the importance of meeting patients where they are • Why alcohol and sedative withdrawal require careful safety assessment • The role of therapy, contingency management, peer support, and other recovery resources Substance use disorder is not a failure of willpower. It is a treatable medical condition influenced by biology, environment, learning, trauma, relationships, and the brain’s reward system. And treatment does not always begin in an addiction clinic. Sometimes it begins with one clinician asking the right question and creating a safe space for an honest conversation. Listen now and follow PA Mindset Matters for more Mini Mindset episodes translating psychiatry, behavioral health, and neuroscience into practical clinical care.