Office-Based Addiction Treatment (OBAT) brings evidence-based care for alcohol, opioid, stimulant, and nicotine disorders into the same primary care and behavioral health clinics where patients already receive trusted services. This page converts OBAT from a good idea into a reliable clinic workflow: universal screening during vitals; same-day warm handoffs; and registry-driven follow-up that tracks cravings, function, sleep, and safety across the panel. We lay out how nurses, peers, counselors, and prescribers share work—brief motivational conversations, linkage to medications for OUD/AUD, contingency management for stimulants, and practical help with benefits, IDs, and transport—so change starts at the first visit, not the third referral. If you’re comparing playbooks at an office-based addiction treatment conference, you’ll find order sets for induction (including micro-inductions), laboratory bundles that avoid low-value testing, and visit-flow templates that fit 15–30-minute slots without sacrificing dignity. Equity is designed in: interpreters, evening/tele options, and pharmacy partnerships for on-the-spot starts reduce silent barriers that keep people sick. Partner pages—like Long-Acting MOUD—add details for injectables when daily dosing is a hurdle.

Reliability is the difference between hoping for retention and actually getting it. We map same-day starts for buprenorphine, naltrexone, or acamprosate with plain-language consent and hepatic/renal checks; outline perioperative/pain coordination so procedures don’t derail recovery; and script missed-dose rescue (grace windows, bridges) to prevent avoidable lapses. For stimulants, we integrate contingency management and CBT for craving and cue control, coupled with sleep/circadian repair that strengthens executive control. Tobacco treatment is opt-out: combination NRT or varenicline with quitline/digital supports, and antipsychotic-level checks when smoking status changes. Youth and perinatal pathways protect confidentiality and safety, while older-adult care accounts for falls, cognition, and polypharmacy. Dashboards surface nonresponse and disparities by language or neighborhood; weekly huddles tune staffing and protocols. OBAT works best when success is measured in life outcomes—work/school, caregiving, housing stability—not just negative tests. Build humane, fast, and flexible routines, and the clinic becomes a doorway to steadier sleep, fewer crises, and more days that feel possible.