There are plenty of cards stacked against substance use disorder (SUD) orgs in 2025: margins are tightening, waitlists are growing, and documentation constantly pulls providers away from care. And with workforce shortages worsening and policies like OBBBA creating even more financial instability, “working harder” isn’t enough to stay viable.
“In 15 years, we will be 500,000 clinicians short of capacity…and I think, not all, but a significant portion of that, is due to burnout from documentation.” – Dr. Denny Morrison, Chief Clinical Officer, Eleos
The good news (I promise, there is some): Purpose-built AI is already giving providers time back, strengthening compliance, and helping smaller non-profit SUD programs work smarter (not harder) to compete with larger, capital-backed organizations.
That’s what brought Dr. Denny Morrison, Chief Clinical Officer at Eleos, and Phil Rutherford, Vice President, Substance Use Continuum at the National Council for Mental Wellbeing, together for a recent webinar hosted by the National Council. They shared how technology can help address the challenges facing SUD orgs today and practical ways they can do more with less—right now and in the future.
Want to watch the full webinar? Catch the replay here.
SUD Challenges and Market Pressures
Even as SUD programs have evolved over the years, providers continue to experience many of the same challenges that stifled innovation and progress for decades.
Industry-Wide Fragmentation
The SUD landscape is incredibly fragmented. Small orgs are going through cycles of consolidation; providers are stretched thin by staffing shortages and administrative burdens; and there are too many payers and data silos, making it difficult for organizations to get paid.
“We need to be banding funding together, probably now more than ever, to make sure that we’re getting people served,” Rutherford explained. “But the data is a problem. The lack of access to real-time data sharing and sustainable payment models…that’s kind of what we’re seeing right now, and I do not believe the current model is sustainable.”
Without real-time data reporting and payment models that account for work that happens outside of therapy sessions—like outreach and care coordination—SUD providers won’t be able to support clients in a way that sustains recovery.
Continued Stigma Around Addiction
While mental health issues have become more widely recognized and supported in recent years—especially after the COVID-19 pandemic—substance use disorders are often still viewed as a choice rather than an illness. That stigma shows up in many ways, including the limited number of medications available for addiction treatment.
It also shapes how relapse is interpreted. For many chronic conditions—like diabetes, hypertension, or asthma—relapse is a sign to adjust treatment. Yet for people living with addiction, relapse is often met with blame instead of care. For that reason, substance use disorders do not receive the same amount of research or funding as other chronic conditions, which is a huge part of why the industry lags in treatment options.
As Dr. Morrison noted, “Addiction is the only [chronic condition] people get stigmatized for because they relapsed.”
The One Big Beautiful Bill Act (OBBBA) & Workforce Shortages
The passage of OBBBA has shaken up Medicaid funding in a big way. With roughly 10 million Americans expected to lose coverage in the coming years, behavioral health and SUD organizations are scrambling to figure out how they’ll continue serving clients who depend on Medicaid for care.
Get experience-driven insights on what to do about OBBBA from Dr. Denny Morrison, a former behavioral health CEO.
With workforce shortages on top of OBBBA pressures, SUD organizations will have to redesign the way work gets done—starting with tackling one of the industry’s biggest pain points: documentation.
“What it boils down to is that organizations are going to have to do more with less,” said Rutherford.
Why Documentation Became So Complex—and What Needs to Change
Documentation is arguably one of the biggest day-to-day challenges for the people actually providing SUD care. But before looking for solutions, it’s worth understanding how documentation became so demanding in the first place.
In the 1970s and 1980s, behavioral health lacked consistent standards—and, in some cases, accountability. As a result, regulators and payers tightened requirements to prevent vague or fraudulent billing. That was necessary at the time—but over the years, the pendulum swung too far. Today, SUD providers often spend more time documenting care than actually delivering it.
Part of the challenge also stems from the lack of objective measures in behavioral health. Because SUD and mental health conditions are “stigma-based,” we’ve underinvested in science that could help these fields develop the same level of measurable clarity that exists in other areas of health care.
While the burden is real, it doesn’t have to be a permanent blocker—at least not anymore. To do more with less—while maintaining quality and compliance standards—SUD organizations are increasingly turning to tech innovation.
How Technology Can Solve SUD Challenges
With all the challenges facing SUD providers, there’s never been a more important time to think beyond the traditional tech stack.
“I believe some of the answers to the challenges we’re talking about now exist in the AI space,” said Rutherford. “Leveraging technology to do some of the work that previously we have not had the manpower to do, and also increasing some of the efficiencies or [solving] scale problems that we haven’t been able to address.”
Reducing Documentation Burden
Documentation is one of the most universal pain points across behavioral health and SUD care. As Rutherford put it, “People don’t get into this work because they want to fill out forms.”
Providers enter the field to help people heal, yet they spend hours each day on administrative tasks that add little value to the therapeutic process.
AI can help shift this balance. By securely capturing session data and generating high-quality note drafts, solutions like Eleos allow clinicians to review and finalize notes in minutes instead of hours—without compromising compliance. That means more time for care, less provider burnout, and a better experience for clients and clinicians alike.
Solving the Group Therapy Dilemma
With upwards of 95% of treatment happening in group settings, SUD programs face an even greater documentation challenge.
To help ease this unique burden, Eleos captures live group sessions in real time, distinguishes between speakers, and drafts a single compliant group note—along with individualized summaries for each participant. That means providers can stay present and engaged with the group—and finish their documentation post-session with just a few clicks.
Curious how Eleos works for group therapy in the SUD setting? Hear about Gaudenzia’s experience with Eleos in this webinar.
Leveling the Playing Field for Smaller Orgs
Small to medium-sized SUD organizations don’t always have the staff or funding to continue business as usual in uncertain funding environments. That’s where AI can act as a “force multiplier,” giving teams more capacity without adding headcount.
“Technology will make it easier for these smaller to mid-sized organizations to compete,” explained Rutherford. “It will level the playing field.”
By reducing documentation time, identifying compliance risks early, and lowering administrative costs, smaller providers can focus resources where they matter most—on client care and recovery outcomes.
Creating a Clearer Value Story with Better Data
In addition to driving operational efficiency, AI is laying the foundation for more consistent data collection at scale—moving SUD organizations closer to truly value-driven care.
Specialized ambient AI can detect and organize key insights from each session—such as evidence-based techniques used, therapy themes, client engagement, and indicators of progress. Over time, this helps organizations build objective datasets they can use to demonstrate the impact of their services to payers, regulatory bodies, and policymakers.
The ROI of AI in SUD Care
The cost of new technologies can be a deterrent for many SUD orgs. In fact, 36% of viewers on the webinar reported in a live poll that upfront cost and return on investment concerns are the biggest barriers their organization faces when considering new technology solutions like AI.
However, Rutherford challenged leaders to flip the script: “What’s the cost if you don’t do it?”
The return on investment (ROI) for solutions like Eleos is easy to see. In fact, organizations using Eleos Documentation report up to 80% time savings on notes with its live session audio solution. Even when audio capture isn’t appropriate or a client prefers not to use it, providers can switch to a quick bullet-point text summary mode and decrease documentation time by 70%, so efficiency gains hold up in any setting.
“Even the clinicians who were reticent about even trying it became advocates of it, because it really did save their time and energy,” Dr. Morrison shared, recalling a current Eleos customer’s experience.
How Eleos Reduces Costs
Unlike general AI chat tools, Eleos is purpose-built for behavioral health and SUD documentation. That specialization helps ensure the creation of clinically relevant notes—which in turn reduces downstream denials and clawbacks.
The impact is felt by teams, too: organizations see 2x higher client engagement and 20% lower clinician turnover as time shifts from paperwork back to people. Some teams even use Eleos as a recruiting tool, helping attract clinicians with the promise of better work-life balance.
Want to see how Eleos can help your organization cut costs and ramp up revenue? Check out our detailed ROI analysis.
How to Choose a Technology Partner Responsibly
As pivotal as it is to invest in technology, it’s just as important to choose the right partner.
Here’s what behavioral health and SUD organizations should look for when implementing an AI solution:
- Confirm the AI is purpose-built for SUD and behavioral health (and steer clear of general chatbots repackaged to look like clinical tools).
- Check for SOC 2 certification and other emerging AI compliance standards (like ISO 42001).
- Look for transparency about how the AI model works and where the data goes.
- Ask whether the system stores audio or client data, and whether you can opt out of data sharing or model training.
For everything you need to know about choosing the right AI partner for your organization, check out our Complete Guide to Behavioral Health AI Implementation.
What SUD Leaders Can Do Today & in the Future
If you’re leading an SUD organization, the most important AI move is simply getting started.
“Look for a particular pain point and try to work on that,” Rutherford advised. “Set a 90-day, six-month, or maybe even a year [timeline], but pick a time, a pain point, and see what you can do to fix it.”
Next, look for people within your organization who are already interested in AI. It’s helpful to get their input on how it may benefit your organization on a day-to-day basis, and they can help pilot the new solution.
Then, widen your net: Talk to two or three peer organizations using the solutions you’re considering, and ask for candid feedback about results, support, and change management.
Finally, as Dominic Miller, LCSW, MPA, stated on a recent episode of the No Notes podcast: “Don’t panic, pivot.”
“Rethink the business, both in terms of a technological adaptation and also a business philosophy, and think about how to do the work that needs to be done in a different way,” said Dr. Morrison. “I think using these technologies is really one of the best ways to change that.”
In a moment defined by OBBBA uncertainty, workforce shortages, and enduring stigma, progress will come from rethinking both technology and operations. Simply put, the name of the game right now is working smarter, not harder.
Feeling like the deck is stacked against your SUD org? Put AI to work as your force multiplier. See Eleos in action.
