Collaborative care is an evidence-based model of integrated mental health in primary care settings that shows clear and significant effectiveness for the treatment of depression, anxiety, and PTSD. Widespread implementation of Collaborative Care is now occurring across the country to answer the need for increased access for mental health treatment. Concurrently, there is a growing need for the treatment of substance use disorders, which often present in the primary care setting where they have traditionally been inadequately addressed. The core principles of Collaborative Care suggest that this model would lend itself to effectively working with patients with substance use disorders in the primary care setting. And now, with the widespread implementation of Collaborative Care, it makes sense to leverage this existing model’s resources and workflow at a clinic to include the treatment of substance use disorders. However, there are also challenges inherent in this model that need to be addressed for this expansion in scope to occur such as how to incorporate Medication Assisted Treatment (MAT) into treatment, adding medical treatment to manage physical consequences of substance use disorders and managing stigma. The promise of a collaborative care model for substance use disorders and primary care is a powerful one that if done correctly and dynamically can make a significant impact on minimizing harm from addiction.