San Antonio, Texas is confronting a deepening addiction treatment crisis with too few clinicians trained to address it, and two University of Texas campuses are now working to change that. A $501,215 federal grant from the Substance Abuse and Mental Health Services Administration (SAMHSA) will fund a three-year program to embed substance use disorder training into the curricula at UT Health Science Center San Antonio (UTHSCSA) and UT San Antonio (UTSA).

The stakes are significant in a city where fentanyl overdose deaths have climbed sharply since 2020, proximity to the U.S.-Mexico border has made drug trafficking a persistent problem, and the demand for addiction care far outstrips the supply of providers. Texas ranks near the bottom nationally in mental health providers per capita, and Bexar County carries federal Health Professional Shortage Area designations for behavioral health.

The program, called Substance Use Education in the Interprofessional Setting (SEIS), targets physician assistant and clinical psychology students at UTHSCSA and clinical mental health counseling students at UTSA. Both schools are federally designated Hispanic-Serving Institutions, and the grant specifically focuses on San Antonio's Hispanic community, which makes up roughly 64 percent of the city's population. Hispanic residents nationally face lower rates of addiction treatment engagement due to stigma, language barriers, and a lack of culturally competent providers, a pattern documented in Bexar County as well.

The program also zeroes in on the city's large military and veteran population. Joint Base San Antonio, which spans three major installations, makes the metro one of the largest military communities in the country. Veterans and active-duty service members experience substance use disorders at an estimated 1.5 to 2 times the civilian rate, often alongside PTSD and chronic pain, yet a 2023 RAND Corporation study found that only about half receive treatment.

The curriculum centers on SBIRT, a framework for screening patients for substance misuse and intervening early, alongside trauma-informed care approaches. Training physicians, psychologists, and counselors together is central to the design, reflecting research showing that providers who train across disciplines collaborate more effectively in practice. SAMHSA has invested over $1.5 billion in SBIRT-related training since 2003.

Over three years, the program aims to train at least 275 students and professionals total, with at least 250 students introduced to evidence-based SUD screening and intervention strategies across the two campuses. Faculty development is also built in, with workshops designed to sustain the curriculum after the grant period ends.

The grant was awarded on September 30, 2024. Whether the training pipeline it builds can keep pace with San Antonio's growing treatment gap remains an open question, particularly as the fentanyl crisis continues to intensify across South Texas.