Back [[Framework to understand addiction management challenges]] _(Challenges within the healthcare/service team itself)_ ## Skill & Training Gaps - **Limited expertise**: Too few addiction-trained clinicians, generalist staff feel underprepared - **Knowledge deficits**: Lack of training in withdrawal management, motivational interviewing, harm reduction, medication-assisted treatment - **Skill mismatches**: Non-physician team members lack appropriate skills; peer workers need more support ## Attitudes & Stigma - **Moralizing views**: Some providers hold judgmental attitudes about addiction ("willfulness" vs. medical condition) - **Stigma within teams**: Embarrassment about working with addiction patients; viewing them as "difficult" - **Therapeutic alliance problems**: Non-empathic staff relationships, poor rapport, lack of trust ## Team Dynamics - **Workload issues**: High caseloads, burnout, staff shortage, fatigue - **Role conflicts**: Tensions between peer workers and program staff; unclear role boundaries - **Communication gaps**: Poor interdisciplinary coordination, lack of team meetings