Unlocking Locum Tenens Opportunities in Addiction Medicine: A Guide

As addiction medicine continues to grow as a distinct subspecialty, many physicians are searching for flexible ways to practice, explore different care settings, and build a sustainable career. Locum tenens work—temporary physician assignments that can range from a few days to many months—has become an attractive route for addiction medicine specialists at all stages, from recent fellowship graduates to seasoned clinicians.

This guide explores how locum tenens opportunities fit into an addiction medicine career, how to prepare during residency or an addiction medicine fellowship, and how to evaluate and negotiate assignments—especially if you’re considering travel physician jobs or balancing locum work with other professional goals.

---

Understanding Locum Tenens in Addiction Medicine

Locum tenens (Latin for “to hold the place of”) refers to temporary physician coverage when a facility has gaps due to vacancies, leaves of absence, expansion of services, or seasonal demand. In addiction medicine, this often means filling essential roles in community clinics, hospital consult services, detox units, or correctional health programs that might otherwise go understaffed.

Where Addiction Medicine Locum Tenens Jobs Exist

Addiction medicine positions are still fewer in number than some other specialties, but the landscape is expanding. Common settings include:

• Outpatient addiction clinics

  • Office-based opioid treatment (OBOT) programs
  • Methadone clinics (opioid treatment programs, or OTPs)
  • Integrated primary care and behavioral health practices
  • Federally Qualified Health Centers (FQHCs)

• Hospital-based roles

  • Inpatient addiction consultation (liaison) services
  • Medical floors, ICUs, and EDs with high rates of substance-related admissions
  • Inpatient detox or withdrawal management units
  • Psychiatric units that manage co-occurring disorders

• Community and public sector

  • Veterans Affairs (VA) facilities
  • Public health departments
  • State or county-funded treatment programs
  • Correctional facilities and re-entry programs

• Telehealth

  • Remote MAT (medications for addiction treatment) clinics
  • Hybrid models (on-site initial evaluations with telehealth follow-up)
  • Rural or underserved regions leveraging virtual care

Assignments may be part-time, full-time, or a mix; some locum tenens physicians develop long-term relationships with a single system by recurring at the same site.

Why Facilities Recruit Locum Tenens Addiction Medicine Physicians

Several forces drive demand:

• Escalating overdose crisis and increased emphasis on evidence-based treatment
• Workforce shortages, especially in rural and underserved areas
• Program expansion, e.g., new MAT clinics or hospital consult services
• Coverage gaps for maternity leave, sabbaticals, turnover, or administrative restructuring
• Pilot programs testing addiction medicine services before hiring permanent staff

For you as a physician, this means a wide range of practice environments and patient populations—ideal if you value variety, want to explore different models of care, or are still refining your long-term career path.

---

Is Locum Work Right for You? Pros, Cons, and Career Fit

Before diving into travel physician jobs in addiction medicine, it’s important to understand how this model can shape your professional trajectory.

Potential Advantages

1. Flexibility and control of schedule

   • Choose when and where you work.
   • Take breaks between assignments for board exam study, research, family, or travel.
   • Adjust your workload seasonally (e.g., lighter during children’s school breaks or heavy months to maximize savings).

2. Exposure to diverse practice models

   • Compare:
     • OTP vs office-based MAT
     • Academic vs community vs correctional settings
     • Integrated psychiatric/addiction vs siloed programs
   • This real-world exposure can guide your eventual choice of a permanent job or inform how you’d design a program you may lead in the future.

3. Geographic exploration

   • Try life in urban centers, mid-size cities, or rural communities before relocating.
   • Explore regions with strong recovery ecosystems, robust community partnerships, or innovative harm reduction approaches.

4. Potential for competitive compensation

   • Many addiction medicine locum roles offer:
     • Hourly or daily rates that can be higher than a salaried starting position
     • Travel, housing, and malpractice coverage
   • Well-structured locum work can help rapidly pay down loans or build savings.

5. Skill-building and career agility

   • Enhance skills in:
     • Rapid assessment and stabilization
     • Managing high-acuity withdrawal and complex poly-substance use
     • Cross-disciplinary collaboration (social work, psychiatry, primary care, peer support)
   • Locum tenens experience signals adaptability—often valued in leadership and systems-level roles.

Potential Disadvantages and Trade-offs

1. Less stability and predictability

   • Income can fluctuate depending on assignment length and gaps between contracts.
   • Scheduling far in advance is not always guaranteed; sometimes start dates shift.

2. Limited continuity of care

   • Many addiction medicine physicians prize long-term relationships with patients.
   • Short assignments can hinder seeing the full trajectory of recovery or relapse prevention.

3. Variable institutional cultures

   • Some facilities are strongly recovery-oriented and multidisciplinary; others are still developing their approach.
   • You may encounter:
     • Limited resources
     • Stigma among staff toward patients with substance use disorders
     • Misalignment with your treatment philosophy (e.g., policies discouraging MAT)

4. Benefits and career development

   • Locum tenens work often means:
     • No employer-sponsored retirement match (unless via long-term contracts)
     • You are responsible for your own health insurance, disability coverage, and retirement planning
   • Less built-in mentorship and fewer structured academic opportunities (though not impossible).

Signs Locum Tenens May Be a Good Fit

You might thrive in addiction medicine locum work if you:

• Enjoy adapting quickly to new teams and EMR systems
• Value autonomy and are comfortable with less overhead support at times
• Have strong communication and boundary-setting skills
• Are open to travel and living in new places (or at least short-term)

You may prefer a permanent role first if you:

• Strongly value stable long-term patient relationships
• Want to develop a specific research or academic niche early
• Need predictable income and benefits (e.g., for family planning or mortgage qualification)

---

Training Pathways: Building Toward Locum Tenens in Addiction Medicine

If you’re still in residency or an addiction medicine fellowship, you can deliberately prepare for future locum tenens opportunities.

Educational Pathways Into Addiction Medicine

Common routes include:

• Addiction Medicine Fellowship

  • Typically 1-year ACGME-accredited programs for physicians from internal medicine, family medicine, psychiatry, emergency medicine, and other primary specialties.
  • Provides robust clinical training in:
    • MAT (buprenorphine, methadone in some settings, naltrexone)
    • Management of alcohol, benzodiazepine, and other substance withdrawal
    • Co-occurring psychiatric and medical conditions
    • Legal, regulatory, and public health aspects of substance use care
  • Strongly recommended if you want maximum flexibility and credibility for future locum roles.

• Addiction Psychiatry Fellowship

  • For psychiatrists who then add addiction expertise.
  • Often very attractive for hospital-based consult services or programs targeting co-occurring disorders.

• Experience-based pathways (for some states and systems)

  • In certain contexts, robust experience plus waiver training allows physicians to work in addiction medicine, though formal fellowship increasingly sets a competitive standard.

Skills That Make You a Strong Locum Candidate

Focus on developing the following during residency or fellowship:

1. Clinical breadth

   • Comfort managing:
     • OUD, AUD, stimulant use disorders, sedative-hypnotic use, and polysubstance use
     • MAT initiation in varied settings: ED, inpatient, outpatient, correctional
   • High-yield experiences:
     • Rotations in detox/withdrawal units
     • ED-initiated buprenorphine programs
     • Co-occurring psych/addiction clinics

2. Procedural and systems skills

   • Managing complex withdrawal protocols
   • Familiarity with:
     • State Prescription Drug Monitoring Programs (PDMPs)
     • OTP regulations and DEA requirements
   • Leading or participating in quality improvement projects focused on addiction care.

3. Documentation and regulatory literacy

   • Precise documentation of:
     • Diagnosis and level of care indicated
     • Risk assessments (suicide, overdose, diversion)
     • Coordination with behavioral health and social services
   • Understanding billing and coding basics for addiction visits and MAT.

4. Communication and interprofessional collaboration

   • Working productively with counselors, social workers, peer recovery coaches, nursing, and pharmacy.
   • Clear, non-stigmatizing patient communication, essential in high-turnover locum settings.

Certifications and Licenses That Boost Marketability

• Board Certification
  • American Board of Preventive Medicine (ABPM) – Addiction Medicine
  • American Board of Psychiatry and Neurology (ABPN) – Addiction Psychiatry
• Buprenorphine prescribing
  • As of 2023, the federal X-waiver requirement was removed, but many sites still expect comfort and experience with buprenorphine prescribing and regulatory compliance.
• State licenses
  • Multiple active state licenses significantly increase your locum options.
  • Compact licenses (if applicable) can streamline work across several states.

Plan licensing early—many travel physician jobs stall because of slow state board processing.

---

Finding and Evaluating Addiction Medicine Locum Tenens Positions

Once you’re ready to explore locum tenens opportunities, you’ll need to navigate agencies, negotiate contracts, and thoughtfully select assignments that align with your values.

Where to Find Opportunities

1. Locum Tenens Agencies

   • Many large agencies now have dedicated behavioral health and addiction recruiters.
   • Benefits:
     • Assistance with licensing, credentialing, and travel logistics
     • Malpractice coverage (often claims-made with tail included)
   • Consider working with 2–3 agencies to broaden your options while maintaining manageable communication.

2. Direct-to-hospital or clinic contracts

   • Some addiction programs recruit locum tenens physicians directly, especially:
     • OTPs needing consistent coverage
     • Health systems piloting new consult services
   • Pros:
     • Potentially higher pay (no agency margin)
     • Closer relationship with program leadership
   • Cons:
     • More personal responsibility for contract review, malpractice, and logistics.

3. Professional networks and societies

   • ASAM (American Society of Addiction Medicine) job boards and listservs
   • State addiction medicine societies or listservs
   • Colleagues and mentors who know of programs needing temporary coverage

4. Telehealth platforms

   • Some companies specialize in remote MAT and SUD care.
   • These can often be combined with in-person locum assignments.

Key Questions to Ask About Any Locum Assignment

When a recruiter presents an addiction medicine fellowship graduate or experienced physician with a potential role, ask detailed questions:

Clinical Scope and Expectations

• What substances are most prevalent? (OUD, AUD, methamphetamine, fentanyl, etc.)
• Is MAT (buprenorphine/methadone/extended-release naltrexone) routinely offered? Are there philosophical or institutional barriers?
• What is the typical patient volume per day?
• Are you expected to manage:
  • Co-occurring psychiatric conditions?
  • Chronic medical comorbidities (e.g., HIV, HCV, cirrhosis)?
• Is there call? Nights? Weekends? In-person vs phone?

Team and Support

• What other disciplines are on-site (psychiatry, internal medicine, psychology, social work, peer coaches)?
• Is there on-site therapy, case management, and recovery support?
• Who handles prior authorizations, lab follow-up, and coordination of care?

Safety and Environment

• What security measures exist if working in higher-risk settings (EDs, correctional, homeless outreach)?
• How are behavioral crises handled? Is there a rapid response or security protocol?

Systems and Logistics

• What EMR is used? Is there training and on-site support?
• How long are appointment slots? New vs follow-up?
• Are there structured protocols for:
  • Withdrawal management
  • MAT induction
  • Overdose prevention (naloxone distribution)

Ethical and Philosophical Alignment

• How does the program view harm reduction (e.g., syringe services, naloxone, MOUD continuity for incarcerated patients)?
• Are there any policies that conflict with your standards of care (e.g., forced tapering, refusal to continue MAT)?

Document answers carefully; they will guide your choice and negotiation.

Evaluating Compensation and Contract Terms

Locum tenens physician compensation in addiction medicine varies by:

• Region (rural often pays more)
• Setting intensity (inpatient/hospital consult vs outpatient clinic)
• Call responsibilities
• Urgency of need

Important points:

• Pay structure

  • Hourly, daily, or per-shift rates
  • Overtime or after-hours rates
  • On-call compensation vs in-house coverage

• Covered expenses

  • Travel (flights, rental car, mileage)
  • Housing (hotel vs corporate apartment)
  • Licensure and DEA costs for the state

• Malpractice coverage

  • Occurrence vs claims-made with tail
  • Adequate limits given the nature of addiction medicine practice

• Cancellation and guarantee clauses

  • Guaranteed minimum number of hours/days per month
  • Compensation if the facility cancels shifts or terminates early

Consider having an attorney or experienced colleague review your first few contracts, especially if you’re negotiating directly without an agency.

---

Practical Tips for Succeeding as a Locum Tenens Physician in Addiction Medicine

Beyond choosing the right assignment, your success depends on how effectively you integrate into new environments and maintain professional sustainability.

Before You Start: Preparation Checklist

1. Licensing and Credentials

   • Ensure:
     • State license is fully active
     • DEA registration covers the assignment state
   • Maintain updated:
     • CV with precise dates
     • Board certification and CME records
     • Immunization and health records
     • Reference list (supervisors, fellowship directors, colleagues)

2. Clinical Readiness

   • Refresh knowledge on:
     • Local controlled-substance regulations and PDMP rules
     • Current MAT guidelines and dosing strategies
     • Management of complex withdrawal (including polysubstance and fentanyl-related patterns)
   • Prepare personal quick-reference materials:
     • Favorite detox protocols
     • Patient education scripts on MOUD
     • Safety plans and relapse prevention handouts

3. Personal Logistics

   • Consider:
     • Housing arrangements that support adequate rest
     • Transportation, especially in rural areas
     • Strategies to maintain personal wellness (exercise, sleep, nutrition, social connection)

First Days on Assignment: How to Onboard Efficiently

Treat your first days as a rapid “needs assessment”:

• Clarify roles and expectations

  • Meet with site leadership to confirm:
    • Daily schedule and patient mix
    • How referrals come to you
    • How to reach on-call psychiatry, medicine, or security
  • Ask for:
    • Policies for high-risk scenarios (overdose, suicidality, domestic violence, child welfare reporting)
    • Protocols for missed appointments and early refills

• Get oriented to key staff

  • Intake coordinators and front-desk: they shape patient flow and no-show rates.
  • Nurses and MAs: often your closest collaborators.
  • Behavioral health staff: crucial partners in recovery planning and crisis support.

• Learn the EMR quickly

  • Ask for:
    • Order sets for withdrawal, MAT, and standardized labs
    • Templates for intake, follow-up, and safety assessments
  • Build or adapt note macros to promote accuracy and efficiency.

Clinical and Ethical Best Practices

In addiction medicine locum work, you may inherit complex patients with limited prior records. A few guiding principles:

• Stabilize first, optimize later

  • Prioritize safety: withdrawal control, overdose prevention, continuity of life-saving medications.
  • Avoid abrupt changes (e.g., sudden MOUD discontinuation) unless clearly indicated and well-documented.

• Document risk and rationale meticulously

  • For high-risk prescribing decisions or changes in therapy, explain:
    • Why you’re continuing/adjusting MAT
    • How you assessed diversion risk and safety
    • Coordination with prior prescribers if applicable

• Avoid punitive care

  • Approach missed doses, relapses, and positive tox screens as clinical data, not moral failures.
  • Advocate for trauma-informed, non-stigmatizing care—even if the local culture is still evolving.

• Build bridges for continuity

  • Whenever possible:
    • Arrange warm handoffs to permanent clinicians before your departure.
    • Provide clear outpatient plans in the chart and in patient-facing language.
    • Encourage naloxone distribution and overdose education at all transitions.

Protecting Your Own Sustainability

Locum work can be intense, especially in high-need addiction settings. Safeguard yourself by:

• Setting boundaries

  • Clarify after-hours expectations and triage responsibilities.
  • Protect off-days, especially if you’re far from home and support systems.

• Debriefing and support

  • Dealing with recurrent overdose deaths, trauma, and social adversity can be emotionally taxing.
  • Identify:
    • Peers or mentors for debriefing
    • Structured supervision or consultation groups (even via teleconference)

• Investing in your professional growth

  • Maintain membership in professional societies (e.g., ASAM).
  • Attend conferences and complete CME focused on:
    • Emerging substances and trends
    • New pharmacologic and behavioral interventions
    • Policy and advocacy work in addiction medicine

---

Integrating Locum Tenens Into a Long-Term Addiction Medicine Career

Locum work doesn’t have to be an “all or nothing” career choice. Many physicians creatively combine it with other professional goals.

Common Career Models Incorporating Locum Work

1. Bridge to Your First Permanent Job

   • Use 6–18 months of locum tenens post–addiction medicine fellowship to:
     • Explore different regions and systems
     • Clarify what you want in a long-term role (academic vs community, inpatient vs outpatient)
   • This can strengthen your bargaining position when negotiating your first permanent contract.

2. Portfolio Career

   • Combine:
     • Part-time permanent clinic or academic position
     • Periodic locum assignments (e.g., a hospital consult service in another state several times per year)
     • Telehealth sessions from home
   • This structure diversifies income and clinical experience.

3. Seasonal or Sabbatical-Based Locum Work

   • Some physicians plan:
     • Several months of intensive locum work annually
     • Followed by time for research, writing, global health, or family responsibilities

4. Late-Career Flexibility

   • Senior physicians may exit full-time leadership or academic roles but maintain:
     • Occasional locum tenens assignments
     • Teaching or mentorship engagements
   • This can prolong clinical contribution while reducing administrative burdens.

How Locum Experience Enhances Your Professional Profile

• Systems insight

  • Exposure to multiple models of addiction care gives you credibility in:
    • Consulting on program development
    • Leading quality improvement initiatives
    • Advocating for policy changes at institutional or regional levels

• Adaptable leadership

  • If you’ve successfully integrated into multiple different teams, you can:
    • Identify workflow bottlenecks quickly
    • Serve as a bridge between disciplines
    • Mentor teams in evidence-based addiction practices

• Negotiation leverage

  • Understanding real-world pay scales, staffing ratios, and resource ranges across settings helps you negotiate realistic and fair terms in any permanent or leadership role.

---

FAQs: Locum Tenens in Addiction Medicine

1. Do I need to complete an addiction medicine fellowship before doing locum work in this field?

Not strictly, but it is highly beneficial. An accredited addiction medicine fellowship greatly strengthens your clinical foundation and marketability. Some locum tenens physician roles in primary care or psychiatry-heavy settings allow non-fellowship-trained clinicians with strong addiction experience. However, for more specialized or hospital-based addiction roles, fellowship training and board certification are increasingly expected and provide a clear advantage.

2. Can I do locum tenens addiction medicine jobs right out of fellowship?

Yes. Many new graduates start with locum tenens assignments while they:

• Decide on a preferred practice setting
• Test different regions for long-term relocation
• Pay down loans with higher short-term income

Just ensure you have appropriate mentorship or supervision available (informal or formal), maintain strong professional networks, and are comfortable handling complex cases with relative autonomy.

3. How does being a locum tenens physician affect my malpractice risk in addiction medicine?

Most agencies or hiring facilities provide malpractice coverage, often with tail coverage included. Addiction medicine does involve specific risks (overdose, diversion, co-occurring psychiatric crises). You can mitigate risk by:

• Practicing evidence-based care (especially for MAT)
• Documenting risk assessments and clinical reasoning clearly
• Avoiding abrupt changes to life-sustaining medications without clear documentation and planning
• Knowing local regulations and institutional protocols

Always verify coverage details and consider additional personal coverage if needed.

4. Is it possible to combine locum tenens work with academic or research careers in addiction medicine?

Yes, but it requires planning. Options include:

• Holding a part-time academic appointment while doing locum work during specific blocks
• Selecting locum assignments near your academic home institution
• Using locum work in off-peak academic months (e.g., summer) while focusing on research or teaching during the academic year

Be transparent with your department about your schedule and ensure that locum commitments don’t conflict with your academic obligations.

---

Locum tenens opportunities in addiction medicine can offer an exciting combination of flexibility, diverse clinical exposure, and meaningful impact during a national overdose and addiction crisis. Whether you are in residency, an addiction medicine fellowship, or already in practice, understanding how to navigate locum work—and how it can fit into your broader career vision—will help you make informed, sustainable choices.