Patients with comorbid substance use issues and cancer are some of our most vulnerable patients who require specialized care that is not widely available. There is currently no designated provider, nor clinic or standard operating procedure (SOP) for patients with concurrent substance use disorder (SUD) and cancer. This results in a referral to supportive medicine on most occasions, and the clinicians in that clinic do not have the staff or programmatic support to treat these patients optimally. As City of Hope grows and seeks to be a top tier cancer center, this need will increase and this is a step to establish a better approach this patient population's care. 

Our ability to identify concurrent SUD is improving and it is a very niche specialty that typically requires a cautious balance between trying to maintain sobriety while appropriately treating cancer-related pain and symptoms. In the past, these patients were typically triaged and referred out, eliminating the pressing need that is currently being experienced in City of Hope Orange County. There is not a robust community referral base, and typically have an imperative need to treat, so patients can receive their cancer care.