Importance: Substance use disorders are associated with high rates of emergency department (ED) use and challenges engaging with primary care services.

Question: Is an intervention to connect patients undergoing addiction treatment to primary care practitioners associated with long-term improved engagement with primary care?

Findings: This post hoc analysis of 5-year follow-up data from a nonrandomized controlled trial with 503 participants found that LINKAGE intervention participants, relative to usual care, were more likely to discuss substance use problems with primary care practitioners, use the electronic patient portal, and have relative annual increases in primary care use and relative annual decreases in substance use–related emergency department utilization.

Meaning: In this study, a patient activation intervention provided with addiction treatment was associated with improved long-term health care engagement patterns.