Importance: Digital health technologies may expand organizational capacity to treat opioid use disorder (OUD). However, it remains unclear whether these technologies serve as substitutes for or complements to traditional substance use disorder (SUD) treatment resources in health care organizations.

Question: How often are digital health technologies for opioid use disorder used by US health care organizations, and which organizational features are associated with their use?

Findings: In this cross-sectional study using data from a national survey of 276 organizations with accountable care organization contracts, 34% used at least 1 category of technology, including remote mental health therapy and tracking (27%), virtual peer recovery support programs (15%), and digital recovery support for adjuvant cognitive behavior therapy (9%). Organizations with traditional substance use disorder resources were significantly more likely to use technologies.

Meaning: These results suggest that health care organizations use digital health technologies as complements to, rather than substitutes for, traditional resources.