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This paper examines the impetus and existing evidence on programs that integrate employment services with treatment and recovery services for people with opioid and other substance use disorders (SUDs). It includes an overview of the nature and recent history of SUDs and their treatment, including the important role that employment can play in recovery, and discusses the factors that historically limited the role of employment services in treatment programs. It also provides a brief review of the limited but promising evidence on the effectiveness of integrating substance use disorder treatment and employment services in improving participants’ employment outcomes.