According to National Survey on Drug Use and Health, 16.5% of U.S. adults had a substance use disorder (SUD) in 2021. Despite this high prevalence, up to 93.7% of adults with SUD do not receive treatment. In the past year, 96.8% of adults with a SUD who did not receive treatment at a specialty facility did not think they needed treatment. If only 3.2% of people with SUD feel they need treatment, how do we engage the other 96.8% of people who may not acknowledge a need for and/or be ready to seek care? This workshop is will begin by reviewing current epidemiological trends on pursuit and receipt of treatment by individuals with SUD. Next, we will review social determinants of health (SDoH), including race and ethnicity, as they relate to SUDs. We will consider the importance of recognizing and addressing SDoH in patients with SUD as a strategy to engage and retain patients in care. We will then illustrate the concept of ‘no wrong door’ and ‘meeting patients where they are at’ through motivational interviewing (MI). We will showcase MI skills for engaging patients who may otherwise be deemed ‘difficult’ to engage. We will conclude with a robust interactive discussion of cases by participants and presenters. This workshop is a collaboration between the AADPRT Addictions Committee and AAAP Education Committee in an ongoing effort to strengthen partnerships between the organizations.