A national sample of addiction treatment Program Directors (N = 296) were assessed regarding their attitudes about pharmacological treatment for addiction disorders. Multivariable analyses indicate that directors who worked in organizations affiliated with research institutions and who had more professional experience had significantly more positive attitudes about a range of pharmacological therapies. Also, directors in organizations serving higher percentage homeless clients and clients with severe and persistent mental illness had more negative attitudes toward use of buprenorphine. Community-based organizations providing addiction treatment to specific vulnerable client groups exhibit more negative attitudes about pharmacological evidence-based practices and may underutilize those practices.