This paper aims to understand the impact on student learning of redesigning an elective substance use course with the intent of contextualizing the topic by modeling a structural critical lens. In addition, we look at how this shift impacts students' approaches to working with clients who use substances. Secondary data from student course evaluations were used to determine themes. The findings reinforce the value of a social work approach, the need to rebalance individual and society's responsibility for substance use, the necessity of a critical structural lens, new skills students learned, and the existing gaps students have identified in relation to integrated substance use practice.