Introduction Internationally, clinical/practice supervision is considered essential in the development and maintenance of professional proficiency across health disciplines. Among alcohol and other drug (AOD) workers, however, access to effective clinical supervision is limited. This study examined perceived barriers and facilitators to: (i) AOD workers accessing effective clinical supervision; and (ii) effective implementation of a clinical supervision exchange model in the AOD sector. Methods Qualitative interviews with frontline workers (n = 10) and managers (n = 11) employed by eight government and non‐government AOD treatment services in Brisbane, Australia were undertaken. Interviews were audio recorded, transcribed and data were thematically analysed. Results Frontline workers and managers shared similar views. Reported barriers and facilitators to accessing effective clinical supervision included limited time, the high cost of providers, availability of skilled clinical supervisors, supervisor–supervisee matching and supervision modality. Participants considered the implementation of a clinical supervision exchange model to be a resource‐effective strategy to increase access to external, individual clinical supervision while also exposing workers to a greater diversity of perspectives, increasing sector collaboration and improving the perceived value of clinical supervision among the workforce. Discussion and Conclusions The findings of this study suggest that limited time, cost and availability of skilled supervisors are primary barriers to AOD workers accessing high‐quality clinical supervision. Implementation of a clinical supervision exchange model is perceived by frontline workers and service delivery managers to be a resource‐effective strategy for increasing access to high‐quality clinical supervision among workers.