Clinical Initiatives & Special Programs
The Division of Addiction Research and Treatment has been a pioneer in driving evidence-based approaches to OUD treatment for the past several decades. This effort is evident on several fronts, from innovative clinical treatments to education initiatives at the medical student and postgraduate trainee level. These endeavors represent a level of excellence that is demonstrated by several long standing clinical service and basic research grants.
National Leadership in Telemedicine: Our Division has been a national leader in the utilization of telemedicine applications to treat individuals with Opioid Use Disorders (OUD), The current opioid epidemic has disproportionally impacted rural areas, which are ill-equipped to handle this problem.
The Division provides Medication Assisted Treatment via telemedicine to patients in underserved communities.
These unserved areas lack access to life saving Medication Assisted Treatment (MAT). Our division developed a program to deliver buprenorphine treatment-- one of the medications approved for the treatment of OUD – using video-conferencing, a type of telemedicine. We're are currently collaborating with substance abuse treatment programs at five different sites and have treated approximately 500 patients. Our outcomes are excellent, demonstrating that telemedicine patients do as well as patients that are seen in person. We are currently providing these services in Caroline, Dorchester, Garrett, Talbot, and Washington Counties. We're recognized as national leaders in this type of work, a vanguard in providing buprenorphine treatment to patients in underserved areas. Recently we were awarded both a federal and foundation grant to expand this work. Additionally the Division has partnered with the State of Maryland in the development of the Maryland Addiction Consultation Service. This is an innovative program that provides telephone warm line consultation to front line providers who need support with patients that have substance use and pain issues.
Current and Pending Clinical Service Initiatives
Baltimore Buprenorphine Initiative
Initiated in 2006, this model program involves a collaborative approach between the City of Baltimore and several health providers to eliminate barriers to buprenorphine treatment.
Eastern Shore Mobile Care Collaborative at the Caroline County Health Department (ESMCC)
ESMCC is a Mobile Treatment Unit that aims to increase access to care by providing Medication Assisted Treatment (MAT) for individuals with Opioid Use Disorders (OUD) in under-served rural communities in order to maximize access to life-saving treatment and develop a model of care that can be adopted by other under-served rural areas with similar needs. To learn more, visit: www.easternshoremobilecare.org.
Emergency Department (ED) Buprenorphine Initiative
Funded by Open Society Institute, this outreach initiative developed protocols for engaging patients with Opioid Use Disorders (OUDs) in MAT in Baltimore Emergency Departments (EDs), in collaboration with the Mosaic Group. Currently, protocols have been implemented in six EDs (including UMMC), with plans to initiate protocols in all city Emergency Departments.
Maryland Addiction Consultation Service (MACS)
This initiative provides support to primary care and specialty prescribers' across Maryland in the identification and treatment of Substance Use Disorders and chronic pain management. To learn more, visit www.marylandmacs.org.
Methadone Treatment Program
As the first hospital-based methadone program in the state of Maryland (in place since the 1970s), our drug treatment center has long embraced a tradition of integrating rigorous, empirically validated approaches for the treatment of Opioid Use Disorder (OUD). 500+ patients are currently receiving treatment in the program. Along with the Baltimore Buprenorphine Initiative and the Deaf Addictions Program, this program Is located at 1001 West Pratt Street.
Overdose Survivor Outreach Program (OSOP)
OSOP provides peer recovery coaches for outreach to overdose survivors from the UMMC Emergency Department, linking overdose survivors into care and providing training in the use of naloxone.
Screening, Brief Intervention and Referral for Treatment (SBIRT) Project
Initially funded by the state of Maryland, this project establishes SBIRT support with peer recovery coaches in the Emergency Department at the University of Maryland Medical Center (UMMC). Current program funding allows for four peer recovery coaches. As part of this initiative all Emergency Department patients are screened for substance use disorders. The peer recovery coaches then intervene with patients with positive screens, and do a brief intervention and referral for treatment. When indicated they will follow-up with patients after discharge.
Substance Abuse Consultation Service
Founded in 1989 the program is one of the first and well developed of its kind in the nation. The program’s multi-disciplinary team provides consultation to hospitalized medical and surgical patients that have co-morbid substance use disorders. It is a major teaching service for medical students and residents from a variety of specialties. The service has been a leader in engaging these individuals in substance use treatment including MAT while being treated in the hospital for their medical issues.
The Division of Addiction Research and Treatment has established collaborations with addiction treatment programs in Caroline, Garrett, and Washington Counties. This has allowed medication assisted therapy (MAT) to be provided via videoconferencing to patients with opioid use disorders in these under-served communities.
SAMSHA: STIRR-IT Co-located HIV/HCV TX in a Substance Use Setting, 2018-2023 - $250,000 per year for 5 years
HRSA: Evidence-Based Tele-Behavioral Health Network Program, 2018-2021 - $300,000 per year
CareFirst: “Expanding Access to Medication-Assisted Treatment in Rural Areas with the Use of Telemedicine” 2018-2020 - $110,000 per year
Deaf Addiction Services at Maryland (DASAM): DASAM has provided services for deaf and hard of hearing individuals with substance use disorders from the state of Maryland for the past 17 years. Funding for expansion of this program is pending.
1001 West Pratt Drop in Center: The Drop in Center provides patients from our community addiction programs a place to spend time during the day. Initially open 3 days a week and staffed by a peer recovery coach, long term plans include a variety of recovery services; work support programs; access to computers; support in obtaining benefits; and exercise and nutrition education.
Reverse Colocated Primary Care Practice at 1001 West Pratt: This initiative will provide primary care, urgent care, wound care, and infectious disease treatment for active patients at our 1001 West Pratt Programs programs. This is a population based initiative to improve care for our patients and curb the costs of preventable Emergency Departments and inpatient hospital care. Thanks to a generous seed grant of $100,000 dollars from a private donor, we anticipate launching the practice by autumn 2018.
Workforce Development for Individuals in Recovery: To improve outcomes for patients with opioid use disorders, this program Identifies barriers preventing these individuals from obtaining work and developing strategies and interventions to improve the situation. Development of this initiative is in progress.
Skilled Nursing Facilities (SNF): With numbers of individuals with OUD in skilled nursing facilities increasing rapidly, this initiative provides services including Medically Assisted Treatment in Skilled Nursing Facilities. Development in progress.
Sports Psychiatry & Performance Psychology Program: The Division has operated the nation’s most successful Sports Psychiatry Program since 1996. The Program works with athletes and teams from more than 35 different sports at all competitive levels, including the Baltimore Ravens (NFL) and Orioles (MLB), to help establish team-based mental health, substance abuse, and mental skills services.
The Maryland Center of Excellence on Problem Gambling: This Center offers training for counselors throughout the state to provide services for individuals with gambling problems. It maintains a helpline for individuals and conducts on-going public awareness outreach to the citizens of Maryland. With its help website, it connects individuals looking for help with no-cost counseling in their community.
Clinical Neurobehavioral Center (CNC): The Clinical Neurobehavioral Center (CNC) is dedicated to conducting research combining neuroscientific, behavioral-pharmacological, and clinical-psychological methods into an integrated program of human laboratory and clinical outpatient research and treatment studies, which are designed to identify new medications that are effective for the treatment of various subpopulations of individuals with substance use disorders.