Rethinking Recovery
For patients who have substance use disorder, this collaborative program offers empathy and treatment choices.
Substance use disorder has long carried stigma, making it difficult for those in need to receive treatment. Connie Greene, senior vice president, the Institute for Prevention and Recovery (IFPR), part of Behavioral Health Services at RWJBarnabas Health (RWJBH), was determined to change the way patients with substance use disorder were cared for. After applying for and receiving funding through the Opioid Overdose Recovery Program of the New Jersey Department of Human Services, she approached the then regional medical director of Emergency Medicine for RWJBarnabas Health, Chris Freer, DO.
"Dr. Freer became one of the most important partners for the evolution of this program," Greene says. With support from Dr. Freer, IFPR created the Peer Recovery Program (PRP), introducing recovery specialists with lived experience who could provide pathways to recovery and work within the clinical care team, advocating for treatments such as buprenorphine for individuals with opioid use disorder. These specialists helped change the perception of substance use disorder, allowing patients to receive treatment without judgment.
Together, Greene and Dr. Freer conceptualized the Tackling Addiction Task Force (TATF), a systemwide team that is focused on prioritizing and improving substance use disorder care across RWJBarnabas Health.
Signs of Substance Use Disorder
- Inability to limit or stop using a substance
- Increased tolerance, leading to higher or more frequent doses
- Continued substance use despite negative personal, legal or financial consequences
- Physical (tremors, sweating, vomiting) or emotional (anxiety, insomnia) symptoms when not using the substance
- Decline in performance of daily responsibilities
- Significant behavioral changes and secrecy to hide substance use
- Significant changes in weight or appearance and extreme fatigue
Source: The Substance Abuse and Mental Health Services Administration
Redefining Addiction
"No one uses a substance for the first time and thinks, 'I want to become addicted to this,'" says Greene. Yet, 12 to 15% of the U.S. population does become addicted due to genetic and environmental factors that alter brain function. "Substance use disorders are not a choice, but recovery is. Our team supports thousands of individuals in navigating their recovery every year," she adds.
Dr. Freer, now executive vice president and chief clinical officer for Acute Care Providers, RWJBarnabas Health, and his team of addiction specialists emphasize that substance use disorder is a treatable medical condition. "Just as there are medications for other medical conditions, there are medications for substance use disorders," he says.
RWJBarnabas Health leads the nation in prescription rates for medications for opioid use disorder, particularly buprenorphine. "We're demonstrating that there are effective care options for individuals with substance use disorder and reducing the barriers and stigma around those choices," Dr. Freer says.
Pathways to Recovery
When TATF and PRP launched a decade ago, treatment largely centered on abstinence. Today, the team embraces all pathways to recovery.
"Recovery is a highly personal journey based on the individual's goals," Greene explains.
Recovery specialists build trust with patients and rapport with the medical team by sharing their own recovery journey. Through conversations with patients, these individuals open a window to recovery.
The PRP began in the emergency department and now serves patients at all RWJBarnabas Health hospitals, ensuring that those with substance use disorder receive the same compassionate care as patients with any other medical condition. The program operates under the philosophy, "Meet people where they are with kindness and understanding."
"We're looking to create a gold standard for substance use care that can be replicated anywhere."
A Patient-Centric System
Greene is proud of the work the PRP has already accomplished, helping more than 100,000 patients and their families feel welcome and safe. "We've successfully changed the way individuals with substance use disorder are treated in our hospitals," says Greene. "Now, we're looking to create a gold standard for substance use care that can be replicated anywhere."
According to Dr. Freer, the goal is to keep growing by continuing to build out the medical team for addiction care. RWJBarnabas Health currently has two addiction physicians working with Emergency Hospital Medicine, but the aim is to double, then triple that number to expand TATF's imprint across New Jersey.
Dr. Freer adds, "We've made tremendous strides in treating and supporting individuals with substance use disorder in our system and want to continue to expand our program, reaching more families and communities across the state."
Learn More
Visit rwjbh.org/preventionandrecovery to learn more.
