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his mental health and primary care appointments, the patient and CES would process the appointments either by phone or in person.
Encouraged to address residual legal issues, the CES escorted the patient to court. The judge, who had seen the patient in the past, was so impressed with the patient’s progress, he dropped all
the courthouse, and with the assistance of the CES developed a payment plan. With his legal issues resolved, the CES escorted the patient to the Department of Motor Vehicles (DMV) to obtain a state ID and assisted him through his successful application for social security disability income (SSDI).
The CES also helped the patient connect to a sober social network including introducing him to 12-Step meetings which he now alcohol-free social and recreational skills critical to his improving from whom he had been estranged for many years. Recently he
Due to close collaboration between the inpatient medical staff at
the patient’s psychiatrist, and the patient’s primary care physician, the patient was able to realize a number of positive changes and results in his life.
In the nine months working with the CES, the patient attended
AA meeting and remained sober thus breaking a 43-year cycle diabetes and hypertension became well controlled, and his legal issues were resolved. Prior to entering the PE Community Program, over the past ten months. In the nine months following working visits. There was one ED visit due to a prescription medication interaction. After being contacted by the patient, the CES contacted
REFERENCES
1. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. The NSDUH Report: Substance Use and Mental Health Estimates from the 2013 National Survey on Drug Use and Health: Overview of Findings. Rockville, MD: September 4, 2014.
2. CSH, The Source for Housing Solutions. Frequent Users of Health Services Initiative. Available at: www.csh.org/.../frequent-users-of- health-services-initiative
the PE Social Worker who set up emergency appointments with the psychiatrist and the PCP to have this issue addressed.
CONCLUSION
Substance abuse has a severe impact on the individual, the family, and society, including hospitals, the criminal justice system, and social services. Substance abuse is ubiquitous, destructive, and hard to address because users are hard to engage. Project Engage
is effective. Experientially credentialed peer counselors, trained in early engagement strategies can forge therapeutic relationships with hospitalized patients helping them initiate and sustain recovery.
As this case presentation shows, success requires coordinated efforts of the hospital medical psychiatric teams, the Inpatient Engagement Specialist, the Project Engage Social Worker, and the Community Engagement Specialist. By working together this team helped facilitate a continuum of care that has enhanced long-term addiction recovery outcomes for this patient.
ACKNOWLEDGEMENTS
We wish to acknowledge the Inpatient Medical Team at
Specialist Peter Booras, Project Engage Community Specialist Franshawn Ricketts, Project Engage Social Worker Kim Jackson, Sandeep Gupta, MD, and Daniel Elliott, MD.
CONTRIBUTING AUTHORS
■ MARK D. LANYON, PH.D., ICADC, ICCDPD, LCDP, LCP, is the Project Engage Clinical Program Manager at Brandywine Counseling and Community Services in Wilmington, Del.
■ BEVERLY WILSON, MS, is Senior Program Manager of Project Engage at Christiana Care Health System in Newark, Del.
■ TERRY L. HORTON, M.D., FACP is Chief of the Division of Addiction Medicine at Christiana Care Health System in Newark, Del. and creator of Project Engage.
3.
4. 5.
Henry Ford Health System. (2014, May 18). Most emergency department ‘super-frequent users’ have substance abuse addiction. Science Daily. Available at: www.sciencedaily.com/ releases/2014/05/140518092635.htm
Walley AY, Paasche-Orlow M, Lee EC, et al. Acute care hospital utilization among medical inpatients. J Addict Med. 2012;6:50-56.
Pecoraro A, Horton T, Ewen E, at al. Early data from project engage:
a program to identify and transition medically hospitalized patients into addictions treatment. Addicti Sci Clin Pract. 2012:7:20.
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