Medication for Alcohol and Opioid Treatment Clinic, Addiction Medicine Consultation Service, Substance Use Disorder Programs

The outpatient alcohol and opioid use disorder clinic at Grady Memorial Hospital provides comprehensive outpatient care (ASAM Level of Care 1.0) for patients with AUD and/or OUD. Funded by the Department of Behavioral Health and Developmental Disabilities, the clinic provides:

• Medications for AUD and OUD management (e.g., buprenorphine, extended-release naltrexone)
• Group and individual counseling
• Peer support
• Case management
• Access to psychiatric and medical services at no cost to patients who are uninsured

The patient population faces many challenges not typically seen in other office-based treatment settings including high rates of job insecurity, housing instability, trauma, severe concurrent substance use disorders, and untreated psychiatric and medical comorbidities. 

Fellows work collaboratively with the entire care team--faculty trained in Addiction Medicine, Addiction Psychiatry, and Medical Toxicology; Certified Drug and Alcohol Counselors (CADC's); and Certified Addiction Recovery and Empowerment Specialists (CARES)--to develop and implement care plans for patients in various stages of recovery. The clinic serves a unique population for an outpatient treatment program, seeing patients who experience high rates of homelessness, job insecurity, and lack health insurance. The MAOT clinic is also one of the few programs in the state that serves pregnant women with OUD.

Housed under the Section of Medical Toxicology, Department of Emergency Medicine, Addiction Medicine consults are available to the Emergency Department and inpatient services 24/7.

Bedside consultations are performed to manage complicated alcohol and benzodiazepine withdrawal, provide recommendations regarding novel substances of abuse, and assess and manage opioid use disorder (OUD), including ED- and inpatient-based initiation of MOUD with buprenorphine.

LINCS UP
Linking Individuals Needing Care for Substance Use Disorders (LINCS UP) is a Peer Recovery Coach (PRC) program that supports Grady Memorial Hospital Emergency Department + hospital patients with linkage to a broad range of recovery resources for patients with non-alcohol substance use disorders. Available virtually and in-person, the PRCs continue working with patients after they are discharged from the hospital to provide ongoing support. Peer recovery coaches are individuals in long-term recovery with specialized training who through shared experience offer motivational interviewing and linkage to resources according to the needs and desires of the individual. 

LINCS UP is funded by the Centers for Disease Control (CDC 5R01CE003509) in partnership with the GA Council for Recovery.The program is led by Dr. Joe Carpenter and Dr. Alaina Steck from the Emory Emergency Medicine team, Nicholas Giordano, PhD, RN, from Emory Nursing, and Umed Ibragimov MPH PhD, from Florida State University.

REAL TTIME
Rural Expanded Access to OUD Care and Linkage Using Toxicologists for Telehealth-Initiated TreatMEnt (REAL TTIME) provides training to rural ED providers to help identify patients requesting treatment for OUD, presenting with acute opioid withdrawal, or following an acute opioid overdose, and will call the Georgia Poison Center (GPC) to be connected to the on-call toxicologist. Using telehealth and the existing infrastructure at GPC, our toxicologist will support rural ED providers in managing acute opioid withdrawal and evaluating for OUD to assist the rural ED provider with initiating buprenorphine (Suboxone)/MOUD. The REAL TTIME team will also support and provide linkage to local community services through Georgia Council for Recovery (GC4R), local Peer Recovery Coaches and Recovery Community Organizations (RCOs), and referral to the nearest outpatient OUD treatment provider(s), along with information about state-funded behavioral health and social services.

REAL TTIME is funded by Health Resources and Services Administration, HRSA, (G28RH46273). The program is led by Emory EM team members Dr. Emily Kiernan, Dr. Joe Carpenter, Dr. Alaina Steck, and Patrick Filkins, PharmD, BCPS, DABAT from Georgia Poison Center.