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The Road to Treating Substance Use Disorder Starts in the Primary Care Office
For a groundbreaking offering in the treatment of substance use disorders, ChristianaCare’s Family Medicine residency program team received a Wellness Hero Award in the 2024 Delaware Lt. Governor’s Wellness Leadership Challenge. ChristianaCare was recognized for creating “a comprehensive program designed to address the pressing need for behavioral health services in Delaware.” ChristianaCare’s Family Medicine residency established a substance use disorder treatment program in 2020 to identify and provide targeted substance abuse treatment to patients in need and, importantly, to train future providers in the specific and unique issues that patients with addiction often face in primary care settings. “The purpose,” said James LaRosa, M.D., associate residency program director, “is to create an eager and competent workforce of providers ready to help this population.” LaRosa, an alumnus of ChristianaCare’s Family Medicine residency, is also lead for the Family Medicine substance use disorder treatment program. “James was intentionally recruited to our program to carry the torch for this important work,” said Erin Kavanaugh, M.D., FAAFP, chair of Family and Community Medicine. “He has taken the program and department to new heights, particularly in terms of grant-funded work and educational opportunities, all anchored in dedication to comprehensive patient care and improved outcomes.” “Family medicine practitioners take a holistic approach so patients receive personalized and consistent care for better health and well-being for them and their communities,” said Anna Filip, M.D., FAAFP, director of the residency program. “With opportunities like the substance use disorder treatment program, we are preparing the next generation of doctors to treat the whole person.” At the 2024 presentation, then-Lt. Gov. Bethany Hall-Long praised the program for “its impact on closing the gaps in treatment capacity for those with substance use disorders” and “taking measurable steps to expand access to care in our community.” The primary goal of the program is to support patients through withdrawal, LaRosa said. Patients identified for the program via ChristianaCare’s hospitals and emergency departments are connected with the Family Medicine Department to open the door to primary care. The program also provides vital social supports for these patients through the robust ChristianaCare network. “We utilize the services of our in-house social work, behavioral health and case management teams to help provide wraparound services to a population where those things are as crucial as the medical care,” LaRosa said. Third-year resident Deanna Gorgei, D.O., said she chose ChristianaCare’s Family Medicine residency for its “forward-thinking and innovative leadership” who support residents in exploring their interests in the field. One of her interests in addiction medicine. “Not only are residents like me getting this experience in how to treat different substance use disorders, but we’ve also gained exposure on how to set up a program like this,” she said. “It’s been a huge part of my training and has shaped my interest going forward.” Family medicine provides an especially effective setting to treat substance use disorders, in part because its providers are qualified to identify and treat comorbid conditions like hepatitis as well as a host of other illnesses and injuries. “Since starting the program,” said LaRosa, “we have stabilized multiple patients’ chronic medical conditions, identified and treated a patient with bladder cancer, and cured 26 cases of hepatitis C.” Combining care for substance use disorder with primary care, said Gorgei, is appealing for residents and fosters better patient experience and outcomes. “I like being able to have both opportunities,” she said. “It’s so beneficial to have addiction medicine rotate with routine primary care, because it is primary care.”
