Dr. Terry Horton is a national expert and recognized authority on addiction, substance use disorder, and the integration of addiction medicine into various health care settings.
He is the chief of ChristianaCare’s Division of Addiction Medicine and a nationally recognized authority on substance abuse. He is also medical director for Project Engage, an award-winning, pioneering early intervention for hospitalized patients with substance use disorder.
Launched in 2008, Project Engage integrates peers in recovery, who are called engagement specialists, into the clinical setting in the hospital to meet with patients at their bedside about their alcohol or drug use. The program identifies individuals at their reachable moment in the hospital and acts on it.
Project Engage has drawn national attention for its innovative approach and success in reducing health care costs and utilization by reducing emergency room visits and hospital stays.
Dr. Horton is regularly interviewed by the national press, including The New York Times and the Associated Press, and has appeared more than 40 times on local and national television and radio, including CBS News, ABC News and CNN.
Areas of Expertise (5)
Substance Use Disorders
Addiction and Primary Care
Jefferson Medical College: MD 1987
Brown University: BA 1983
Media Appearances (3)
Asking About Opioids: A Treatment Plan Can Make All The Difference
The hospital's chief of addiction medicine, Dr. Terry Horton, worked to make questions about opioid use standard protocol because emergency room doctors at ChristianaCare see about 300 patients a month go through withdrawals. It's called Project Engage.
Data-sharing struggles slow Delaware commission's review of fatal overdoses
The News Journal
"I understand the impatience," said Dr. Terry Horton, who serves as the chair of the commission. "But this is a method to last, in some levels, in perpetuity. We're creating a method that will be here for this drug epidemic and the next and the next and the next. And I hope we create a model that is worthy of being able to provide that."
Whip-Its: Brief Highs, Big Dangers for Demi Moore?
Nitrous oxide interacts with the brain's reward system to cause "out-of-body, mild, hallucinatory, euphoric-type stuff," said Dr. Terry Horton, chief of addiction medicine at ChristianaCare Health System in Wilmington, Del. "To some folks, that's appealing."
Selected Papers and Publications (20)
Can Substance Use Disorders be Managed Using the Chronic Care Model? Review and Recommendations from a NIDA Consensus GroupPublic Health Reviews volume
A. Thomas McLellan PhD, Joanna L. Starrels MD, MS, Betty Tai PhD, Adam J. Gordon MD, MPH, Richard Brown MD, MPH, Udi Ghitza PhD, Marc Gourevitch MD, Jack Stein PhD, Marla Oros RN, MS, Terry Horton MD, Robert Lindblad MD & Jennifer McNeely MD, MS
Brain imaging and genetic studies over the past two decades suggest that substance use disorders are best considered chronic illnesses. The passing of the Affordable Care Act in the United States has set the occasion for integrating treatment of substance use disorders into mainstream healthcare; and for using the proactive, team-oriented Chronic Care Model (CCM). This paper systematically examines and compares whether and how well the CCM could be applied to the treatment of substance use disorders, using type 2 diabetes as a comparator.
Using the AUDIT-PC to Predict Alcohol Withdrawal in Hospitalized PatientsJournal of General Internal Medicine
Anna Pecoraro, Edward Ewen, Terry Horton, Ruth Mooney, Paul Kolm, Patty McGraw, George Woody
Alcohol withdrawal syndrome (AWS) occurs when alcohol-dependent individuals abruptly reduce or stop drinking. Hospitalized alcohol-dependent patients are at risk. Hospitals need a validated screening tool to assess withdrawal risk, but no validated tools are currently available.
Predictors of outcome for short-term medically supervised opioid withdrawal during a randomized, multicenter trial of buprenorphine–naloxone and clonidineDrug and Alcohol Dependence
Ziedonis, D.M., Amass, L., Steinberg, M., Woody, G., Krejci, J., Annon, J.J., Cohen, A.J., Waite-O’Brien, N., Stine, S.M., McCarty, D. and Reid, M.S.
Few studies in community settings have evaluated predictors, mediators, and moderators of treatment success for medically supervised opioid withdrawal treatment. This report presents new findings about these factors from a study of 344 opioid-dependent men and women prospectively randomized to either buprenorphine–naloxone or clonidine in an open-label 13-day medically supervised withdrawal study.
Alcohol Withdrawal Rates in Hospitalized Patients During the COVID-19 PandemicJAMA Network
Ram A. Sharma, Keshab Subedi, Bayo M. Gbadebo, Beverly Wilson, Claudine Jurkovitz, Terry Horton
Coronavirus disease 2019 (COVID-19) is disrupting communities across the globe, causing physical, mental, and financial distress.1 Economic crises have been associated with increased alcohol consumption.2 Necessary public health measures may exacerbate isolation and stress, negatively impacting those who are at risk for harmful alcohol use.
Modeling Emergency Department Length of Stay of Patients With Substance Use Disorder Using an Accelerated Failure Time Model.J Clin Transl Sci. 3(Suppl 1): 49.
Subedi, K, Zhang Z, Horton, T, and Jurkovitz C
Emergency department (ED) length of stay (LOS) is one of the important indicators of quality and efficiency of ED service delivery and is reported to be both cause and result of ED crowding. Increased ED LOS is associated with ED crowding, increases service cost and sometimes poor patient outcome.
Guest EditorDelaware Journal of Public Health
Opioid Addiction Issue
Example of Coordinated Effort between Behavioral Health and Primary Healthcare.Delaware Medical Journal
Lanyon, M; Wilson, B; Horton, T;
Vol. 88, No. 6, Pg 174-6
Nurses’ screening and referral behaviors and opinions about brief interventions before and after implementation of Project Engage.Drug and Alcohol Dependence
Anna Pecoraro, Ruth Mooney, Terry Horton
01/2015; 146:e66. DOI: 10.1016/j.drugalcdep.2014.09.548
Improving Alcohol Withdrawal Outcomes in Acute CareThe Permanente Journal
Melson, J., Kane, M., Mooney, R., Williams, J., Horton, T.
Perm J 2014 Spring;18(2):e141-e145
Can Substance Use Disorders be Managed Using the Chronic Care Model?Public Health Reviews, Vol. 35, No. 2, 2014
McLellan, T., Starrels, J., Tai, B., Gordon, A., Brown, R., Ghitza, U., Gourevitch, M., Stein, J., Oros, M., Horton, T.,Lindblad, R., McNeely, J.
Review and Recommendations from a NIDA Consensus Group
Using the AUDIT-PC to Predict Alcohol Withdrawal in Hospitalized Patients.Journal of General Internal Medicine
Pecoraro, A., Ewen, E., Horton, T., Mooney, R., Kolm, P., McGraw, P., Woody, G.
Identifying Differences in Communication Technology Preferences Across the LifespanJournal of the American Geriatrics Society
Weinberg, J.L., Guarino, J.M., Savoy, M.L., Horton, T., Reed J.
Early Data from Project Engage: A Program to Identify and Transition Medically Hospitalized Patients Addictions TreatmentAddiction Science & Clinical Practice
Pecoraro, A., Horton, T., Ewen, E., Bechler, J., Wright, P.A., Silverman, B., McGraw, P., Woody, G.E.
2012, 7:20 (25 September, 2012)
Hospital-Wide Inpatient Screening for Alcohol Withdrawal and Algorithm-Driven Treatment to Improve Care and Reduce Acute Delirium EpisodesAHRQ Healthcare Innovations Exchange
Agency for Healthcare Research and Quality
Common Medical Illnesses in Dually Diagnosed PopulationsSubstance Dependence and Co-Occurring Psychiatric Disorders: Best Practices for Diagnosis and Treatment
Manubay, J. & Horton, T.
In E.V. Nunes, J. Selzer, P. Levounis, & C.A. Davies (Eds.), Kingston, New Jersey: Civic Research Institute, Inc. 2010
Predictors of Outcome for Short-Term Medically Supervised Opioid Withdrawal during a Randomized, Multi Center Trial of Buprenorphine-Naloxone and Clonidine in the NIDA Clinical Trials NetworkDrug and Alcohol Dependence
Douglas M. Ziedonis, M.D., Leslie Amass, Ph.D., Marc L. Steinberg, Ph.D., Jonathan Krejci, Ph.D., George Woody, M.D., Jeffrey J. Annon, M.A., Allan J. Cohen, M.A., M.F.T., Nancy Waite-O’Brien, Ph.D., Susan M. Stine, M.D., Ph.D., Dennis McCarty, Ph.D., Malcolm S. Reid, Ph.D.1, Lawrence S. Brown Jr., M.D., Robert Maslansky, M.D., Theresa Winhusen, Ph.D., Dean Babcock, M.S.W., L.C.S.W., Greg Brigham, Ph.D., Joan Muir, Ph.D., Deborah Orr, Ph.D., Betty J. Buchan, Ph.D., Terry Horton, M.D., and Walter Ling, M.D.
99 (2009) 28-36
Using Buprenorphine to Facilitate Entry to Residential Therapeutic Community RehabilitationJournal of Substance Abuse Treatment
Eric D. Collins, M.D.; Terry Horton, M.D.; Katherine Reinke, R.N.; Leslie Amass, Ph.D, Edward V. Nunes, M.D.
Bringing Buprenorphine-Naloxone Detoxification to Community Treatment Providers: The NIDA Clinical Trials Network Field ExperienceThe American Journal on Addictions
Amass, L., Ling, W., Freese, TE., Reiber, C, Annon, JJ., Cohen, AJ, McCarty, D Reid, M., Brown L, Clark, C,. Ziedonis, D., Krejck, J., Stine, S., Winhusen,T., Brigham, G., Babcock, D, Muir, J., Buchan, B., and Horton, T.
2004, 13:S1-S25, 2004
Community Treatment Programs Take Up BuprenorphineScience & Practice Perspectives
Casadonte, P., Kolodner, G., Horton, T., McMurphy, S.
Impact of Attention-Deficit Hyperactivity Disorder and Other Psychopathology on Treatment Retention in a Therapeutic CommunityAddictive Behaviors
Francis Levin, M.D., Suzette Evans, Ph.D., Suzanne Vosburg, Ph.D., Terry Horton, M.D., Daniel Brooks, M.A., Jennifer Ng, B.A., C.A.S.A.C.
29 (2004) 1875–1882
Selected Honors & Awards (3)
Project Engage recognized as national model by American Society of Addiction Medicine (professional)
Project Engage has been highlighted by the American Society of Addiction Medicine as a national model.
Testimony before U.S. Senate Committee on Homeland Security and Governmental Affairs (professional)
estimony before U.S. Senate Committee on Homeland Security and Governmental Affairs on nation's opioid epidemic.
Institute for Healthcare Improvement and the Innovations Exchange of the national Agency for Healthcare Research and Quality (professional)
National recognition from the Institute for Healthcare Improvement and the Innovations Exchange of the national Agency for Healthcare Research and Quality.
Research Focus (1)
The integration of addiction medicine into various health care settings