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“There was a guy standing at the end of my hospital bed that I didn’t know,” recalled Brandon Younce. “I’ll never forget this. He had a shirt on that said ‘Got Narcan.’ He introduced himself as Aaron from Voices of Hope. He said he was a peer recovery specialist, and he asked me, ‘Hey, man, are you ready to go to treatment?’”
This encounter took place before the peer recovery specialist program at Voices of Hope formally partnered with ChristianaCare’s Union Hospital and the Cecil County Health Department in 2023 to grow the program into the robust offering it is today. For Younce, the program has meant not only a path to reaching and maintaining his own sobriety: It has also allowed him to become a specialist himself.
And for the over 600 patients assisted through the program in fiscal year 2024, 440 of whom were connected to long-term recovery treatments, the program has meant receiving a chance at healing under the stewardship of peers who have themselves experienced addiction and recovery.
Emily Granitto, M.D., of Emergency Medicine at Union Hospital, said that the process “works really seamlessly: We have a discussion with a patient and say ‘hey, we have someone available. Would you like to talk to peer recovery and see what we can do to help?’ Then a specialist comes, and they talk through the resources and options.”
By having the specialist located in-hospital and ready with resources at the patient’s bedside, said Granitto, the chances for a patient’s successful transfer to long-term treatment are much higher than if the patient is expected to fend for themselves upon discharge.
“We’re able to address their substance abuse concerns and tie it all into their visit here in the Emergency Department. That opportunity may not necessarily arise otherwise in the community — so offering it here and providing that olive branch can be a good bridge to the next step,” she said.
The need for programs like these has never been more urgent. According to a 2022 Community Health Needs Assessment report from ChristianaCare and the Cecil County Health Department, Cecil County’s “drug poisoning death rate” is nearly double the statewide rate and triple the national average. Services like the peer recovery specialists at Union Hospital are a critical lifeline for many.
Harnessing the Power of Lived Experience The peer recovery specialist program currently places 10 trained peer specialists at Union Hospital to provide supportive coverage for patients admitted to the emergency room in active withdrawal or with a history of addiction.
“The peer program at Union Hospital is the perfect example of what is possible when you harness the power of lived experience and strong community partnerships,” said Health Officer Lauren Levy, JD, MPH, of the Cecil County Health Department.
“The collaboration between caregivers and the peer workforce has been integral to strengthening linkages to care and improving health outcomes for people with substance use disorder.”
In collaboration with caregivers — including doctors, nurses and social workers — these specialists help to support patients and to connect them with longer-term treatment and rehabilitation options within and outside of ChristianaCare. They’re present and available at the hospital from 8:30 a.m. to 1 a.m., seven days a week.
Doctors and nurses who work alongside peer recovery specialists can pair patients with specialists based on patients’ needs; some patients are admitted in active withdrawal, whereas for others, a need for treatment comes up as part of their intake.
“What the peers do is really very magical because they can connect to the patient,” said Lisa Fields, manager for community engagement on ChristianaCare’s Cecil County campus, “They can tell their story to the patient and say, ‘This is where I have been. I do understand.’”
Partnerships Support People in Need Voices of Hope, with a primary mission of supporting addiction recovery for Maryland residents and their families, trains peer specialists alongside the Cecil County Health Department, another vital partner in the peer recovery specialist program. Training requires 500 hours in the role and 25 hours of supervision from a registered peer supervisor.
Peer recovery specialists provide a form of connection that is unique and impactful for someone struggling with substance use disorder: empathy informed by personal experience.
For Erin Wright, Voices of Hope’s chief operations officer, this partnership has enabled all the involved providers to build a unique, vital community to support people in need of help. “The opposite of addiction is connection,” she said.
“I’ve had doctors come to my peers, and say, ‘How did you just do that?’ A peer can walk in the room and, in 20 minutes, walk out and say, ‘Listen, here’s the plan.”
Back in 2019, Younce’s emergency-room encounter with Aaron led to a treatment plan that included rehab, which led to his graduation from treatment and ongoing sobriety, which then led to his decision to become a peer recovery specialist himself and eventually, he hopes, a social worker.
“It’s very surreal,” he said, “working at Union Hospital and actually telling patients, like, ‘I know how you feel. I’ve been in this position.’”
Recovery Support Through Project Engage in Delaware ChristianaCare’s commitment to supporting patients with substance use disorders is systemwide. Project Engage, a vital initiative serving ChristianaCare’s Newark, Wilmington and Middletown campuses, aids patients struggling with alcohol or drug use by providing early intervention and referrals to substance use disorder treatment. Peer recovery specialists engage with patients in the emergency department and at the bedside, helping them understand their substance use and offering treatment options.
Since 2012, Project Engage has served more than 13,000 patients and conducted over 27,000 patient engagements, with more than 60% of these engagements resulting in referrals to community treatment at discharge.
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.”
ChristianaCare is enhancing care options in Milford, Delaware, with the addition of two highly skilled physicians to better serve the community's growing health needs.
Chinwe Ike-Chinwo, M.D., is a board-certified primary care physician with a special interest in preventive medicine. Thinesh Sivapatham, M.D., is a fellowship-trained neurointerventional surgeon and member of ChristianaCare's Neurointerventional Surgery team, specializing in minimally invasive techniques to treat conditions affecting the blood vessels of the head, neck and spine, including strokes and aneurysms. The practice is located at Halpern Plaza, 701 N. DuPont Blvd. To schedule an appointment, patients can call 302-725-3420.
Convenient and Accessible Primary Care At the new ChristianaCare Primary Care at Milford practice, Ike-Chinwo is passionate about building long-term relationships with her patients, helping them achieve optimal health through personalized care.
“I am excited to serve the Milford community and help individuals achieve their best health,” she said. “Through prevention, chronic disease management and wellness care, we aim to support our patients in leading healthier, more fulfilling lives.”
Ike-Chinwo introduces herself in this video. The primary care practice offers a comprehensive range of services to adult patients, including sick visits, immunizations, physical exams, preventive screenings and treatment for both acute and chronic conditions and women’s health. The practice is open Monday through Friday, from 8 a.m. to 4:30 p.m. In March 2025, the practice will welcome a second provider.
In April 2025, the Milford site will also offer ChristianaCare’s My65+ program, which focuses on preventive care and chronic disease management for patients 65 and older.
The providers at ChristianaCare’s new Milford location will play a crucial role in addressing the growing health care needs of Sussex County, which is experiencing rapid population growth, particularly among older adults. Sussex County has been designated as a Medically Underserved Area by the federal government, with projections showing that the population will increase from 237,378 in 2022 to over 361,000 by 2050, further intensifying the demand for primary care services.
As the demand for primary and specialty care in Sussex County grows, especially among older adults, ChristianaCare is committed to meeting the health care needs of the community with personalized, patient-centered care.
“Our mission is to make high-quality, compassionate care accessible to every resident of the communities we serve,” said Priya Dixit-Patel, M.D., physician executive for Core and Advanced Primary Care at ChristianaCare. “As primary care providers remain in short supply in many areas like Milford, we are focused on delivering care that can prevent disease, manage chronic conditions, and improve overall well-being, particularly for older adults.”
Specialized Neurointerventional Consults Close to Home Sivapatham is excited to bring neurointerventional care to the Milford community and surrounding areas.
“Neurointerventional Surgery is a highly specialized field that is often only found in larger metropolitan areas,” said Sivapatham, who speaks about treatment for stroke in this video. “I look forward to working closely with patients to ensure they receive the same high-quality care right here in Sussex County.”
Kim Gannon, M.D., Ph.D., medical director of the Comprehensive Stroke Program and physician executive of the Neuroscience Service Line at ChristianaCare, highlighted the importance of improving access to physician consults for patients in Sussex County.
“Providing neurointerventional care closer to home significantly improves access to specialized services for stroke patients who might otherwise need to travel to Newark,” said Gannon. “We want to ensure that patients receive the ongoing care and support essential for their recovery and long-term health at a location close to where they live.”
