Page 25 - Focus March 2018

| Addiction Medicine
Kara Odom Walker, M.D., MPH, MSHS, secretary of the Delaware Department of Health and Social Services; Leslie and Edward Goldenberg, M.D.; and Christiana Care Chief People Officer Neil Jasani, M.D., MBA, FACEP.
Dr. Goldenberg has made outreach and education his keystones, Dr. Jasani said. His efforts include:
• HeadStartforaHealthyHeart:Aneffort to educate teachers on how to teach their students about heart health.
• UseofLDLapheresis:Adialysis-like procedure in which blood is removed from the body and filtered to remove bad cholesterol.
• Smokingcessation:ChristianaCare's campuses became smoke-free in 2005 after a campaign led by Dr. Goldenberg.
Affordable, effective, patient-friendly care
Dr. Walker said an estimated 11,000 Delawareans have substance use disorder, but only about 5,000 receive treatment.
Effective alternatives to hospital beds already exist to help the remaining 6,000 people, she said.
For example, if Delaware added 45 prescribers of medication-assisted therapy, an increase of 50 percent, it could serve 1,350 more patients.
Moreover, health providers could tap their full capacity if they communicated among each other and other stakeholders in a more systematic way. For example, if first responders were better educated about how overdose victims could begin treatment, they could direct these victims to services more consistently.
At present, Dr. Walker said, to call it a “system” is more an aspiration than a description.
“I’m not sure I would use the word ‘system’ right now, but we’re getting there,” she said.
Dr. Walker also described how office- based opioid treatment that incorporates MAT and group counseling could be a cost-effective way to increase access to treatment. Furthermore, its collaborative, team-based approach could support providers while enhancing the patient experience.
“I want doctors to realize that our role goes beyond taking care of the sick.”
Edward Goldenberg, M.D., FACC
In other words: Patients and providers love it, it’s been shown to be effective, and it’s financially sustainable.
During the question-and-answer session, Anand Panwalker, M.D., associate vice president for medical affairs at Christiana Care, suggested that courage is needed to adopt harm-reduction strategies such as needle-exchange programs. It’s a value that Dr. Goldenberg demonstrated in 2005, when he campaigned for Christiana Care to go smoke-free.
“He single-handedly changed the culture and made this campus smoke-free,”
Dr. Panwalker said. 
FOCUS • MARCH 2018 23