Substance Abuse and Mental Health, Partners Open Bridge Clinic for Those Impacted by Mental Health, Addiction Issues

The Bridge Clinic, operated by DSAMH and community partners, offers services for people impacted by addiction and mental health issues.

NEW CASTLE (March 26, 2019) – As a new support for individuals and families impacted by the effects of mental health and substance use disorders, the Division of Substance Abuse and Mental Health (DSAMH) and its partners have opened the Bridge Clinic near New Castle to provide screening and referrals to treatment, as well as additional services.

The Bridge Clinic, which is open from 9 a.m. to 4:30 p.m. Monday through Friday, is available to all Delaware residents at 14 Central Ave., New Castle (just off U.S. 13). The clinic’s services, which do not require an appointment, include:

  • Screening and referrals to treatment for mental health and substance use disorders.
  • Access to on-site qualified, licensed clinicians.
  • Guidance navigating the care network.
  • Naloxone and naloxone training.
  • Transportation to and from the facility may be available.
  • All services made available regardless of ability to pay.

“The Bridge Clinic meets a need in our state to provide rapid access to qualified clinicians who can help individuals and their families to understand what treatment may be needed and how to engage with the treatment system,” said Department of Health and Social Services (DHSS) Secretary Dr. Kara Odom Walker, a board-certified family physician. “Sometimes, families don’t even know where to begin. The Bridge Clinic provides that starting point.”

Secretary Walker said the opening of the clinic helps to engage high-risk populations in treatment, one of four main recommendations from a team of researchers and clinicians at the Johns Hopkins Bloomberg School of Public Health. In April 2017, Secretary Walker asked Johns Hopkins to conduct a review of Delaware’s addiction treatment system. In July 2018, the Johns Hopkins team issued a 33-page report that proposed four main strategies:

  • Increase the capacity of the treatment system.
  •  Engage high-risk populations in treatment.
  • Create incentives for quality care.
  • Use data to guide reform and monitor progress.

“The aim of the Bridge Clinic is to engage diverse communities across our state who are facing the challenges of an addiction or mental health issue,” said DSAMH Director Elizabeth Romero. “We are here – in the community – providing that place where individuals and families can go

when they aren’t sure where to turn for help. With our community partners, we are working to educate individuals and families, to bring awareness and to promote resources as part of the solution.”

For more information, call the Bridge Clinic at 302-255-1650.

Johns Hopkins Team Releases Major Recommendations for Strengthening Delaware’s Substance Use Disorder Treatment System

NEW CASTLE (July 24, 2018) – Following a 14-month review of Delaware’s opioid use disorder treatment system, a research team from the Johns Hopkins Bloomberg School of Public Health and the Bloomberg American Health Initiative today recommended four major strategies to achieve the state’s goal of a system of care that is accessible, evidence-based, individualized, comprehensive and accountable.

Brendan Saloner, PhD, an assistant professor at the Johns Hopkins Bloomberg School of Public Health, presented the findings today at a meeting of the Behavioral Health Consortium at Buena Vista. The report proposes four major strategies for the state to meet its treatment vision:

  • Increase the capacity of the treatment system.
  • Engage high-risk populations in treatment.
  • Create incentives for quality care.
  • Use data to guide reform and monitor progress.

In April 2017, Department of Health and Social Services Secretary Dr. Kara Odom Walker asked a team of researchers and clinicians from the Johns Hopkins Bloomberg School of Public Health to conduct the review by meeting with state officials representing multiple agencies, behavioral health organizations, treatment providers and patient advocates, and by studying data on Delaware’s epidemic, available literature, and the experiences of other states and localities.

“Families across the state have urged me to make changes to our public addiction treatment system,” Governor John Carney said. “This Johns Hopkins report is an important step forward in building a stronger treatment system so we can help more people get the access to care they need.”

“The recommendations from the Johns Hopkins team gives us a solid foundation in data, evidence and experiences from which to strengthen the opioid use disorder treatment system in our state,” said Secretary Walker, a board-certified family physician. “With almost one Delawarean dying each day from overdoses and thousands of more individuals and their families impacted by this epidemic, we need to meet people whenever and wherever they are ready for the most effective treatment we can provide.”

In 2017, 345 Delawareans died from overdoses, according to the Division of Forensic Science (DFS). That total was up about 12 percent from 2016. In 2016, the report says, Delaware’s overdose rate tied for ninth (with Rhode Island) among all states at 30.8 deaths per 100,000. Through July 23 of this year, 145 people have died from suspected overdoses in Delaware, according to DFS.

“This report really helps to identify those priority areas we need to address to fix our broken system of treatment in Delaware,” said Lt. Governor Bethany Hall-Long. “These recommendations support the action items included in the Behavioral Health Consortium’s Three Year Action Plan. Implementing these recommendations will allow us to better serve our population and meet their needs most effectively.”

“We deeply appreciate the thoughtful recommendations from the Hopkins/Bloomberg Team to help us strengthen our response to this critical public health epidemic,” said Division of Public Health Director Dr. Karyl Rattay. “The recent passage of an Overdose System of Care bill will help us fulfill the recommendation to engage high-risk populations into treatment, through the creation of a statewide system to ensure that consistent, humane, evidence-based treatment and care is available and provided to those requiring acute management for overdose or substance use disorder.”

The Overdose System of Care will involve establishing consistent EMS and emergency department protocols to improve acute response, initiate medication-assisted treatment to manage withdrawal, and rapidly engage individuals into SUD treatment. Additionally, the bill enables the establishment of stabilization centers, which could provide medical management for individuals who have overdosed or who require acute management of SUD. The ultimate outcome of system implementation is a reduction in morbidity and mortality and improved engagement into SUD treatment.

In embracing another recommendation of the Johns Hopkins report, DHSS’ Division of Substance Abuse and Mental Health (DSAMH) will begin contracts this summer with providers to increase access to care, peer support and effective treatment for individuals living with substance use disorder. In addition to meeting individuals’ treatment needs, the new centers also will address needs for medical care, housing, vocational opportunities, education and other wraparound services.

“We need to treat each person with an opioid use disorder as a whole person,” DSAMH Director Elizabeth Romero said. “At the new centers, we will use certified recovery peers to help individuals navigate their way through both the treatment and the social services worlds. Being able to talk with someone with a similar lived experience will help individuals suffering from opioid use disorder to better coordinate their services and maintain their engagement with treatment.”

“Delaware’ leadership recognizes that the rising tide of overdoses is a public health crisis,” said Joshua Sharfstein, MD, Professor of the Practice and the Director of the Bloomberg American Health Initiative at the Johns Hopkins Bloomberg School of Public Health. “We are pleased to help the state save lives by expanding access to treatment.”

The Johns Hopkins report, available on DHSS’ website, includes details on each of the four strategies:

  • Increasing treatment capacity: Recommendations include DHSS’ Division of Substance Abuse and Mental Health (DSAMH) implementing a Centers of Excellence-type program to provide rapid intake and assessment, treatment, peer services and access to chronic disease management; DSAMH creating an online inventory of all credentialed treatment providers; DHSS leading a campaign to increase the number of providers who prescribe buprenorphine; and DHSS developing a plan to support housing and employment for individuals in recovery.
  • Engaging high-risk populations in treatment: Recommendations include the Department of Correction offering opioid use disorder treatment that includes all FDA-approved medications to all individuals in detention facilities; the state upgrading the three existing withdrawal management centers; and DHSS setting standards for hospital provision of SUD treatment for medication-assisted treatment and the use of peers.
  • Creating incentive for quality care: Recommendations include DSAMH reviewing its current rates to ensure there is adequate and consistent reimbursement for high-quality care; DHSS’ Division of Medicaid and Medical Assistance (DMMA) ensuring that current value-based payment initiatives applied through Managed Care Organizations (MCOs) are extended to opioid use disorder treatment; and DHSS, in partnership with other state agencies, developing a compliance strategy.
  • Using data to guide reform and monitor progress: Recommendations include DHSS developing a dashboard that collects and publicizes statewide data on treatment capacity, utilization and quality indicators; DHSS overseeing a linkage project that brings together multi-agency data for understanding system effectiveness and identifies opportunities for improvement; and DHSS evaluating program and policy changes and rapidly disseminating findings to facilitate continuous improvement.

Governor and Legislators Propose Expansion of Needle and Syringe Exchange Program

Part of continuing efforts to address addiction epidemic

Dover, DE – Today, Governor Markell announced his support for legislation that would authorize the Division of Public Health (DPH) to expand the Syringe Exchange Program (SEP) statewide to help reduce the sharing of potentially infected needles and support the state’s larger efforts to address opioid addiction and HIV transmission. This enabling legislation would allow the program to go statewide should federal funding become available.

“Heroin abuse continues to affect communities across our state, and needle exchange programs can help those struggling with addiction to avoid getting other diseases as we connect them to treatment for their addiction,” said Governor Markell. “A statewide expansion of Delaware’s needle exchange program will protect IV drug users from infections such as HIV, hepatitis and other bloodborne diseases. In doing so, we also protect the families and partners of these individuals, keep our streets and neighborhoods free of needle litter, and hopefully get more people into treatment for their addiction.”

“While our ultimate goal must continue to be securing addiction treatment for the Delawareans who need it most, we must do whatever we can to ensure that IV drug users are not putting themselves or the public at further risk by using contaminated needles,” said Senate Majority Whip Margaret Rose Henry. “Like drug use, diseases like HIV and hepatitis disproportionally impact low-income and minority populations and we have a moral responsibility to take these sorts of prudent measures to stop the spread of these devastating diseases.”

“During the past decade, we have seen the needle exchange program have a positive impact in the City of Wilmington by reducing the spread of HIV infections and other diseases that can be transmitted through a used needle. It also has helped connect people to various services and resources to reduce drug use,” said Rep. Helene Keeley, who sponsored the original needle exchange bill in 2006. “However, intravenous drug use is not just a problem in Wilmington; it’s a concern throughout our state. Expanding this successful program throughout Delaware will hopefully have the same benefits up and down the state that it has had in the city, reducing the spread of diseases and connecting people to the services they need to combat drug use.”

“We have long been supporters of needle exchange programs because they work in preventing the spread of HIV/AIDS,” said Peter Houle, executive director of the Delaware HIV Consortium, one of the state’s largest providers of services to people with HIV/AIDS. “We helped form the coalition that pushed through Delaware’s first effort at needle exchange. We support expansion of the program to serve all three counties in Delaware effectively. Since the recent surge in the use of heroin began, we have been hoping for expansion of the clean needle exchange program – it’s just good public health policy that will save lives.”

The Delaware SEP was established in 2007, initially as a pilot program in Wilmington. With this legislation, the program will no longer be limited to Wilmington and will be permitted to operate in areas of need throughout the state. While New Castle County and the City of Wilmington have significant numbers of people living with HIV resulting from IV drug use, the issue, along with the larger addiction epidemic, exists statewide.

Under the law, injection drug users can be provided with referrals to appropriate treatment and access to a 1-for-1 exchange where participants will receive one sterile needle and syringe unit in exchange for each used needle. The program is also designed to maintain maximum security of exchange sites and equipment, including security measure that will allow for:
• Identification of Program needles;
• Full accounting of the number of needles distributed;
• The number of needles in storage;
• Safe disposal of returned needles;
• And any other measures that may be required to control the use and dispersal of sterile needles and syringes.

In addition, the program educates participants about the dangers of contracting HIV or hepatitis through needle-sharing practices, and provides HIV and other communicable disease testing when and where available and appropriate. All participants can access counseling and treatment services, as well as follow-up to any of those services, to ensure participants can receive the most comprehensive treatment possible.

SEP has proven to be an effective way of reducing the use of potentially contaminated needles:

• Since June of 2015, 2,532 participants have been enrolled in the program and more than 353,000 potentially contaminated syringes have been safely disposed of and kept off of Wilmington streets.
• Currently, the program exchanges approximately 80,000 potentially contaminated syringes each year.
• The program promotes substance usage treatment and has successfully enrolled 894 clients in treatment programs.
• The number of Delawareans diagnosed with HIV attributable to intravenous drug use has dropped significantly, from 38 cases in 2005 to three cases in 2015.
• The program is a national model for cooperation between needle exchange services and law enforcement, and has been publicly endorsed by a number of medical associations and community organizations:
o American Medical Association
o American Public Health Association
o National Academy of Sciences
o American Nurses Association
o U.S. Conference of Mayors
o American Bar Association

IV drug use is a one of the primary paths to acquiring HIV. In Delaware, 43 percent of those currently living with HIV/AIDS and 50 percent of all HIV/AIDS cases are directly or indirectly related to needle sharing. This legislation could reduce the health risks for intravenous drug users and also protect their wives, husbands and partners.

Governor Markell Marks Next Stage in Fight against Addiction Epidemic

Details $4.45M in Spending Priorities for FY16

Harrington, DE – Responding to the need for increased addiction treatment and recovery services statewide in the face of an epidemic that claims a life from overdose every other day, Governor Markell joined Department of Health and Social Services Secretary Rita Landgraf and other leaders today to detail the state’s priorities for the $4.45 million in new resources provided by the Fiscal Year 2016 budget.

Speaking at the construction site for a new withdrawal management clinic in Harrington, Governor Markell said that facility exemplifies the state’s commitment to serve the thousands of Delawareans and their families affected by the state’s addiction epidemic. In 2014, there were 185 suspected overdose deaths in Delaware, or about one every other day. Across the country, Delaware ranked 10th for overdose deaths. Almost 10,000 Delaware adults sought public treatment in 2014, with about one-third of those adults indicating heroin as their primary drug at the time of admission.

“The addiction epidemic is straining our public system beyond its capacity, with many people turned away for services when they are ready for treatment, or being forced to wait for services or supports to open up for them,” said Governor Markell, who proposed additional resources to treat substance use disorders in his State of the State address and FY2016 budget proposal. “I am grateful these new resources to increase treatment capacity remained in the budget, and I applaud members of General Assembly for holding steadfast to a commitment to increase treatment and recovery services, especially in a challenging fiscal environment.”

The withdrawal management clinic, operated for the Department of Health and Social Services by Connections Community Support Programs, Inc., is expected to open within a month to serve people in need, especially those in Kent and Sussex counties. The state’s other withdrawal management clinic is in New Castle County. With $750,000 in funding, both clinics will match withdrawal services to the individual’s needs, rather than using a one-size-fits-all approach. Both programs will have:

  • 16 beds for clinically managed and medically monitored detoxification;
  • 12 23-hour slots to allow for stabilization and observation of an individual who might not need a medically or clinically monitored withdrawal program; and
  • Ambulatory withdrawal management services, which can serve 30 to 100 individuals for 30 days in an intensive outpatient setting.

Secretary Landgraf detailed the state’s efforts to fight addiction on three fronts: prevention and education; treatment and recovery; and criminal justice. She cited the training and increased use of the overdose-reversing medication naloxone among members of the community and law enforcement, the use of the Good Samaritan/911 Law to allow people to call in overdoses without risking arrest for minor drug offenses, and an ongoing underage and binge drinking prevention campaign.

“We know all too well that addiction is indeed a disease of epidemic proportion, one that does not discriminate and that takes a toll every day on Delaware families,” Secretary Landgraf said. “With the help of these new state resources, we will continue to embrace communities of recovery such as the one being built in Harrington.”

Department of Correction Commissioner Robert Coupe noted additional state spending in community treatment services will have a positive impact on the criminal justice system.

“For far too many individuals across our state, their addiction is a primary driver of destructive behavior that puts them into contact with the criminal justice system,” Commissioner Coupe said. “Increasing the number of treatment facilities in the community will ensure those who return to the community from a period of supervision by our department will have an opportunity to continue to participate in the addiction-related treatment they need to stay clean and sober, break their cycle of criminal behavior, and support their successful reentry to society.”

Mike Barbieri, the new director of DHSS’ Division of Substance Abuse and Mental Health (DSAMH), detailed the priorities for the remainder of the $4.45 million in new funding. It would allow DSAMH to:

  • Expand the capacity of residential treatment programs throughout the state by opening new programs statewide. This will be done by reconfiguring the existing program at Delaware City and opening three 16-bed units across the state. When the changes are completed, the number of residential treatment beds is expected to increase from 78 to 95. ($800,000)
  • Double the number of sober living residential beds statewide from 60 to 120, allowing more individuals who are in the early stages of recovery to live in safe and secure housing that is free from drugs and alcohol. ($935,000)
  • Double the number of residential treatment beds across the state from 16 to 32 for young people age 18 to 25 who are beginning their recoveries from addiction to heroin or other opiates. ($1.15 million)
  • Fund start-up costs for residential treatment programs. ($815,000 in one-time funds)


Governor Announces Expansion of Addiction Treatment Services

Downstate detox center, increase in individualized treatment services, and informational website part of Statewide efforts

Wilmington, DE – Building on ongoing efforts to address the addiction epidemic in Delaware and the growing need of drug treatment services statewide, Governor Markell today unveiled efforts to expand addiction treatment services and support for Delawareans impacted by addiction.AddictionTreatmentPlan

“Across our state, too many of our neighbors and their family members are impacted by their loved one’s addiction to heroin, prescription drugs, alcohol or other substances,” said Governor Markell. “We must remain committed to opening the doors to addiction treatment because people deserve the opportunity to reach their full potential, free from the pain that addiction brings.”

Part of the efforts unveiled include establishing a new withdrawal management treatment center in Sussex County to serve individuals who live downstate. Currently, the State operates one detox center, NET Kirkwood Detoxification Center, in New Castle County. In addition, the State plans to offer more individualized treatment services at both locations through variable lengths of stay and increased supervision for those who require intense monitoring.

Funding for the new facility, which totals $950,000, is part of the $1 million that was approved by the General Assembly for FY15 to address gaps in the State’s drug treatment services after the Governor called for additional resources in his State of the State address. The other $50,000 of those funds will allow the Delaware Division of Public Health to work closely with Delaware school nurses to expand the “Smart Moves, Smart Choices” prescription drug abuse education and prevention campaign statewide.

“Above all else, we will achieve our greatest success if we can educate and prevent substance use among our young people,” said Governor Markell.AddictionTreatmentPlan

Recognizing the importance of education and prevention in addressing the addiction epidemic, the State also launched, an information website that puts an emphasis on prevention, treatment and recovery; and announced the launch of a public awareness campaign that will support the website and focus on reducing the stigma associated with addiction.

The Governor also expressed his gratitude to Members of the General Assembly, including Senators Margaret Rose Henry and Bethany Hall-Long, as well as Representatives Mike Barbieri, Helene Kelley and Michael Mulrooney, who have worked with the Department of Health and Social Services (DHSS), advocates, health care providers and other community leaders to help shape the state’s priorities to address addiction.

Photos from the event