September is National Recovery Month, and services provided by Project ASSERT (Alcohol & Substance use Services, Education, & Referral to Treatment) are a lifeline to patients with substance-use disorders (SUDs). Patients seen in emergency departments across much of Yale New Haven Health are benefitting from the program at a time when it is needed most.
“With the climate of COVID-19 and an increasingly vulnerable population, the escalating opioid crisis has really impacted access to care,” said Gail D’Onofrio, MD, director of Project ASSERT, which the Yale New Haven Hospital Emergency Department launched in 1999.
In 2018, Project ASSERT – a collaborative effort between Yale New Haven Health and the Yale School of Medicine Department of Emergency Medicine – was awarded a five-year, $4.8 million grant by the federal Substance Abuse and Mental Health Services Administration (SAMHSA) to expand services to Bridgeport and New London. With some of Connecticut’s highest numbers of opioid-overdose deaths, these cities, in addition to New Haven, have shown the greatest need for increased access to SUD services.
“Over the past four years, we have added eight health promotion advocates (HPAs) to the existing positions for a total of 14 staff,” said Shara Martel, Project ASSERT program manager. “The HPAs are spread across the EDs at Yale New Haven, Lawrence + Memorial and Bridgeport hospitals and the Yale Addiction Medicine Consult Service, which is a multidisciplinary service for inpatients.”
The HPAs screen ED patients for drug and alcohol problems, provide interventions and directly refer them to community services, such as Cornell Scott Hill Health Center and Fair Haven Community Health Care. Since 1999, Project ASSERT has connected more than 52,000 patients to life-saving care and treatment. In the past four years, the program has conducted an additional 5,500 patient visits, including 3,200 unique visits, for substance and alcohol use.
In addition to training clinicians and staff on screening, brief intervention, and referral to treatment – an evidence-based approach to identifying and treating individuals with SUD – Project ASSERT has integrated screening tools into Epic for participating primary- and emergency-care settings and has prepared primary care providers to prescribe specific medication for opioid-use disorder.
Dr. D’Onofrio, who is also professor of Emergency Medicine, Public Health and Addiction Medicine at Yale School of Medicine, oversees Project ASSERT with Rebekah Heckmann, MD, associate director of Project ASSERT, and Michael Pantalon, PhD, a psychologist in the Department of Emergency Medicine.
Project ASSERT is the second program of its kind in the nation and continues to serve as a national model for addressing substance misuse and addiction in an urban emergency department. “We were pioneers in initiating treatment for opioid-use disorder, and the health system should be applauded for supporting Project ASSERT and being part of the solution,” Dr. D’Onofrio said.
