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Current Issue – Substance Use, Abuse, Recovery, and Treatment

Substance use disorder (SUD) encapsulates a complex set of conditions that affect a person’s brain and behavior, and canlead to an inability to control the use of an illegal (or legal!) drug or medicine. Although the risk of addiction and how fast someone can become addicted varies by the drug, some drugs and medications are known to have a high risk, and cause addiction more quickly. SUD can start simply enough, with an experimental use of a recreational drug like alcohol, nicotine,or marijuana, which then becomes more frequent. Others may be prescribed pain medication—particularly opioids—and may find they need more and more to get the same level of pain relief.

SUD is not unique to Delaware, nor indeed to the United States. Anyone, anywhere can find themselves addicted to a substance. It is not a moral failing, and individuals may need help to overcome this disorder. Fortunately, help is available, in many forms. The Substance Abuse and Mental Health Services Administration (SAMHSA) has a National Helpline that is free, entirely confidential, and operates 24 hours a day, 7 days a week (1-800-662-HELP | 1-800-662-4357), offering treatment referrals and information in both English and Spanish.

This issue of the Delaware Journal of Public Health on substance use, abuse, treatment, and recovery offers information on many more programs and connections in Delaware, all with the goals of helping people out of substance use and into treatment and recovery. As always, we would like to thank our Guest Editors for this issue, Joanna R. Champney (Director of the Delaware Division of Substance Abuse and Mental Health) and Dr. Vishesh Agarwal (Chief of Addiction Services at ChristianaCare) for curating an excellent issue on such an important topic. Help is here. If you are struggling with substance use, please reach out.

Table of Contents

3 | In This Issue: Substance Use, Abuse, Treatment, and Recovery
Omar A. Khan, M.D., M.H.S. & Katherine Smith, M.D., M.P.H.

4 | A Word from the Guest Editors
Joanna R. Champney, M.A. & Vishesh Agarwal, M.D., E.M.B.A.

5 | Highlights from the Nation’s Health

6 | Cannabis Use in Adolescents
Gurkirat K. Bhangu, D.O.; Aakanksha Singh, M.B.B.S.; Avni Shah, D.O. & Narpinder Malhi, M.D.

16 | A Look at Substance Use Diversion Programs in the Delaware Criminal Justice System Using the Sequential Intercept Model
Ellen Donnelly, Ph.D.; Joanna Champney, M.A.; & Michael Records

20 | Rethinking Pain Relief After Surgery: What We Can Learn from Knee Replacements
Asim Trimzi

24 | Statewide Prehospital Buprenorphine in Delaware: Two-Years of Paramedic-Initiated Medication for Opioid Use Disorder After Overdose
Gregory K. Wanner, D.O., F.A.C.E.P.; Mollee Dworkin, M.S.; & Robert A. Rosenbaum, M.D., F.A.E.M.S., F.A.C.E.P.

30 | Enhancing Client Engagement in Substance Use Treatment Through the Perspective of Recovering Professionals
Jesse Tallyen, L.M.S.W., L.C.D.P. & Amy Habeger, Ph.D., L.C.S.W.

38 | Advancing Harm Reduction through Data Mapping: The Role of Delaware’s Overdose Response Center
Brent Waninger, M.Ed. & Edward Schiavi, B.A.

44 | Fogarty International – Global Health Matters

60 | Boots on the Ground: DSAMH’s Bridge Clinic Encampment Outreach Team
Nicholas Panunto

66 | Medical Marijuana in the Mid-Atlantic Region
Marym Khan, D.O. & Vishesh Agarwal, M.D.

72 | Upstream Solutions: Building Delaware’s Future Through Prevention Science
Amy M. Herb

76 | Building Competence and Compassion: Addiction Education for Medical Students
Amy Modi

78 | Addiction Psychiatry Training Within the State of Delaware: Need of the Hour
Emily Smith, M.D.; John Q. Berlin, D.O., & Ram A. Sharma, M.D.

80 | Are Substance Use Deflection Programs Seen as Effective? Exploring Police Attitudes on Program Implementation
Jullianne Regalado, M.A.; Ellen Donnelly, Ph.D.; Emalie Rell, Ph.D.; Adam Gavnik, M.A.; Madeline Stenger, Ph.D.; & Daniel J. O’Connell, Ph.D.

88 | Susan’s Recovery Story: A Journey of Rediscovery and Renewal
Ashley Reed

90 | Innovation Collaboration: Harnessing the Power of Nurse Scientist and Bedside Nurse Partnerships
Briana Abernathy, B.S.N., R.N., C.E.N. & Kathryn Shady, Ph.D., R.N., O.C.N.

92 | Reimagining Nursing Through Innovation and Design Thinking
Hannah Rackie, B.S.N., R.N., C.-E.F.M. & Patricia C. Pawlow, Ph.D., A.C.N.P.-B.C.

96 | Bedside Brain Breaks: How Stepping Back into Education Can Step Healthcare Forward
Morgan Tallo, B.S.N., R.N., C.C.R.N. & Susan Smith Birkhoff, Ph.D., R.N.

98 | Stop the Bleed: How a Standardized Policy and Reporting May Assist Healthcare Organizations with Tackling the Workplace Violence Crisis
Elizabeth Mitchell, B.S.N., R.N.-B.C. & Julie McCulloh Nair, Ph.D., R.N., P.H.N.A.-B.C., C.C.R.E.

100 | Resources for Addiction Treatment and Crisis Response in Delaware

101 | Index of Advertisers