Section of Treatment, Research, and Education in Addiction Medicine

Internal Medicine-Recovery Engagement Program (IM-REP)

The Internal Medicine-Recovery Engagement Program (IM-REP) is an outpatient clinic working to bring low-barrier primary care and substance use treatment to individuals, serving almost 800 patients annually. Our multidisciplinary team includes medical providers and a psychiatrist, peer recovery specialists, behavioral health specialists, and a community resource coordinator. IM-REP strives to create a clinic environment that incorporates the principles of trauma-informed care and patient-centered care to restore a feeling of self-determination and self-worth in a population that has often felt stigmatized and ignored by the healthcare system. 

Clinical Services and Program Innovation

IM-REP clinical services include primary care, psychiatry, mental and behavioral health counseling, peer support, and substance use disorder treatment.

In addition to these services, IM-REP strives to increase patient access to substance use disorder care and evidence-based treatment practices through innovative programs:

• Addiction Medicine E-Consults: Our team provides expert guidance on evaluation and management of substance use disorder to general practitioners and specialists throughout the UPMC system, expanding treatment access across Pennsylvania including rural areas.
• Contingency Management for Stimulant Use Disorder: In August 2024, we launched the only contingency management clinic-based program in the UPMC system to assist patients with cocaine or methamphetamine cessation.
• Harm Reduction Services: In February 2023, our clinic pioneered an initiative to provide harm reduction services including drug checking test strips and safer use supplies to address substance use-related morbidity and mortality. This initiative has now been scaled to four other UPMC outpatient addiction treatment settings.
• Palliative-Recovery Engagement Program (P-REP): Formed in 2020, this palliative-addiction program cares for individuals who have advanced illness, primarily cancer, who also have substance use disorders.
• WoundWell: In response to the growing number of individuals affected by xylazine wounds, WoundWell provides xylazine wound care services co-located with addiction treatment to ensure patient access to wound care supplies, care guidance, and pain management.

Research

IM-REP has served as a study site for multiple funded clinical trials:

Ongoing:

• NCT04464980: Optimizing Retention, Duration and Discontinuation Strategies for Opioid Use Disorder Pharmacotherapy (RDD)
  • Aim: Test strategies to improve OUD pharmacotherapy treatment retention and to improve outcomes among patients who have been successfully stabilized on OUD medications and want to stop medication
• NIH NIDA K23DA063654: Prescribe to Prevent HIV
  • Aim: Co-create and pilot test a tailored multi-level implementation strategy bundle to increase the prescribing of sterile injection equipment and PrEP in four outpatient clinics, ultimately reducing the risk of HIV and SIRI among PWID.
• NIH NIDA RM1DA055311: Tailored Retention and Engagement for Effective integrated Treatment of OUD and Pain (TREETOP)
  • Aim: Improve treatment for comorbid chronic pain and opioid misuse/opioid use disorder (OUD) across the OUD treatment cascade including patients residing in urban and rural communities.

Selected Publications:

• Shang M, Thiel B, Liebschutz JM, Kraemer KL, Freund A, Jawa R. Implementing harm reduction kits in an office-based addiction treatment program. Harm Reduct J. 2023;20(1):163. Published 2023 Nov 2. doi:10.1186/s12954-023-00897-5

• Zhou A, Hamm M, Merlin JS, Childers JW. Patient Perceptions of the Palliative Recovery Engagement Program (P-REP) Clinic, a Novel Outpatient Model for Patients with Advanced Illness and Substance Misuse. Am J Hosp Palliat Care. Published online March 29, 2025. doi:10.1177/10499091251328977