Section of Treatment, Research, and Education in Addiction Medicine
Substance Treatment and Recovery Service (STARS)
The Substance Treatment and Recovery Service (STARS) provides compassionate, evidence-based care for hospitalized patients living with substance use disorders. Our multidisciplinary team delivers holistic, patient-centered addiction management that addresses both the medical and psychosocial dimensions of substance use. By mitigating risk, enhancing motivation, and bridging patients to community and outpatient resources, STARS helps patients begin or continue their recovery journey during hospitalization and beyond.
Mission
The mission of STARS is to provide exceptional, integrated addiction care within hospital settings by:
- Offering compassionate, individualized interventions that promote safety, dignity, and recovery.
- Partnering with patients, healthcare professionals, and the community to share knowledge about the evolving drug supply and emerging treatment strategies.
- Creating an environment of trust and support for people with addiction throughout their hospital stay.
Vision
STARS strives to advance the field of inpatient addiction medicine by:
- Strengthening partnerships with community providers to ensure seamless transitions of care.
- Developing innovative recovery tools and programs adaptable across different levels of care.
- Expanding services to additional hospital campuses and community-based sites, including telehealth and bridge services.
- Promoting lifelong learning through addiction-related training and professional education.
- Fostering collaboration among multidisciplinary care teams to deliver consistent, high-quality patient care.
- Integrating research and education to inform and improve addiction medicine practices.
- Training the next generation of addiction medicine clinicians, including physicians, advanced practice providers, social workers, and certified recovery specialists.
Clinical Services and Program Innovation
STARS clinical services include withdrawal management for opioids and related adulterants, initiation of medications for opioid and alcohol use disorder, tobacco cessation, recovery support, and linkage to outpatient or higher levels of care.
- Diversionary materials: To meet the holistic needs of admitted individuals who use substances, our team provides multimodal addiction treatment services with diversionary materials including recovery texts and workbooks, art therapy including coloring books and pencils, journaling materials, and meditation texts.
- Endovascular Infection (EVI): STARS partners with the Endovascular Infection consult service (EVI), part of the Division of Infectious Diseases, to provide multi-disciplinary, holistic care for patients with serious injection-related infections, specifically infectious endocarditis. STARS and EVI meet weekly with representatives for cardiothoracic surgery, neurology, and electrophysiology, among others, to review challenging cases of infectious endocarditis and coordinate care between medical and surgical specialists to ensure people who use substances receive timely and equitable treatment for their disease.
- Harm reduction services: STARS provides naloxone distribution, wound care kits, and drug checking tools including fentanyl and xylazine test strips.
- MOUD initiation strategies: For patients interested in starting MOUD, STARS offers a variety of strategies for initiation including rapid methadone titration, low-dose and high-dose buprenorphine initiation, and direct-to-inject buprenorphine initiation with Brixadi.
- Seeking Safety: Our service also provides a substance use and trauma-informed behavioral therapy known as Seeking Safety to patients.
- Withdrawal management: As much of the local unregulated opioid supply is adulterated with alpha-2-adrenergic agents, in addition to managing opioid withdrawal with short-acting full-agonist opioids, our team provides specialized withdrawal management for xylazine and medetomidine.
Research
STARS has served as a study site for multiple funded clinical trials.
- NCT06843213: Teaching Harm Reduction in a Hospital Setting: A Peer-led Intervention (THRIVE)
- To develop an acceptable, feasible, and effective peer-led bundle of harm reduction services to be delivered in the hospital setting and assess if this intervention reduces risk of self-reported non-fatal overdoses or skin/soft tissue infections.
- NCT07079826: Sparrow Link device for opioid withdrawal management
- Aim: To offer the Sparrow Link device for opioid withdrawal management in people with a history of opioid use disorder experiencing opioid withdrawal in the hospital setting.
Previous:
- NCT04921787: CTN-0098A: Exemplar Hospital Initiation Trial to Enhance Treatment Engagement (EXHIT ENTRE), 2023-2026
- Aim: To examine whether in hospitals with addiction medicine consultation services, hospital-initiated extended-release buprenorphine (XR-BUP), compared to other OUD medications, results in increased engagement in treatment with MOUD following hospital discharge.
Selected Publications
- Shang M, Hull I, Liebschutz JM, et al. Building Multidisciplinary Consensus on Inpatient Xylazine Management through Clinical Protocols. Subst Use Addctn J. 2025;46(4):806-816. doi:10.1177/29767342251329681
- Karavolis ZA, Roy PJ. Adapting low-dose buprenorphine induction to meet patient needs: A pilot study. Drug Alcohol Depend Rep. 2022;5:100104. Published 2022 Oct 7. doi:10.1016/j.dadr.2022.100104
- Wilson JD, Altieri Dunn SC, Roy P, Joseph E, Klipp S, Liebschutz J. Inpatient Addiction Medicine Consultation Service Impact on Post-discharge Patient Mortality: a Propensity-Matched Analysis. J Gen Intern Med. 2022;37(10):2521-2525. doi:10.1007/s11606-021-07362-8
Support STARS
Donate here to support STARS. Money is used to purchase diversionary materials and harm reduction supplies.
People
Clinical Director:
Core Staff:
Emily Beahm, MSW, LCSW
Erica Heslet, CRS
Isabella Kessler, MSW
Deanna Pantaleo, CRNP
Rotating Attendings:
Julie Childers, MD, MS
Ilana Hull, MD, MSc
Jane Liebschutz, MD, MPH, FACP
Diana Samberg, MD, MS
Margaret Shang, MD, MS
Bryant Shuey, MD, MPH
5th Annual Retreat 2/26/25