Integrated Substance Use Disorder Training Program

Overview

Twenty-three million Americans have a substance use disorder (SUD), yet only 10% receive treatment annually. Among hospitalized patients, 22% have an active drug or alcohol use disorder. Despite the growing prevalence of SUDs, few clinical providers have the opportunity to gain specialty training in addiction medicine.

The Massachusetts General Hospital Integrated Substance Use Disorder Training Program will prepare nurse practitioners, psychologists and social workers for clinical and academic careers in addiction medicine with a particular focus on developing and enhancing evidence-based addiction prevention and treatment services for all patients, including those vulnerable to health disparities because of poverty, race, culture, age, gender, disability or stigma.

Through a combination of inpatient and outpatient care spanning diverse settings, trainees will receive training in the knowledge and skills to become expert clinicians and leaders in the field of addiction medicine. Clinical rotations include:

• Outpatient addiction treatment provided as a multidisciplinary behavioral health team integrated into primary care at Mass General community health centers
• Low threshold, urgent and transitional addiction treatment in the Mass General outpatient Bridge Clinic
• Dual-diagnosis treatment in Mass General’s specialty outpatient clinics for both adults and youth
• Inpatient consultation on the Addiction Consult Team at serving the entire Mass General Hospital

Electives and longitudinal experiences will be further tailored to each trainee’s interests and guided by the interdisciplinary program faculty. The diverse program faculty includes the following:

• Physicians from Internal Medicine, Psychiatry and Family Medicine
• Psychologists
• Nurse Practitioners
• Recovery Coaches
• Clinical Social Workers

The primary goal of the one-year, full-time training program is to prepare nurse practitioners, social workers and psychologists for clinical and academic careers in addiction medicine. Trainees will benefit from working within the Program in Substance Use & Addiction Services (PSAS), a hospital-/community-wide collaboration to deliver state-of-the-art addiction medicine care for those suffering with substance use issues. This program also benefits from close collaboration with Mass General’s addiction medicine and psychiatry fellowships for physicians and trainees will work together in many shared settings.

Fellows receive benefits through Mass General. More information on benefits can be found on the Mass General website.

Curriculum

Training Experience

Core training includes an overview of the field of addiction medicine with an emphasis on training addiction medicine nurse practitioners, psychologists and social workers who will educate other clinicians and trainees in the community; rigorously assess and incorporate scientific evidence into their practice and deliver compassionate care to a diverse population of patients, particularly those who are most marginalized. Training will comprise didactic and clinical experiences across the spectrum of addiction care, including the following:

• Comprehensive behavioral treatment of the full spectrum of substance use disorders using evidence-based models
• Psychosocial interventions to address social determinants of health in substance using populations
• Harm reduction
• Motivational interviewing
• Focus on providing care for vulnerable populations
• Neurobiology of addiction
• Pharmacotherapy for substance use disorders
• Novel and integrated care models for substance use disorder treatment

Core Clinical Sites

• Massachusetts General Hospital
• Mass General Community Health Centers

Clinical Experience Area

• Outpatient Addiction Treatment within a Community Health Center: 12-month longitudinal rotation within an integrated care setting at a Mass General primary care health center

• Inpatient Consultation Service at Mass General: Rotation on the Mass General inpatient Addiction Consultation service. The multidisciplinary Addiction Consult Team (ACT) offers expert consultation and support for patients with moderate to severe substance use disorders (SUDs) across Mass General’s inpatient units

• Outpatient Co-occurring Disorders Rotation: Outpatient rotation providing treatment for co-occurring disorders at the Mass General Addiction Recovery Management Services (ARMS) and West End Clinic

• Mass General Bridge Clinic: Rotation in a low barrier, transitional outpatient addiction clinic for vulnerable patients who are unable to benefit from more traditional outpatient SUD care. Patients served include discharged inpatients with unstable outpatient options, patients leaving the emergency department who are not yet connected to outpatient care, and primary care patients who are not stable enough to benefit from structured care. The Bridge Clinic provides patients with continued necessary treatment for their SUDs delivered in a patient centered, patient determined approach until they stabilize enough that they can access appropriate community-based treatment.

• Mass General HOPE Clinic: Rotation in a perinatal clinic for families impacted by substance use disorder. The HOPE Clinic is interdisciplinary, offering obstetrics, pediatric, family medicine, addiction and psychiatric care for the birthing person, partner and child(ren) from pregnancy through the first two years of the child’s life.

Elective Rotation

Trainees will have 24 weeks of an elective rotation. Electives will offer fellows an opportunity to deepen their experience in one of the areas of required training, including Inpatient care, Low Threshold Care, Integrated Primary Care, care for co-occurring disorders, and care for pregnant and post-partum families. Trainees may also create custom electives with the help of the program director focused on their unique interests.

Trainees learn to work in a team-based model with other professionals, including counselors, social workers, nurses, psychologists, recovery coaches and physicians from a variety of specialties. Teams will be based in outpatient treatment agencies, outpatient primary care settings and within community-based teams providing essential services to those suffering with substance use disorder.

Academic Preparation

Trainees will have weekly didactic sessions delivered by experts in a broad range of topics related to providing care for those with substance use disorder. Trainees will have the opportunity to participate with addiction medicine fellows and addiction psychiatry fellows in applicable didactic opportunities. In addition, fellows will have the opportunity to become involved in ongoing research projects as one of their elective rotations as time and interest allow.

Mentorship and Career Development

Mentorship and career development is an important aspect of our program. Within the first three months of the program, each fellow has the opportunity to meet with our Program Director and faculty to discuss career goals. The Program Director and faculty concretely explore fellows’ career aspirations including geography and type of position and provide guidance on the job search process, including where to search for posted job opportunities and what networking opportunities exist at local and national meetings. The program director and faculty directly connect fellows to relevant colleagues based on fellows’ interests and utilize their own professional networks to make introductions for fellows to speak with leaders in the field in geographic regions of interest to begin exploring job opportunities. In addition, our faculty represent a variety of diverse care settings and are eager to support and mentor fellows depending on their interests. After the initial meeting, career planning sessions continue monthly for the remainder of the training year.

Anti-racism Plan

As a key training program in the Mass General Program in Substance Use & Addiction Services (PSAS), the ISTP fellows will be able to be involved in the ongoing anti-racism efforts of the initiative. The leadership is currently working to implement concrete action steps as part of its anti-racism plan and welcomes input and involvement from staff across the program. This work is integrated with the Mass General Brigham United Against Racism initiative, a sweeping system-wide approach outlining broad social justice and equity goals and strategies. The Integrated Substance Use Disorder Fellowship is committed to recruiting diverse classes of fellows and works toward that goal in close collaboration with the Mass General Center for Diversity and Inclusion.

Our Team

Meet our faculty

Current Fellows

Integrated Substance Use Disorder Training Program Fellows 2023-2024

Sophia Mendez

Sophie Mendez was born and raised just outside Mexico City. She moved to the United States for college, where she graduated with a nursing degree from the University of Massachusetts, Boston. Most recently, after obtaining her master's degree in psychiatric nursing at Northeastern University, she completed a 1-year nurse practitioner residency at the VA Boston Healthcare System where she had the opportunity to provide care to veterans with complex psychiatric and substance use disorders. Prior to receiving her master’s degree spent her career as a nurse pursuing opportunities working with vulnerable populations in urban settings, spending time at Arbour Hospital, McLean Hospital, Boston Medical Center, and a community health center in Charlestown, developing a focus in treating patients with mental health and substance use disorders. She is eager to continue to learn about substance use disorders and from the people affected by this disease as well as the everchanging treatments for SUDs with the hope of expanding low threshold, harm reduction focused care within the community. She lives in the North End with her fiancé and her 5-month-old rescue puppy, Matzah. In her free time she enjoys traveling, riding her Peloton bike, and eating her way through the North End."

Lauren Pedi

Lauren is a graduate of Massachusetts College of Pharmacy and Health Sciences for Psychiatric Mental Health Nurse Practitioner – Master of Science in Nursing program in 2022 and became a licensed PMHNP-BC in 2023. For much of her professional nursing career she has provided case management services for patients in acute hospital settings earning a CCM in 2000 and PMGT-BC in pain management in 2007. She joined the case management department at Massachusetts General Hospital in 2020. In 2015 the mental health care needs of her child impassioned her decision to pursue graduate education as a PMHNP-BC, and to foster compassion and advocacy for persons experiencing mental health and substance use disorder.

In 2015, Lauren’s advocacy plan included developing relationships with mental health and substance use disorder councils and recovery organizations, supporting fundraising for recovery-based networks, and guest-attending peer-based recovery meetings. Lauren was fortunate to be provided with access to MA legislators to encourage support for mental health and substance use disorder advocacy. She presented testimony at the April 2015 Governor Baker Opioid Working Group: a collaboration between the Massachusetts Office of Health and Human Services and the Office of the Governor to create an action plan for MA to respond to the dramatic increase in numbers of opioid and heroin associated overdose deaths, registered as occurring in 2014, in persons experiencing opioid use disorder. Lauren is extremely excited to be included with her colleagues as a Fellow of the Substance Use Disorder Initiative.

Ainslie Wallace

Ainslie completed her undergraduate education at New York University and received her master’s degree in clinical social work at Boston University. Ainslie is a Licensed Independent Social Worker with diverse experience in working with victims of domestic violence, children with developmental disabilities, college students, hospice patients and individuals with chronic mental illness. Ainslie’s recent experience includes working in Adult Community Clinical Services at Vinfen as a Clinician and Assistant Team Leader. Ainslie is passionate about working in a collaborative team environment to deliver person-centered care and help individuals with mental health and substance use challenges. Ainslie is excited to utilize the ISTP fellowship to develop her clinical skills in order to offer enhanced rehabilitative, clinical and recovery-oriented support to individuals diagnosed with substance use disorders, and to continue to work in community-based mental health services.

Learn more about our past fellows

How to Apply

Eligibility

Eligible candidates will be from one of the below disciplines and meet the following criteria:

• Nurse Practitioners: Master of Science in Nursing (MSN). Current licensure as a Nurse Practitioner or Clinical Nurse Specialist in the Commonwealth of Massachusetts. Mass Controlled Substances Licensing
• Psychologists: PhD, PsyD or EDD in Psychology
• Social workers: Master of Social Work (MSW) degree required. Massachusetts license (LICSW or LCSW)

All applicants should have an interest in providing substance use disorder care in under-served, community-based settings.

Timeline & Process

Please contact Jessica Carbonneau, Program Coordinator, jcarbonneau@mgh.harvard.edu, with any questions.