Intersection of Infectious Diseases and Substance Use Disorders/Addiction Medicine

1. To provide evidence-based, high quality clinical care to patients with infectious diseases and substance use disorders;
2. To drive forward the field of research on infectious diseases and substance use disorders;
3. To contribute collective expertise in ID and Addiction Medicine to policy and advocacy initiatives at local, national, and international levels.

The Nathan Smith Clinic houses a joint ID/Addiction Medicine clinic, dedicated to the ambulatory management of HIV and Hepatitis C among people with substance use disorders and the management of substance use disorders among people living with or at-risk for HIV (including provision of buprenorphine and naltrexone for opioid and alcohol use disorders). The clinic is interdisciplinary and involves monthly care coordination rounds with ID/Addiction Medicine clinicians (led by Drs. E. Jennifer Edelman, Jaimie Meyer, and Lydia Aoun-Barakat), pharmacists, social workers, nursing staff, and clinic administrators.

The Yale Center for Clinical and Community Research (YCCR) involves a number of opportunities to integrate ID and substance use disorders. These include the Community Healthcare Van (CHCV), a mobile medical clinic developed by ID faculty member Dr. Frederick Altice to deliver community-based, low barrier-to-access primary medical care throughout many impoverished neighborhoods in New Haven. YCCR also operates the New Haven Syringe Services Program (NHSSP), the largest syringe services program in the Connecticut, which provides harm reduction services, including syringe exchange and home delivery, drug testing services, overdose prevention services, testing the safe supply of drugs and onsite treatment for substance use disorders. Linked to the CHCV and NHSSP is a fixed location that provides onsite clinical services as well as research activities.

The InSTRIDE ACTION initiative, led by Dr. Sandra Springer, partners with an Alliance for Living, and HIV service organization in southeastern Connecticut, to provide a one-stop mobile health clinic service delivery model.

Several ID faculty members (Drs. Jaimie Meyer, Sandra Springer, and Lydia Aoun-Barakat) are Core and Affiliated faculty with the Addiction Medicine Program, through the Section of General Medicine. The Yale Addiction Medicine Consult Service provides consultative services for the treatment of substance use disorders among hospitalized patients at Yale New Haven Hospital.

Dual training in ID and addiction medicine is available at Yale. Upon completion of the ID fellowship program (in either the 2-year clinical or 3-year investigator tracks), trainees can track into the ACGME-accredited Addiction Medicine Fellowship program to complete an additional 1-2 year program, culminating in ABPM Board Certification in Addiction Medicine. For individuals who are interested in additional hands-on clinical experience (but without formal participation in the Addiction Medicine fellowship), ID fellows can participate in joint ID/Addiction Medicine clinics to receive hands-on mentorship with clinical experts.

The Malaysian Implementation Science Training (MIST) Program is a collaboration between Yale University and University of Malaya in Kuala Lumpur, Malaysia. The MIST program is designed to train the next generation of implementation scientists in Malaysia to overcome health disparities for people who inject drugs, men who have sex with men, female sex workers, transgender populations, and people who are incarcerated.

The Georgian Implementation Fellowship Training (GIFT) Program, is a collaboration between Yale University and Ilia State University in Tbilisi, Georgia. GIFT, like MIST, is designed to train the next generation of implementation scientists in Georgia, with an emphasis on biostatistical training, to develop and test innovation implementation strategies to overcome health disparities for people who inject drugs, men who have sex with men, female sex workers, transgender populations, and people who are incarcerated.