PANDA: Preventing Alcohol, Nicotine and Drug Addiction
A new substance abuse prevention program offers patients in-house support and resources.
Substance abuse is an ongoing battle in the United States. In 2018, more than 60,000 people died from drug overdose. According to the Centers for Disease Control and Prevention, the number of drug overdose deaths was four times higher in 2018 than in 1999. Additionally, recent provisional data shows an acceleration of overdose deaths during the COVID-19 pandemic.
“Substance use disorder is a major crisis in our country and has gotten worse during the COVID-19 pandemic as people spend time in quarantine and practice physical distancing,” said Judella Haddad-Lacle, MD, an associate professor and medical director of UF Health Community and Family Medicine – Jacksonville. “My team and I want to help patients turn their lives around in the early stages of abuse.”
Haddad-Lacle worked Melissa Caperton, reimbursement and quality improvement manager at UF Health Jacksonville, to find a solution. They partnered with the value-based care and IT teams to build screening tools and workflows in Epic, UF Health’s electronic medical records system.
The solution was an in-house prevention program called PANDA, or Preventing Alcohol, Nicotine and Drug Addiction. It focuses on attempting to prevent addictions through the use of proven screening tools, educational and behavioral support, cross-system referrals and the development of effective interdepartmental partnerships.
In late 2020, Caperton and Haddad-Lacle, with the support of several teams, officially launched PANDA as a pilot program at two UF Health primary care locations. By incorporating the tools and surveys built into Epic, primary care providers are able to identify at-risk patients and offer resources for support. Caperton and her team are also offering training for primary care providers to increase their knowledge and comfort level with discussing these sensitive topics with their patients.
Judella Haddad-Lacle, MD, associate professor and medical director of UF Health Community and Family Medicine – Jacksonville.
The PANDA Process
The process begins with a questionnaire patients take during their annual visit. On the basis of the patient’s response to certain questions, he or she may receive a score that raises a red flag and alerts their primary care doctor to review. The doctor will determine if further conversation with the patient is needed.
In the event there is substance abuse potentially identified, the doctor may then carefully bring up the topic with the patient. For example, if a patient has an issue with nicotine, the doctor will gauge their interest in quitting and offer them the resources available at UF Health. After that, the patient has a chance to speak to either a counselor or a pharmacist to discuss options for addressing concerns. For nicotine users, the four-week smoking cessation class called “BIG STEP” is available.
For more serious issues, such as opioid use disorder, the doctor refers the patient to Michael Sorna Jr., MD, medical director of addiction psychiatry services at UF Health Jacksonville. Sorna works with the patient and creates a medication-assisted treatment plan, which uses a combination of medications alongside counseling or therapy to offer a well-rounded approach to treating opioid use disorders.
One of the main benefits of PANDA is the opportunity for patients to access these resources and programs in-house at UF Health versus going to an outside resource or recovery program.
As the program rolls out to more UF Health primary care locations across Jacksonville, its main goal is not only to help patients struggling with substance abuse get treatment, but to also provide tools and resources patients need to prevent addictions. Additionally, Caperton and Haddad-Lacle hope to increase education and awareness on the topic with primary care providers and the general public.
“If we can catch signs of substance abuse early on and help the patient before addiction takes hold, it will significantly improve their overall quality of life,” said Caperton.
For more information on the PANDA program, contact Melissa Caperton at Melissa.Caperton@jax.ufl.edu.
Michael Sorna Jr., MD, medical director of addiction psychiatry services at UF Health Jacksonville.
