Addiction Medicine Fellowship - The NE Ohio Center for Addiction Research, Prevention, and Education (“CARPE”) Collaborative will utilize funding provided through the Addiction Medicine Fellowship (AMF) Program [HRSA 25-069] to sustain and expand the ACGME-accredited Addiction Psychiatry Fellowship (APF) at University Hospitals Cleveland Medical Center (UHCMC) and Addiction Medicine Fellowship (AMF) at partner institution MetroHealth. This innovative, city-wide collaborative model also includes faculty from Cleveland Clinic Foundation (CCF) and the Cleveland VA Medical Center. HRSA funding of fellow stipends will be used to recruit and retain 24 Addiction Fellows over the grant period. The program will sustain relationships with 36 rotation sites in the region, add a rural rotation site in Ashtabula County and a low-barrier buprenorphine clinic, refine and strengthen the didactic curriculum, and continue to raise the profile of this high-need specialty. Ohio and Cuyahoga County continue to grapple with substance use disorders (SUD) and poverty. As the second most populous county in Ohio, Cuyahoga County recorded 2,944 opioid overdose deaths from 2016 to 2020—54 per 100,000 residents, nearly twice the national rate of 28. Additionally, approximately 1,413 youth (1.6% of those aged 12–17) and 62,116 adults (6.3% of those aged 18 and older) in the county experienced untreated alcohol use disorder in the past year. While overall overdose fatalities declined in 2023–2024, overdose deaths continue to increase among some subgroups. These troubling trends underscore the critical need for a well-trained SUD care workforce (see bibliography for data cited). The CARPE Collaborative will address each of the objectives of the funding opportunity: (1) Increase the number of addiction medicine and addiction psychiatry sub-specialists trained to practice in medically underserved community-based settings; (2) Increase fellows’ knowledge and ability to assist their patients with referrals to navigate the legal and social systems related to patients’ clinical needs or care; and (3) Increase awareness of addiction medicine as a sub-specialty and reduce provider stigma. The collaborative will be led by Sybil Marsh, MD an experienced clinician and educator at UHCMC board-certified in Addiction Medicine. The leadership team will include three additional key personnel -- two Program Training Directors (one for APFs and one for AMFs) and a Program Manager. The CARPE Collaborative is applying for Funding Priority 1: Team Based Care and for Funding Preference under Qualification 1: High MUC Placement Rate.
