(125) Feasibility of Addiction CaRE: A Program Supporting Hospitalized Patients With SUD

Background & Introduction: Approximately 5.8 million patients with substance use disorders (SUD) are hospitalized annually [1]. Care for patients with SUD is challenged by structural barriers, including fragmented care and limited access to withdrawal management, as well as social barriers including stigma and isolation [2]. As a result, patients with SUD are more likely to leave the hospital before care is completed, with recent studies showing a 50% rise in patient-directed discharges for patients with SUD between 2016 and 2020 [3].

To target this need, three undergraduate students, supported by the President’s Engagement Prize from the University of Pennsylvania, created the Addiction CaRE Volunteers program to offer non-clinical social support, address social determinants of health (SDOH) needs, and support treatment engagement for patients hospitalized with SUD. Patients referred by certified peer recovery specialists embedded within addiction consult teams. Beyond tangible resources, undergraduate student volunteers visited patients four days a week to provide social support. The aim of this study is to examine the feasibility, acceptability, and early program outcomes during the first year of program implementation.

Methods: The pilot program launched at Penn Presbyterian Medical Center in August 2024. During this time, the co-founders solicited input from providers and patients on preferences for resources to enhance patient comfort and engagement, including iPads for recovery groups or entertainment; SDOH needs were addressed through provision of hygiene and winter kits, clothing, and food. Volunteers completed training with community-based harm reduction organizations to allow them to provide compassionate and low threshold care. The project officially launched with undergraduate student volunteers in October 2024. The program expanded to the Hospital of the University of Pennsylvania in January 2025.

Recognizing the need for more specialized social supports, weekly virtual recovery sessions led by a certified recovery specialist featured personal recovery stories and open discussions among currently admitted patients. Program funds supported attendee incentives, including $25 gift card raffles.

We conducted a mixed-methods evaluation from October 2024 through April 2025. The University of Pennsylvania IRB determined the evaluation was a quality improvement initiative and did not meet the definition of human subject research. Quantitative data included metrics of feasibility including programmatic data on patient reach, frequency of encounters, and resources distributed. Qualitative data included volunteer survey data assessing perceived program impact, and acceptability.

Results: Feasibility and Patient Engagement: Between October 2024 to April 2025, Addiction CaRE Volunteers engaged 386 unique hospitalized patients across two academic medical centers, completing a total of 1,160 interactions. Patients were visited a median of two times (range 1–23), with interaction volume increasing over time, suggesting stable program implementation.

Encounters were patient-directed and varied, ranging from delivery of requested items to longer visits focused on social support and conversation, depending on patient preference. Resources were provided in the majority of encounters (97.8%) including hygiene supplies, food, clothing, and other social determinants of health supports. In addition, iPads were provided in 16.3% of encounters to facilitate participation in virtual recovery groups or for therapeutic entertainment.

Between October 2024 and April 2025, 16 virtual recovery group sessions were held, with participation from 84 unique hospitalized patients. Attendance varied by week, with a median of six participants per session (range 3–10). 12 individuals attended more than one session, including four who attended three sessions and eight who attended two sessions.

Student Volunteer Engagement and Acceptability: 24 undergraduate volunteers participated during the study period in cohort 1 (Fall 2024) and cohort 2 (Spring 2025). Of these, 54% continued in the Fall of 2025, and 21% assumed leadership roles as volunteer coordinators. Among not returning volunteers, 25% had graduated or relocated, reflecting expected turnover in a student-led program. 36 total volunteers participated and were trained in the program from all 3 cohorts (including Fall 2025).

An optional post-program survey was completed by 24 volunteers. Of the 21 respondents who rated their experience, 13 (62%) reported an excellent experience and 8 (38%) reported a good experience, with no fair or poor ratings. All respondents identified patient interaction as a meaningful component of their role, and many reported increased understanding of substance use disorders and harm reduction principles. Commonly reported challenges were operational, including navigating hospital units and coordinating around clinical care. Several volunteers initially reported discomfort entering patient rooms; however, confidence improved with experience and supervision. The majority of respondents (90%) felt adequately supported to perform their duties.

Sustainability: Program expenditures were primarily allocated toward essential patient supplies, individualized patients requests, and salary support for peer recovery specialist. 3.6% of the overall program budget was allocated to recovery-group incentives. The co-founder’s volunteer coordinator positions were turned into work-study positions for the following year to allow future students to secure meaningful employment while also supporting programmatic growth.

Conclusion & Discussion: This evaluation demonstrates the feasibility and acceptability of a student-led, hospital-based support program for patients with substance use disorders. Over a seven-month period, the Addiction CaRE Volunteers program engaged 386 unique patients across two academic medical centers and facilitated more than 1,100 patient interactions, reflecting sustained utilization and integration into inpatient care. Patient engagement occurred across a range of support types, including social interaction, provision of essential resources, and participation in recovery-oriented programming.

The study had some limitations including a focus on programmatic outcomes rather than clinical outcomes. Findings may be harder to generalize beyond academic centers with established addiction medicine teams.

High volunteer retention, volunteer to coordinator conversion, and positive feedback further support the acceptability of the program and its training model. The program’s low-cost, flexible structure allowed it to address unmet social and emotional needs while complementing existing addiction medicine services. These findings suggest that student-led, non-clinical interventions may represent a scalable approach to improving hospital experiences for patients with substance use disorders. Future work will examine associations between program participation and clinical outcomes such as patient satisfaction, length of stay, and discharges before medically advised.

References: 1. Bernstein EY, Calcaterra SL, Chopra V, Edelman EJ, Kruse GR. Prevalence of Hospitalizations Among a National Sample of U.S. Adults With Substance Use Disorders. Ann Intern Med. 2025;178(6):900-903. doi:10.7326/ANNALS-24-03385

2. Wakeman SE, Rich JD. Barriers to Medications for Addiction Treatment: How Stigma Kills. Subst Use Misuse. 2018;53(2):330-333. doi:10.1080/10826084.2017.1363238

3. Thakrar AP, Lowenstein M, Greysen SR, Delgado MK. Trends in Before Medically Advised Discharges for Patients With Opioid Use Disorder, 2016-2020. JAMA. 2023;330(23):2302-2304. doi:10.1001/jama.2023.21288

4. Chan AC, Palepu A, Guh DP, et al. HIV-positive injection drug users who leave the hospital against medical advice: the mitigating role of methadone and social support. J Acquir Immune Defic Syndr. 2004;35(1):56-59. doi:10.1097/00126334-200401010-00008