At the Forefront of Addiction Care
Pharmacist-led addiction consult service takes root at University of Illinois Hospital and fosters a new standard in addiction care.
As academia...
As the Academia and Family Medicine Pharmacy Research Fellow at the UIC Retzky College of Pharmacy from 2021-2022, Dr. Eden Keller frequently navigated Chicago’s West Side in a mobile unit providing care and guidance to individuals battling opioid use disorder.
The experience opened Keller’s eyes to the depths of the opioid overdose crisis ravaging America, delivering insights into addiction and the vulnerability of those battling substance use issues. The frontline experience also brought Keller into the specialized world of addiction medicine, a niche area requiring its own knowledge and skills to craft medical plans rooted in evidence-based care and reducing harm.
Today, Keller calls upon that formative experience often as the first-ever addiction clinical pharmacist at the University of Illinois Hospital. As part of an interdisciplinary team in the hospital’s new addiction consult service, Keller is helping to transform care for those with substance use disorders and drive recovery.
“I’ve had so many positive interactions with patients, which helps me see how we’re impacting individuals and the community at large,” says Keller, a clinical assistant professor in the Department of Pharmacy Practice.
Origins of a novel service
Origins of a novel service
Keller’s new position at the hospital and the interdisciplinary consult service is four years in the making.
In 2022, Dr. Jennie Jarrett, then an assistant professor in the Department of Pharmacy Practice, noted inconsistent approaches to care and use of medications for opioid use disorder at a time in which fentanyl was flooding the city’s street drug supply and opioid overdose rates surged. She also identified incomplete and fragmented training for health professionals across campus, particularly with the prevailing disconnect of inpatient services and linkage to outpatient care. Approaches to patients with substance use and substance use disorder, Jarrett says, appeared more makeshift than evidence-based and coordinated.
“It was pretty clear to me a specialty-type, interdisciplinary service was needed in the inpatient realm, including peer support and pharmacy services to best support patients when they were in the hospital,” says Jarrett, who submitted a grant to the Illinois Department of Healthcare and Family Services’ Division of Substance Use, Prevention, and Recovery (SUPR) to introduce a pharmacist-led addiction consult service at the University of Illinois Hospital.
SUPR’s subsequent approval of a three-year grant enabled a pharmacist to see patients and provide support to physicians and other professionals involved in addiction medicine at the hospital. Keller, then Jarrett’s fellow, was tasked to lead the effort—charged to manage her own patient list, coordinate care plans, and offer referrals to outpatient resources in the new role.
Quickly, however, the program shifted from an addiction consult service—its original intent—into a more narrowly focused opioid use disorder consult service, largely a byproduct of the innovative nature of the inpatient, pharmacist-led service and rising opioid addiction numbers in the Chicago area. Dr. Paul Stranges, clinical associate professor and assistant director of opioid stewardship and drug diversion at UI Health, helped support evaluation and implementation of the service. Over the service’s first three years, Stranges found the service facilitated an exponential increase in the prescription of methadone and suboxone to treat opioid addiction, which helped prevent deaths while ushering in a new standard of care.
Despite the service veering from Jarrett’s original plan, its successful implementation nevertheless underscored the value of strengthening addiction medicine in the 451-bed hospital.
“The service was filling a need and addressing a necessary gap,” says Jarrett, who departed UIC in 2024 to serve as director of science and drug policy at the American Medical Association.
Taking the next step
Taking the next step
With the three-year grant about to expire in mid-2025, leaders of various hospital departments pushed to create a full addiction service based on Keller’s work with the opioid use disorder service. The plan called for something more robust, more encompassing, and more interdisciplinary, featuring a clinically diverse medical team as well as rotations for UIC’s medical residents. UI Health leadership approved the plan last fall and installed Keller as the hospital’s inaugural addiction clinical pharmacist.
Keller’s days now embrace a familiar routine, even if individual cases are far from routine. She identifies new patients in need of addiction consultation as well as those who require follow-up. She attends rounds with a team of clinical colleagues, teaches pharmacy and medical residents in real time through patient cases, and dispenses medications to patients.
Through her previous three-year run in the hospital’s opioid use disorder service, Keller developed relationships with community resources, including methadone clinics. This enables her to direct individuals to appropriate outpatient services and facilitate more coordinated care. Keller’s enterprising spirit also sparked the introduction of a take-home methadone program to bridge the gap between hospital discharge and the methadone clinic visit. The novel program has helped to reduce hospital stays and improve outcomes.
Transforming care, impacting lives
Though the medical establishment widely recognizes substance use disorders as chronic, treatable diseases, negative biases and stigma remain prevalent in the healthcare world, which frequently leads to delayed care and undertreated pain. Patients often get pushed through a hospital system. Care is rushed, disjointed, even deficient.
Keller and her teammates on the hospital’s addiction consult service, however, are reshaping that narrative and providing patients more responsive and compassionate care.
“When they interact with our team, they’re talking with someone who cares, someone who’s present to address their symptoms and withdrawals and provide personal treatment,” Keller says.
Though Jarrett is two years removed from her UIC faculty days, she is proud of Keller and thrilled to see the addiction clinical pharmacist role with the multidisciplinary consult service take root at the University of Illinois Hospital. She says the increased integration of these services at hospitals plays a vital role in increasing access to treatment and combatting substance use disorders in communities across the U.S.
“Ultimately, it’s about meeting patients where they are and systemizing access to these life-saving medications,” Jarrett says.