Humanizing the hospital experience for people with substance use disorders

Anooshey Ikhlas, Catherine Hood, and Brianna Aguilar, winners of a 2024 President’s Engagement Prize, will work with Penn Presbyterian Medical Center to address challenges faced during hospitalization and reduce premature discharges.

Brianna Aguilar, Catherine Hood, and Anooshey Ikhlas.
Brianna Aguilar, Catherine Hood, and Anooshey Ikhlas are recipients of the 2024 President’s Engagement Prize for the Presby Addiction Care Program.

Every Wednesday evening for three hours, fourth-year students Anooshey Ikhlas and Brianna Aguilar head to Love Park to volunteer with The Everywhere Project, a Philadelphia-based harm reduction organization that works to decrease the stigma against people with substance use disorders. At different stations, volunteers hand out a variety of food options; the overdose reversal medication naloxone, fentanyl and xylazine test strips, and other harm reduction supplies; and donated clothes.

This is part of their involvement with the Student Harm Reduction Coalition (SHaRC), an organization that fourth-year Catherine Hood co-founded with Ikhlas and third-year Katelyn Colamesta. Now with about 30 members, its mission is to educate peers and provide consistent support—through volunteer cohorts—to four harm reduction organizations: The Everywhere Project, Prevention Point, Penn Medicine’s Center for Addiction Medicine and Policy (CAMP), and Operation In My Back Yard, where Hood volunteers.

The National Harm Reduction Coalition describes harm reduction as a set of strategies and ideas designed to minimize the negative consequences of drug use—rather than simply ignoring or condemning it—and meet people who use drugs “where they’re at.” Aguilar says the organizations SHaRC works with want to make sure that if people are doing drugs, it’s in a way that reduces risk of infection. To do so, the organizations provide wound care kits and syringe exchanges, she says, an approach that complements prevention and treatment efforts.

Hood, Ikhlas, and Aguilar, all students in the College of Arts and Sciences, are respectively president, vice president of outreach, and vice president of education for SHaRC. They are now preparing to expand their harm reduction work by launching the Presby Addiction Care Program, a volunteer program at Penn Presbyterian Medical Center. The team’s goal is to improve the hospital experience for people admitted for any reason who have a substance use disorder and to decrease premature discharges.

Brianna Aguilar.
Brianna Aguilar

The project is a recipient of a 2024 President’s Engagement Prize, a competitive award that empowers Penn undergraduates to design and undertake post-graduation projects that make a positive, lasting difference in the world. Each project will receive $100,000 in implementation costs and each team member gets a $50,000 living stipend for next year. The Presby Addiction Care Program team will be mentored by Jeanmarie Perrone, professor of emergency medicine in Penn’s Perelman School of Medicine and founding director of CAMP.

“Anooshey, Catherine, and Brianna have a track record of community involvement that brings an impressive level of understanding and empathy to people who struggle with a range of issues, including addiction,” said Penn Interim President J. Larry Jameson. “The Presby Addiction Care Program, now boosted with a President’s Engagement Prize, is a wonderful example of a meaningful partnership that is tackling one of Philadelphia’s most pressing challenges. This project will save lives, and in health care that should always be the goal.”

Penn Medicine researchers found that premature discharges for people with opioid use disorder increased 50% from 2016 to 2020, and being discharged before it’s medically advised is associated with a higher likelihood of death or hospital readmission. Patients with addiction cite withdrawal and pain as their reason for leaving early.

Through collaboration with Penn Presbyterian’s Addiction Consult Team, Aguilar, Ikhlas, and Hood plan to address these issues by training volunteers to offer emotional support and resources—such as prepaid phones, iPads, gaming consoles, and art supplies—on evenings and weekends. Ikhlas says the iPads could help connect patients to peer programs, such as SMART Recovery, and keep them busy to distract from the isolation of being in the hospital.

She adds that the team also plans on providing DoorDash gift cards so patients can look forward to a meal outside of the hospital cafeteria. Between activities and food, the students want patients to have choices, a fundamental tenet behind the project: Everyone deserves dignity.

“The Addiction Consult Team, because of how prevalent the opioid epidemic is here, is spread very thin,” says Aguilar. “With our program, we wanted to create a volunteer system where, especially when doctors and nurses leave in the off-hours, there will be people there to talk to patients.”

Anooshey Ikhlas.
Anooshey Ikhlas

Perrone says although the Addiction Consult Team includes a social worker, a peer, two addiction medicine specialists and often a student or resident, the team is limited in what they can provide due to the number of patients who need their care. Her role as project mentor will be to help the students bridge the gap between their vision of being helpful and making it reality, says Perrone.

The students have outlined ways to address the loneliness and boredom of hospitalization and to empower patients, Perrone says. “They have proposed a new angle for how we can support patients,” she says. “It’s something that I think could be very successful in its simplicity, supporting patients with a special meal, a conversation, or access to an iPad on a regular basis.”

Developing a passion for harm reduction

Ikhlas, a neuroscience major with chemistry and health care management minors, from Raynham, Massachusetts, says she has been aware of the President’s Engagement Prize since the beginning of her second year and has followed the work of prize winners on social media. She had long wanted to apply but says this moment still feels unreal.

She has known Hood, a health and societies major and chemistry minor from West Greenwich, Rhode Island, since they were randomly assigned as roommates in their first year at Penn, and they became friends with Aguilar, a sociology major from West Haven, Connecticut. The three began living together since their third year, and Hood says it was natural for them to have conversations about their interests and activities around harm reduction.

Catherine Hood.
Catherine Hood

With experience as a pharmacy technician, Hood says her understanding of the over-prescription of opiates shaped her desire to change a harmful system. She then volunteered with Prevention Point the summer before her third year, her first introduction to harm reduction. Hood is also a former shift leader and Policy & Outcomes Committee member for Penn’s Shelter Health Outreach Program, which she credits for inspiring the volunteer-cohort design of SHaRC.

“One of our reasons for keeping the same cohort for our shifts every week is familiar faces,” says Ikhlas, who joined Prevention Point as a syringe service volunteer the fall after Hood started. “We want to be familiar faces; we want our volunteers to be familiar faces. I think that’s really important to help with the support and comfort.”

Ikhlas has been involved in addiction prevention since high school, she says, starting with gambling addiction prevention and then presenting to middle schools and high schools about vaping and tobacco. In high school, she formed an addiction prevention peer group and was involved in the Statewide Leadership Team of the 84 Movement. Ikhlas was looking to get involved at Penn, so she became a research assistant in the Addiction, Health, & Adolescence Lab in the Annenberg School for Communication.

Aguilar, who is part of the Civic Scholars Program at Penn, says her interest in addressing the opioid epidemic stems from her passions for social justice and community engagement. She has worked with the Latinx community in South Philadelphia, through internships at the nonprofits Juntos and Puentes de Salud. “It’s been really important to me to get involved in the Philly community as much as possible while also respecting boundaries,” she says.

Once they launch the Presby Addiction Care Program, all three students intend to go on to medical school. Ikhlas and Hood say they’re interested in pursuing a subset of addiction medicine. Aguilar is interested in going into emergency medicine and is particularly passionate about providing undocumented immigrants with health care. They share the desire to see the program continue beyond the next year.

“I’m grateful that Penn put their trust in us with the President’s Engagement Prize and saw this as an issue that’s worth pursuing,” says Aguilar.