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Emergency Department Impact Spotlight

Grace Medical Center: Building an Emergency Department Response to Opioid Use Disorder from Scratch

Published

August 31, 2026

Facility

Grace Medical Center (formerly Bon Secours Baltimore Hospital)

Region

Baltimore City

Featuring

Dr. Aliya Jones, former Chief of Psychiatry & Chair of Behavioral Health, Grace Medical Center

Tagged

• Baltimore City
• Initiation/continuation of addiction medications
• Assessment/management of co-occurring conditions​

“You’ll do much more good the more that you believe that people can change, than you will having a different belief system. A different belief system makes you more punitive in your approach, and that doesn’t help anyone.​”

Dr. Aliya Jones has spent nearly her entire career in Maryland's addiction treatment system. She moved from an office-based opioid treatment practice in Laurel and Hanover, to the psychiatry leadership team at Grace Medical Center, then to two years as deputy secretary of the Behavioral Health Administration during the height of the COVID-19 pandemic, and now to Clifton T. Perkins, the state's only maximum-security forensic psychiatric hospital. Across each of those settings, she has approached opioid and alcohol use disorder the way she approaches any other disease process: with medication, without apology, and led by evidence over inertia.

Building the Emergency Department Response with Mosaic

That approach shaped two of the more significant programs Jones helped bring into Grace Medical Center. Partnering with the Mosaic Group, the vendor Jones credits with launching opioid use disorder (OUD) programs in emergency departments across the state, Grace Medical Center became the group's second pilot site for buprenorphine induction in the emergency department , and shortly after, for what Mosaic called its Overdose Survivors of Opioids program. In that program, a peer was among the first people to greet a patient waking up from an overdose, beginning a relationship that continued for up to 90 days in the community: connecting patients to medication, treatment, and case management—efforts that have been proven to reduce subsequent overdose risk. 

Neither program was easy to stand up. Provider stigma around treating OUD in acute settings was significant, and buprenorphine induction protocols were brand new to the emergency department when Grace Medical Center took them on. Jones's own philosophy left little room for hesitation: "If there's a need, then let's see what we can do to fill the need."

Making Medication the Default, Not the Exception

Jones argues that the biggest gap in acute hospital psychiatry isn't awareness that medications for opioid and alcohol use disorder work; the evidence on that, she says, is settled. The gap is the reflex to treat them as optional or as something to defer until discharge. "It should be the norm that folks are put on medications and not the exception," she said. "It should be the expectation... Your goal should always be to motivate the patient to take medication for the substance use disorder." She's equally direct about the role clinician attitude plays in outcomes, pointing to years of watching peer recovery specialists change how staff interact with patients in crisis. Peers, she said, are what give people empathy and compassion, and that empathy has a downstream effect on prescribing, and on how willing a patient is to follow through. Her broader view of behavior change extends past any single protocol: "You'll do much more good the more that you believe that people can change, than you will having a different belief system. A different belief system makes you more punitive in your approach, and that doesn't help anyone."

​What Other Maryland Hospitals Can Take Aways

Jones's recommendation to acute-care hospitals is a short list with a long track record behind it: identify every patient with an active or past substance use disorder before they leave, start as many of them on medication as possible, and connect them to treatment rather than assuming the next provider will. She's candid that emergency department buprenorphine induction, more than a decade after Grace Medical Center piloted it, is still underused relative to its potential, a gap she attributes less to evidence than to stigma. Her closing advice doubles as a description of how she has approached every role since her residency: "Go with the science. Go with what the evidence shows... The evidence is very clear that medications do work."

By the numbers

• 2ndGrace Medical Center was Mosaic’s second pilot site in the state for ED buprenorphine induction
• 90 daysthe community relationship a peer began with each overdose survivor
• 7 yearsJones’s tenure leading behavioral health at the hospital

Figures reflect what the interviewee reported and are provided by the participating facility.

More impact spotlights

• Using the DEA 3-Day Rule to Ensure Treatment Continuity — University of Maryland Medical Center, Central Maryland
• Hope as a Strategy — ChristianaCare Union Hospital, Upper Eastern Shore
• Meeting a Life or Death Moment With Care — Meritus Health, Western Maryland