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Emergency Department Impact Spotlight
From the Back of the Campus to the Front of the House: How LifeBridge Health's Sinai Hospital Built Addiction Treatment Into Its Culture
- Published
- August 31, 2026
- Facility
- Sinai Hospital, LifeBridge Health
- Region
- Baltimore City
- Featuring
- Devang Gandhi, MD, Medical Director, LifeBridge Health Addiction Treatment Programs
Tagged
- Baltimore City
- Initiation/continuation of addiction medications
- Assessment/management of co-occurring conditions
Inclusion is not an endorsement
The Maryland Department of Health shares this account to highlight practices other facilities may find useful. Appearing in this series is not an endorsement, recommendation, certification, or approval of any hospital, health system, provider, vendor, or program by the Maryland Department of Health or the State of Maryland. Descriptions and figures are provided by the participating facility.
“Even if the other clinic is across the street from you, the patient won’t cross and go there.”
Dr. Devang Gandhi has spent almost 30 years in addiction medicine, and 13 of them as medical director of the LifeBridge Health Addiction Treatment Programs, anchored at Sinai Hospital's Addiction Recovery Program (SHARP). When he started, SHARP was an old-school outpatient clinic tucked in the back of the Sinai campus, so unknown to the rest of the hospital that many staff didn't realize it existed.
Methadone doses were capped low regardless of clinical need, and patients who relapsed could be discharged from treatment entirely. Hospital staff who admitted patients on methadone often didn't verify their doses. Many told patients their treatment was wrong or their dose was too high. "There was a lot of negative perception around medication treatment amongst the hospital staff, and that obviously didn't help our patients," Gandhi said.
Today, SHARP is an integrated model for opioid and mental health treatment, and Sinai has become a training ground that shapes how the next generation of physicians thinks about addiction.
Integrating substance use and mental health so patients only have to tell their stories once
The vast majority of SHARP's patients have a co-occurring mental health condition, so the program built its treatment around that reality instead of referring people elsewhere. Patients are screened at admission, and if they aren't already connected to mental health care, they see Gandhi directly, who addresses both conditions in the same visit and adjusts medications for either as needed. Staff provide counseling for substance use as well as individual therapy for mental health. Therapist-led groups address both together, including a grief group and an open group covering mental health, addiction, or whatever needs patients raise. Two peer recovery specialists are now embedded in the program, helping new patients find housing, benefits, and food, including through a food pantry SHARP started for patients.
Gandhi said the integration matters because referring patients elsewhere rarely works. "Even if the other clinic is across the street from you, the patient won't cross and go there," he said, pointing to fear of the unknown and past bad experiences with providers as the reason. Keeping treatment in one place also spares patients from repeatedly retelling painful histories, and lets Gandhi, who is trained in both addiction and psychiatry, distinguish symptoms driven by substance use from those driven by mental illness rather than guessing from one side of the picture alone.
Turning the Hospital Itself Into a Training Pipeline
Sinai's second major shift has been institutional: bringing addiction education into every level of medical training that touches the hospital. First and third year internal medicine residents rotate through SHARP, as do third and fourth year George Washington University medical students, since Sinai serves as GW's regional campus with 30 students a year. Each group works through the same core reading list, covering opioid and alcohol treatment as well as medical, non-stigmatizing language. Each group also sees patients directly with Gandhi, many of whom are stable and thriving. "That makes these patients more human to them," he said, countering the common assumption that patients with addiction are something to be feared or beyond help.
That training pipeline hasn't worked alone. It was paired with hospital leadership willing to champion change, including Chief Medical Officer Dr. Albrecht and newly hired staff with prior addiction experience. Together, they've let Sinai revise its inpatient protocols for starting methadone and buprenorphine, including in the emergency department. Grand rounds presentations and training for nurses and social workers run alongside the resident and student rotations. Pharmacy staff have also joined a regular collaborative that is still building out new protocols and order sets. Gandhi credits the culture shift as much to the residents as to any policy: "Their attendings sometimes often have these negative attitudes still, but the residents can influence them."
What other Maryland hospitals can take away
Gandhi's clearest message for other hospitals is that addiction treatment should never be treated as optional or as someone else's problem. He compares it to a hospital sending home a newly diagnosed diabetic without any plan to manage their blood sugar: unthinkable in any other area of medicine, yet still common practice for patients with opioid use disorder, even though the medications are highly effective and not complicated to manage. He also points to a few concrete, transferable lessons: find a leadership champion, since change is hard to sustain without one; build a coalition across nursing, pharmacy, and social work rather than relying on one department; and get medical trainees into the room with real patients early, since that exposure shapes how they practice for the rest of their careers.
Despite the challenges, Gandhi remains optimistic about where the field is headed. "I think we are moving in a good direction," he said, "and at least we are getting rid of some of the less productive things that we carried in as baggage from the old things."
By the numbers
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1970show long an addiction treatment program has operated on the Sinai campus
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30 studentsmedical students hosted this year, in addition to rotating internal medicine residents
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2 peerspeer recovery specialists embedded in the program to connect patients to housing, benefits, and food
Figures reflect what the interviewee reported and are provided by the participating facility.
What other Maryland hospitals can take away
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Find a leadership champion. Protocol changes that stalled for years moved once a supportive chief medical officer and like-minded hospitalists were in place.
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Build a coalition, not a single department. Nursing, pharmacy, and social work all sit on the collaborative writing Sinai’s new protocols and order sets.
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Get trainees in the room with patients early. Residents and medical students who see stable patients carry that perspective into practice, and back to their attendings.
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Integrate rather than refer. Patients frequently do not follow through on outside referrals, even to a clinic across the street.
Despite the challenges, Gandhi remains optimistic about where the field is headed. “I think we are moving in a good direction,” he said, “and at least we are getting rid of some of the less productive things that we carried in as baggage from the old ways.”
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