Division of General Internal Medicine

Clinical Addiction Research and Education (CARE) Fellowship

Substance abuse disorders are highly prevalent in the Bronx.

  • The New York State Office of Alcoholism and Substance Abuse Services (OASAS) estimates that over 82,000 adults in the Bronx have alcohol abuse or dependence, 21,000 are non-narcotic drug users, and 40,000 use heroin.
  • There are more drug-related hospitalizations in the Bronx than any other borough in New York City, and the rate of hospital inpatient discharges of Bronx residents with primary diagnoses of alcoholism or substance abuse is almost twice the city-wide rate and highest of the five NYC boroughs.

On a national level, substance abuse accounts for a high proportion of inpatient hospital stays and outpatient visits. National estimates suggest that 25-40% of hospital admissions are related to substance abuse and its sequelae, and that 10-20% of outpatients seen in general medical practice are suffering from problems related to addiction.

The Einstein Clinical Addiction Research and Education (CARE) Program, a 2-year post-doctoral fellowship program that began in 2002, provides clinical research training strategically designed to prepare physicians for independent careers in clinical practice and as HIV and substance abuse researchers. Training in Montefiore Einstein's uniquely diverse Bronx community includes:

  • a foundation course in addiction psychiatry
  • completion of a Master’s Thesis in Einstein’s Clinical Research Training Program (CRTP)
  • clinical work in substance abuse
  • completion of a mentored research project
  • teaching experience

Additionally, CARE Program faculty collaborate with key educational leaders at Montefiore Einstein to enhance evidence-based substance abuse training for Internal and Family Medicine residents and for Einstein medical students.

The increasing prevalence of opioid dependence has led to a broader and deeper focus on alternative methods of treating opioid dependence, including the opioid agonist therapies methadone and buprenorphine. With increasing knowledge about buprenorphine gained through local clinical research, General Internal Medicine researchers have expanded buprenorphine treatment capacity in several primary settings, and regularly train resident physicians to prescribe this medication.

Program Director

Julia H. Arnsten, M.D., M.P.H.Julia H. Arnsten, MD, MPH (bio) 

Professor, Department of Medicine (General Internal Medicine)
Professor, Department of Epidemiology & Population Health
Professor, Department of Psychiatry and Behavioral Sciences
Chief, Division of General Internal Medicine
Director, Center for Comparative Effectiveness Research

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