The Outpatient Pharmacy at Temple University Hospital–Episcopal Campus is now offering long-acting injectable medications for patients with substance use disorder (SUD) and behavioral health conditions. These injectables, which can last from two weeks to six months but are most often given monthly, are part of Temple Health’s efforts to address the community’s needs in these areas.
LJ Rasi, Director of Behavioral Health at Episcopal, explained that hospital readmission rates are high among behavioral health patients, often because they stop taking their medications after discharge. “Behavioral Health patients have a much higher rate of returning to the hospital within 30 days, usually because they stop taking their medications,” Rasi said. “When they’re in inpatient treatment, they’ll start taking medications and feeling better. But once they’re discharged, they’ll figure that since they feel good, they don’t need the medications anymore. Then things will go south, and they’ll end up hospitalized again. It’s a vicious circle.”
Rasi added: “But long-acting injectables guard against that whole issue. A patient will get them when they’re discharged, which prevents them from saying, ‘I’m feeling better, I’m going to stop taking my meds,’ or even forgetting to take them for a few days. They’ve really been a game-changer for our patients.”
Frank Breckenridge Chumley Jr., MD, Medical Director of the Substance Use Disorder Clinic at Episcopal Campus, noted that these medications are also important for SUD patients who may face challenges keeping oral medication secure due to unstable housing situations. “Many of the patients we serve are unhoused or living in shelters, where it’s very difficult to keep their medications secure,” Dr. Chumley said. “If someone loses a month’s worth of oral or sublingual medication a week into treatment, you’re in a tough spot. Insurers typically cover one early refill a year, and after that, you’re on your own. But long-acting injectables make it impossible for your medication to be lost or stolen once it’s already administered.”
Dr. Chumley further explained: “The injectables also play an important role in how patients approach their recovery. There are a lot of people who say, ‘I want to make sure I’m doing something active to participate in my recovery every day, like taking this pill.’ But there’s a whole other group that says, ‘I want to forget that this was ever a problem in my life. I want to move on and for my life to be as close to what it was like before all this happened.’ Long-acting injectables are really helpful for that latter group because they take away the daily reminder.”
Ali Shahbaz, PharmD and Manager of the Episcopal Outpatient Pharmacy stated: “In the past many of the patients we discharged from the hospital were having to rely on outpatient community providers for their medications…It could be very difficult to get appointments at those facilities which meant they would have to wait two or three months…Their only other option was to admit themselves back…But now patients who have been seen at Episcopal can continue to come…for long-acting injectables even if they’re seeking outpatient care elsewhere.”
Dr. Chumley said having pharmacy staff administer injections allows clinic providers more time with each patient: “Now that Ali and his team are administering injections in the Pharmacy it makes my interactions—and those of the other providers in the Substance Use Disorder Clinic—much more focused on having a discussion with the patient and figuring out what they need.”
He added: “Patients can come here every month and receive these injections indefinitely…This is understood as a maintenance medication for a chronic condition.”
Aurelia Bizamcer MD PhD MPH Professor of Psychiatry and Behavioral Science at Lewis Katz School of Medicine described one patient’s experience: “We had one patient who was experiencing residual symptoms of mania and paranoia which made her a little ambivalent about the long-acting injectable,” Dr Bizamcer said.“She told us that because of the Pharmacy staff’s pleasant bedside manner she ended up feeling comfortable taking the medication.Now she’s feeling much better—and she’s grateful for the Pharmacy’s services.”
