When patients are admitted to The University of New Mexico Hospital, they are usually there for something like an infection, a surgery or another medical emergency. But many of those same patients also live with substance use disorders. Until recently, that aspect of their health often went untreated during their hospital stay. 

Now, a program called CAMINOS is changing that. 

“We are an addiction medicine consult service,” said Sergio Huerta, MD, medical director of CAMINOS. “Anybody with an addiction in the hospital, we can see, even if it hasn’t been diagnosed yet. The whole concept is to meet people where they’re at when they’re most vulnerable and most in need.” 

CAMINOS, which stands for Coordinating Addiction Medicine with Inpatient and Outpatient Services, connects patients with treatment during their hospital stay and helps them transition into ongoing care once they leave. 

Huerta, who is board-certified in both addiction medicine and internal medicine, explained how the program works. 

“We go talk to the patient, offer them treatment services, including medications, and refer them to treatment,” he said. “We also have a peer on our team with lived experience in recovery. Patients who are seen by peers tend to do better. They’re more adherent to their medications and treatments when they leave the hospital.” 

For Chris Smith, MD, director of operations for CAMINOS and section chief of Hospital Medicine, the impact is evident. 

“Almost every patient we see is not here primarily for their substance use disorder,” Smith said. “They’re admitted for something else. Before our service, these problems weren’t always addressed. Now, the primary team can call us to see the patient, and we can start them on treatment during their stay.”

Before CAMINOS, patients with addictions often left the hospital with little more than a referral sheet. 

“There wasn’t really much help for patients with substance use disorders,” Huerta said. “We treated the admitting diagnosis, like pneumonia, and then gave them a list of resources for when they left. That really wasn’t the best way to do things.” 

The stakes in New Mexico are especially high. The state has the highest alcohol-related death rate in the country and is consistently ranked among the worst for drug overdose deaths. Huerta estimates that about one in 10 New Mexicans lives with a substance use disorder. 

At UNM Hospital, that means a large share of inpatients also need addiction treatment. In its first year, CAMINOS logged more than 1,200 consults, making it one of the busiest consult services at the hospital. Of those patients, more than 450 were newly started on proven medications like buprenorphine or methadone for opioid use disorder. 

 

Substance use disorders are everywhere. No matter what you end up doing as a physician, you’re going to see patients with this. Having that background makes you a better provider.

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 – Chris Smith, MD, Director of Operations, CAMINOS & Section Chief, Hospital Medicine, UNM Hospital

“Even if only half of those patients continue treatment after discharge, that’s a huge success for a population that can be very difficult to engage,” Smith said. 

The program’s impact is visible every day, Huerta said. 

“These patients are always the most appreciative and the most thankful,” he said. “Just showing them that there’s somebody here who cares goes a really long way.” 

Smith noted that patients who start treatment for addiction are less likely to leave the hospital against medical advice. They are also more likely to follow through with other treatments for conditions like diabetes, infections or chronic disease. 

“It has a dramatic change on their whole hospital stay,” Smith said. 

The program is also shifting how hospital staff think about addiction. Huerta shared how some clinical teams that were once hesitant to start addiction medications are now more comfortable doing so thanks to CAMINOS. 

“Our goal is that the primary teams feel more comfortable identifying and treating substance use disorders,” Huerta said. “We’re beginning to change the culture.” 

CAMINOS is also an educational hub. Medical students, resident physicians, and trainees in their fellowship now rotate through the service, learning to treat substance use disorders alongside experienced providers and peer support specialists. 

“Substance use disorders are everywhere,” Smith said. “No matter what you end up doing as a physician, you’re going to see patients with this. Having that background makes you a better provider.” 

Huerta and Smith see CAMINOS as a model for the future. They hope to expand the program to serve more patients, strengthen outpatient connections and eventually help people across the state through call-in support lines and partnerships with other hospitals. 

“It’s a reachable moment when patients are here,” Huerta said. “By offering treatment, we help them feel more comfortable, we help them stay and complete their care, and we give them a better chance at recovery. That’s what makes this work so meaningful.”