The Emergency Department physician has evolved into a leader in the field of addiction, championing inter-agency alliances, developing innovative treatment programs, and championing the power of peer coaches and support
BERLIN, VT – A longtime Emergency Department (ED) physician and clinical leader at University of Vermont Health Network – Central Vermont Medical Center has been honored for what colleagues and addiction treatment professionals throughout the region call his paradigm-shifting contributions to substance use treatment, recovery and support.
Javad Mashkuri, MD, an emergency medicine physician and former medical director of the ED at UVM Health Network – Central Vermont Medical Center, recently received the 2024 Davida Coady Gorham Medical Professional of the Year Award from NAADAC, the Association for Addiction Professionals (NAADAC). The award, which was last conferred in 2021, recognizes individuals who have made an outstanding contribution to the addiction profession.
Dr. Mashkuri, who joined the hospital’s ED as a staff physician in 2011 and evolved into an addiction services leader in its ED over the next 14 years, has spent more than a decade advocating for and helping to reimagine substance use treatment and recovery in central Vermont. In the process, he has developed a career that includes designing and implementing a new model of outpatient support for individuals in need of alcohol detoxification, advocacy of innovative programs that have made the region a national model for community-based inter-agency collaboration, and combating the silos and stigma that often fracture networks of support and reduce the effectiveness and availability of care.
“The only reason you get an award like this is working with a tight-knit group who have dedicated their lives to achieving what we’ve achieved,” said Dr. Mashkuri. “I look at it as validating the work we’ve done lowering barriers to care and teaching people that successfully treating substance use disorders takes a team. Substance use isn’t an individual problem, it’s a community problem.”
“We have a special relationship with our hospital here that I don’t think is the same anywhere else,” said Robert Purvis, executive director of Turning Point Center of Central Vermont. “That’s because of Javad and [Mark Depman, MD]. He’s a wonderful clinician who cares deeply about people and understands the stigma facing individuals with substance use disorder.”
Launching a Community-Focused Coalition
Dr. Mashkuri began to focus on the treatment of substance use disorders in 2013. Dr. Depman, who at that point was medical director of the hospital’s ED, had recognized an unmet need and co-written a statewide grant proposal that would bring a program known as Screening, Brief Intervention, and Referral to Treatment (SBIRT) to Vermont.
With Dr. Mashkuri leading the program’s implementation at Central Vermont Medical Center, the hospital’s SBIRT program became Vermont’s flagship service for individuals struggling with substance use disorders. However, the two physicians soon realized that in order to be truly effective, the program needed to connect patients with treatment and support outside of the hospital.
Understanding that continuity of care was critical – and realizing that they knew little about the post-acute landscape of services and support – the ED physicians helped found the collaborative now known as Central Vermont Prevention Coalition (CVPC). The group brought together all providers of treatment services a substance use disorder patient might need, as well as interested business, service and government leaders. Their goal: to problem-solve, explore and discover, with Dr. Mashkuri – who served as ED medical director at the hospital from 2016 to 2020-- serving as the group’s clinician lead starting in 2022 and championing its initiatives locally and across the state.
“He’s a pretty remarkable person,” said Eva Zaret, MPH, director of CVPC, of Dr. Mashkuri. “He can connect with people across sectors and interests. He can sit in a room with people of varying or competing interests and he can get them to work together. That’s a big reason why this coalition (CVPC) is continuing to grow and mature.”
Recognizing the Power of Peer Recovery Coaches
Dr. Mashkuri’s work with the Coalition spans a wide range of services and support programs – some already in operation and others launched through the group’s shared advocacy.
“Setting up a system that maximizes a person’s success in recovery and giving substance use disorders the same equity as other medical problems, that’s what this is all about,” said Dr. Mashkuri. “That’s what pushed us, as emergency medicine physicians, out into the community: understanding that there were these people and groups doing this heavy lifting, and we didn’t even know them.”
Dr. Mashkuri’s advocacy for and support of programs bringing peer recovery coaches into hospital emergency departments would prove especially powerful. In 2018, a medication assisted treatment program for individuals struggling with opioid use disorder named RAM – Rapid Access to Medication for Opioid Use Disorder – launched, with Central Vermont Medical Center and Turning Point partnering to incorporate the Center’s peer recovery coach program into the RAM’s support services. Community-based treatment partners also played key roles in maintaining continuity of care and support for individuals in the program.
Purvis said Dr. Mashkuri’s advocacy for peer recovery coaches statewide has made a positive impact on patients and those working in the field of addiction.
“Dr. Mashkuri recognized our value and regularly meets with coaches to pick their brains for ideas,” said Purvis. “He treats them like equals in the process, which is really something else. It’s amazing what it does for our people.”
Building a Better ROAD to Recovery
The success of RAM ultimately led to the launch of a similar initiative: Resources and Options for Alcohol Drinking (ROAD), which is focused the treatment of alcohol use disorder and offers the unusual option of outpatient medically-assisted alcohol withdrawal. Designed by Dr. Mashkuri and inspired by the region’s hub-and-spoke system for medication-assisted treatment, the program has been so successful that it is being rolled out at primary care practices in addition to being available in the hospital’s ED.
“There are plenty of people who would want this help but don’t want to go into inpatient care, for a variety of reasons,” said Purvis. “It’s a really cost-effective way of providing a crucial service – and it was Dr. Mashkuri’s influence that made it possible.”
The program’s scope has also widened significantly, with Dr. Mashkuri leading an effort to provide information and resources on alcohol to people regardless of their relationship with drinking.
“Alcohol is woven into our society, so it’s all about people understanding the risks of what they’re putting into their body,” he said. “We want to involve people who are curious about their drinking habits across a much broader spectrum – not just the sickest of the sick.”
Alcohol is the most commonly-used substance by Vermonters, according to the state’s Department of Health, and attributable deaths and years of potential life lost increased by 36 percent between 2017 and 2021, according to a 2023 report.
“He (Dr. Mashkuri) truly embodies the ‘force for good’,” said Zaret. “He knows what the right thing is for the patient and follows it.”