There are approximately 91 people per day who die from opioid overdose. And each year, an economic burden of $78.5 billion—a result of healthcare costs, lost productivity, addiction treatment, and criminal justice fees—is associated with the opioid crisis. So why aren’t medical schools adequately preparing students to deal with addiction? A recent New York Times article quotes Dr. Timothy Brennan, the director of an addiction medicine fellowship at Mt. Sinai Health System, who compares combating the opioid crisis with the current provider work force to “trying to fight World War II with only the Coast Guard.” Further, Dr. Kevin Kunz, executive vice president of the Addiction Medicine Foundation, notes that while most medical schools now offer some education about opioids, the content varies widely in terms of depth. Additionally, only about 15 of 180 American medical programs teach addiction as it relates to alcohol, tobacco, and other drugs.
Earlier this week, the AAMC put out a Key Issues statement on the opioid epidemic that linked to a January 2018 survey where AAMC researchers asked Medical School deans about their current or anticipated plans for dealing with the opioid crisis. Almost all, 97 percent of respondents, noted the challenges of teaching and/or assessing students’ knowledge of prescription drug abuse. They referred most frequently to a deficiency in faculty expertise, a lack of time within a crowded curriculum, and difficulty assessing students’ mastery.
Attempting to overcome the named challenges, The University of Massachusetts, Tufts University, Harvard University, and Boston University have committed to using a set of ten competencies to drive their opioid education programs. At Boston University, addiction education is incorporated into all four years of training and the school has partnered with Dr. Bradley M. Buchheit, an addiction medicine fellow, to train students in assessing and talking with patients about substance abuse.
Other schools are following suit. The University of Central Florida College of Medicine enhanced its curriculum to include both preclinical and clinical education on pain management, addiction risk mitigation, the use of prescription drug monitoring systems, naloxone training, and the CDC’s new voluntary guidelines for opioid prescribing. Martin Klapheke, MD, assistant dean for medical education and professor of psychiatry at UCF noted that “students are taught to fully engage patients and their families in discussing the risks and benefits of different pain therapies.”[i] At NYU, medical students have always received training in chronic pain and addiction, including a week-long pain management curriculum. And now the school is adding additional elements including a pain assessment and management training for all students going into residency programs, as well as a lecture on alternative pain management techniques.
Learn more about the battle against opioids:
AAMC issue brief on academic medicine’s response to the opioid crisis: https://news.aamc.org/for-the-media/key-issues/academic-medicines-response-opioid-epidemic/
Washington University in St. Louis Medical School hosts roundtable with HHS Leadership on opioid addiction research: https://medicine.wustl.edu/news/roundtable-on-opioids-brings-hhs-leaders-to-medical-campus/