Millions of Americans suffer from chronic pain and many use opioids for treatment. As a result, increasing rates of opioid addiction and opioid-related deaths became a growing problem throughout the United States. Between 1999 and 2017, nearly 218,000 people died in the United States from overdoses related to prescription opioids. To address this growing opioid crisis, several medical schools are restructuring their training of new doctors.
In October 2018, the Association of American Medical Colleges (AAMC) awarded four medical schools Curricular Innovation Awards for their ground-breaking training on pain treatment, substance use and addiction training. These medical schools include The University of Massachusetts Medical School, The Warren Alpert School of Medicine at Brown University, The University of Michigan School of Medicine and the Uniformed Services University of the Health Sciences.
Warren Alpert Medical School of Brown University
At Warren Alpert Medical School, students begin training on opioid use and misuse beginning in their first year, with 30 classroom hours dedicated to opioid and substance use issues. Students also participate in interprofessional workshops, where they work with actors called standardized patients to practice interacting with patients using or misusing opioids. Students are also trained to prescribe buprenorphine, a medication that is combined with the drug naloxone to decrease opioid cravings and overdose risk.
The University Of Massachusetts Medical School
Medical students and nursing students at The University of Massachusetts participate in the school’s Opioid Safe Prescribing Training Immersion (OSTI) program. The OSTI program involves patient panels and workshops where students work with standardized patients. Students are also taught to discuss pain with patients in a realistic way, so patients know what to expect after injury or surgery.
The University of Michigan School Of Medicine
The medical school curriculum and opioid prescribing practices were modified at The University of Michigan in 2016 in response to a student-led study on pain prescriptions after gallbladder surgery. The study demonstrated that patients typically use only a fraction of the pills they are prescribed. These findings highlighted that doctors need to discuss pain with patients more thoroughly while prescribing the minimum quantity of medication required. These changes aim to improve patient care and curb opioid misuse.
The Uniformed Services University of The Health Sciences
At The Uniformed Services University of the Health Sciences, senior medical students are taught an alternative pain management technique called “battlefield acupuncture.” This technique involves placing needles in the patient’s outer ears. The needles fall out after several days. The university has seen drastic decreases in patients’ pain after the procedure, resulting in a decreased need for prescription painkillers. Within two years, 2,700 doctors, nurses and physical therapists were training in the battlefield acupuncture technique.
The AAMC also recently hosted a national workshop in Washington, D.C., which brought together representatives from 134 medical institutions and 15 federal agencies to discuss topics related to pain and addiction and develop effective training strategies for future medical professionals. The AAMC, in collaboration with Samueli Foundation, recently announced that five new grants of $25,000 each would be awarded to medical institutions. These grants will aid in the development of training programs for pain management and substance use disorders, including prevention, screening and recovery strategies. Another promising new approach proposed by Yale University School of Medicine suggests that strategic partnerships between psychiatry and internal medicine departments can address the education gap that exists concerning addiction.
The Centers for Disease Control and Prevention. “Prescription Opioid Data.” December 19, 2018. Accessed June 27, 2019.
Association of American Medical Colleges. “Responding to the Opioid Epidemic Through Education, Patient Care, and Research.” June 20, 2019. Accessed June 27, 2019.
Tetrault, Jeanette; Petrakis, Ismene. “Partnering with Psychiatry to Close the Education Gap: An Approach to the Addiction Epidemic.” Journal of General Internal Medicine, December 2017. Accessed June 27, 2019.