AACOMmunities

Tackling the Opioid Epidemic

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Gregory Reid/ AARP

About

AACOM recognizes that there is an urgent need to effectively address the opioid epidemic across the nation. Substance use disorders (SUDs)—especially those related to opioids—are threatening the lives of Americans: from 1999 to 2016, more than 630,000 people have died from a drug overdose. Furthermore, according to the Centers for Disease Control and Prevention, 40 percent of all U.S. opioid overdose deaths involve a prescription opioid. 

Osteopathic medical education is uniquely positioned to explore and support the educational needs associated with safe opioid prescribing and treating substance use disorders across the continuum of medical education, from the colleges of osteopathic medicine (COMs) to residency programs.

 

Explore Resources, Engagement, and Projects



US COMs overlaying counties with highest rate of opioid abuse and opioid related deaths

Numerous COMs are situated in areas with high rates of prescription opioid abuse and opioid-related deaths. COMs and osteopathic recognized residencies emphasize instruction on osteopathic manipulative medicine (OMM) (also called osteopathic manipulative treatment (OMT)), which has been shown to be important and effective alternatives to opioid treatment for pain.

Because of osteopathic medical education's distinctive training in OMM, its focus on the whole person, the number of graduates training and practicing in areas hard-hit by the opioid crisis, and the high proportion of osteopathic physicians practicing in primary care and other fields that are on the ”front lines” of treating pain and caring for those with SUDs, osteopathic medical education is poised to make a difference in treating these patients.

AACOM Partnerships to Address Opioid Epidemic

AACOM Involvement with Federal Efforts

In October 2017, President Trump declared the opioid crisis a public health emergency. AACOM commends Congress for passing the SUPPORT Act and the Administration for recognizing the magnitude of this national crisis. AACOM remains actively engaged at the federal level to ensure policies are supporting effective treatment options and interventions and OME continues to play a key role in addressing the epidemic.

COM Engagement

Pain Management and Opioid Prescribing Curricula

The Educational Council on Osteopathic Principles, a council of AACOM, has designed a curriculum that includes an additional 200 hours in musculoskeletal medicine, most of which focuses on the treatment of pain and functional enhancement through using OMM, a non-pharmacological treatment. (Source: Annual Osteopathic Medical School Questionnaire, 2017-2018 Academic Year.)

According to AACOM's most recent annual survey of the COMs, the curricula at COMs address both pain management and the treatment of SUDs:

  • 37 of 39 of the COMs have required education addressing pain management;
  • 38 of 39 of the COMs have required education addressing the treatment of SUDs; and
  • 37 of 39 of the COMs teach pain management and assessment using non-pharmacological modalities, specifically OMM. 

COMs Addressing the Opioid Crisis

  • Campbell University Jerry M. Wallace School of Osteopathic Medicine in Lillington, North Carolina, has launched the Opioid Abuse and Drug Abuse Curriculum designed to educate future physicians on both the benefits and dangers of opioids and alternative treatments for pain management. It helps medical students identify when patients are abusing their medications by providing practical guidance on screening pain patients for substance abuse disorder.
  • Edward Via College of Osteopathic Medicine (VCOM) provides curriculum to more than 500 students per year on opioid prescribing with inclusion of CDC guidelines, beginning within the first block of curriculum. This curriculum is provided to students across all three campuses located in Blacksburg, Virginia; Auburn, Alabama; and Spartanburg, South Carolina. Through Clinical Skills Standardized Patient cases, which evaluate over 20,000 student/patient scenarios yearly across all three campuses, VCOM has noted a heightened awareness among students about the dangers of opioid prescribing. Moreover, VCOM is integrating education about addiction and opioid prescribing for third-year clinical medical students, and fourth-year students may choose an elective in substance abuse. VCOM also plans to develop an addiction medicine fellowship.
  • Kansas City University of Medicine and Biosciences College of Osteopathic Medicine (KCU-COM) through its Pharmacology, Neurophysiology, and Behavioral Science Psychiatry courses during Years 1 and 2, addresses CDC guidelines for prescribing opioids for chronic pain, epidemiology, opioid pharmacokinetics, diagnostic criteria for physical dependence versus addiction, genetic and developmental predisposition, associated psychiatric disturbances and medical sequela, and medical treatments for opioid overdose and withdrawal. KCU-COM also uses case scenarios to teach students awareness of drug abuse issues and how to ask about and assess drug use in the primary care setting. KCU-COM led clerkships in an Integrated Behavioral Medicine Clinic are also incorporated to demonstrate practical clinical applications, including implementing CDC guidelines, devising effective treatment plans for intervention, and providing psychiatric support.
  • West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg, West Virginia, utilizes simulation to teach medical students how to interact with patients who have overdosed or patients who are seeking drugs to fuel their addiction, which has been incorporated into WVSOM’s curriculum for more than five years. Additionally, WVSOM has endorsed the state attorney general’s strategy to reduce the use of opioids and aims to reduce the use of prescription opioids by at least 25 percent.

Opioid Resources with Focus on Graduate Medical Education (GME)

AAMC Resources

  • AAMC Webinar Series “Innovative Educational Approaches to Safe Opiate Prescribing and Pain Management

Journal Articles/Articles

Addiction Medicine & GME

  1. Lack of time available to add new content in medical schools and residencies.
  2. Limited number of preceptors who are qualified to teach medical students and residents in this are of medicine.
  3. Challenges in recruiting for a fellowship (additional year in the fellowship).

ACOEP:

ABMS & Addiction Medicine:

Pain Medicine:

AOA Programs / Initiatives

COM Opioid Initiatives/Events

Grants

  • University of New England College of Osteopathic Medicine (UNE COM)

    In 2019 the University of New England was awarded $450,000 by SAMSHA’s three-year Providers Clinical Support System-University grants (PCSS-U), one of 19 national awards. Maine PCSS-U will increase the supply of physicians educated in Maine who graduate with a DATA 200 trainee waiver to provide evidence-based Medication-Assisted Treatment for individuals with opioid use disorder and will revise the curriculum of the University of New England College of Osteopathic Medicine (UNE COM) and UNE’s Physician Assistant program, which is already graduating waiver trained PAs. Learning experiences on substance use disorders and opioid use disorder in UNE COM’s pre-clinical and clinical education years will culminate with the online PCSS Medical Student Waiver Course supplemented by in-person education. Assessment for learning as well as assessment of learning will be built into the course. UNE COM and Physician Assistant Program will map curricula to the Waiver Training Course, CARA and Healthy People 2000 topics and revise standard curricula. Project goals are: Increase supply of physicians educated in Maine eligible for and providing evidence-based medication assisted treatment for individuals with opioid use disorder to meet the need in Maine; ensure that physician faculty with the knowledge, training, expertise, and experience necessary to train students on DATA waiver content are secured to provide the training in pre-clinical and clinical settings; supplement the learning of Physician Assistants educated in Maine who graduate with a DATA 2000 Waiver and increase the supply of PAs who actively prescribe buprenorphine once eligible; and, build on existing infrastructure to ensure the sustainability of MAT, opioid use disorders and addiction overall in the UNE COM and PA curricula. Maine PCSS-U's overarching goal is to ensure that all UNE COM and PA graduates are not only waiver-trained but also possess the knowledge, skills and values necessary to provide person-first, compassionate and evidence-based care for persons with substance use disorders.

  • Rowan University School of Osteopathic Medicine (RowanSOM) and the Atlantic County Sheriff’s Office received a four-year SAMHSA grant to provide overdose prevention training for first responders and enhance access to the medicine Naloxone, also known as Narcan, which can treat narcotic overdoses in emergency situations. The program, called “Enhancing First Responder Access to Overdose Treatment in Atlantic County, New Jersey,” will train police, firefighters, casino and hospital security, and emergency medical technicians in Atlantic County on a train-the-trainer model that will distribute naloxone and train overdose survivors and their family members on its use.
  • The University of Pikeville Kentucky College of Osteopathic Medicine (UP-KYCOM) was awarded a $29,500 grant from the KY Cabinet for Health and Family Services to provide four NARCAN stations on campus, and free NARCAN training to university faculty, staff, and students, as well as first responders and community members. Between 2013 – 2017, the opioid overdose mortality rate in Pike County was twice the national average.
  • Rowan University School of Osteopathic Medicine (RowanSOM) in Stratford, New Jersey, received one of 16 nationwide grants from the U.S. Department of Health and Human Services Office on Women’s Health to study opioid misuse and overdose prevention among high-risk women in the state. The project is expected to benefit the training of thousands of medical students, physicians, and patients over the project’s three years as RowanSOM will work closely with community learning centers, family medicine offices, and Area Health Education Centers to extend the reach of the project across six counties in southern New Jersey.
  • The National Institute on Drug Abuse, in partnership with other federal agencies, awarded more than $500,000 to West Virginia University in 2017 to develop comprehensive approaches to address the opioid crisis in a project titled “Rural West Virginia Responds to Opioid Injection Epidemics: From Data to Action.” West Virginia School of Osteopathic Medicine (WVSOM) will play a key role in the project’s implementation under the leadership of Drema Mace, PhD, the chair of the grant steering committee. In this role, Dr. Mace has connected local health leaders across the project’s focus areas and helped ensure the success of the integrated plan from testing to care delivery and social re-integration.

Does your COM have an initiative addressing the opioid crisis or a new grant that you would like to include on this webpage? Contact us with details on your program.