AACOMmunities

Tackling the Opioid Epidemic

Opioid-Crisis-in-America-848x548

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.

 

Map

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

All of the nation’s 35 COMs incorporate both treatment of pain and opioid prescribing curricula into their courses of study based on responses to AACOM's annual survey of the COMs. 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.)

 The curricula at COMs address both pain management and the treatment of SUDs:

  • 100% of COMs have required education addressing pain management.
  • 86% of COMs have required education addressing the treatment of SUDs.
  • 100% of COMs teach pain management and assessment using non-pharmacological modalities, specifically OMM.

Thirteen percent of COMs have required and 42% have elective experiential features, either early clinical experiences, optional clinical experiences, elective clinical clerkships, or standardized patient experiences in pain management.

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

  • 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.” 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.