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.
Pain Management and Opioid Prescribing Curricula
All of the nation’s 36 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.
- A.T. Still University Kirksville College of Osteopathic Medicine (ATSU-KCOM) student Monica Makar completed a week-long Summer Institute for Medical Students (SIMS) program at the Hazelden Betty Ford Drug and Alcohol Addiction Treatment Center’s campus in Center City, MN. “As a future physician, I will be prescribing medications that have potential for abuse,” Makar said. “It is important to me to learn more about addiction and acquire the ability to have that vital conversation with my patients about drug dependence, tolerance, and addiction.” Working alongside 13 other medical students of all levels from throughout the country, Makar attended lectures regarding spirituality and recovery, motivational interviewing, and the neurobiology of addiction as a disease. In addition, participants were provided the opportunity to follow a patient throughout their therapy and detox journey. According to Makar, the rehabilitation process at Hazelden Betty Ford goes beyond physical healing, addressing mental well-being and spirituality as key aspects of a patient’s addiction recovery. “One of ATSU-KCOM’s core values is professionalism and approaching each patient as a whole – taking into account body, mind, and spirit,” Makar said. “The recovery process at Hazelden Betty Ford made me very thankful and proud of ATSU-KCOM for teaching me how to approach a patient in a wholesome matter.”
- 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.
Grant Projects and Initiatives
- University of New England College of Osteopathic Medicine
The Maine Providers Clinical Support System-University, located at the University of New England, 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. Learning experiences on substance use disorders and opioid use disorder specifically in the pre-clinical and clinical education years will culminate with the online AAAP/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's College of Osteopathic Medicine 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 holistic care for persons with substance use disorders.
- 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 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.” 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 address the opioid crisis or a new grant that you would like to include on this webpage. Contact us with details on your program.