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.
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
COM Opioid Initiatives/Events
- 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.
Opioid Resources with Focus on Graduate Medical Education (GME)
- AAMC Webinar Series “Innovative Educational Approaches to Safe Opiate Prescribing and Pain Management
Addiction Medicine & GME
Lack of time available to add new content in medical schools and residencies.
Limited number of preceptors who are qualified to teach medical students and residents in this are of medicine.
Challenges in recruiting for a fellowship (additional year in the fellowship).
- Inconsistencies in opioid training and significant gaps in faculty development for opioid training are two identified challenges.
- Position statement by the Association of Academic Physicians calling for a new national strategy to address the diagnosis and treatment of pain via a functional approach to reduce the risk of opioid abuse and misuse.
ABMS & Addiction Medicine:
AOA Programs / Initiatives