Curbing the Opioid Epidemic Starts in Medical School

by Olalekan Ogunsakin, MD, PhD

Shocking new data recently released from the Centers for Disease Control (CDC) underscores the need to prepare our physician workforce to combat opioid and other substance use disorders (SUD).

The CDC provisional data shows clearly that the drug epidemic in the United States exploded during the pandemic-induced lockdown: between May 2020 and April 2021 more than 100,000 people died from drug overdoses in the U.S. That was far more than the 70,630 people who died from drug overdoses in 2019, as reported by the U.S. Department of Health and Human Services. And 2018 data from the National Survey on Drug Use and Health indicate that an unacceptably high — 92 percent — of individuals who need SUD treatment do not receive it.

From all indications, drug use and the overdose epidemic are not letting up. According to recent statistics, more than 52 million or approximately 20% of people 12 and over have used illegal drugs or misused prescription drugs within the last year. This is very concerning with 2 million people or 24.7% of those with drug disorders having an opioid disorder including prescription pain relievers and heroin.

Blame for this catastrophe has gone around from pharmaceutical companies to healthcare providers, and, of course, to misinformed, uninformed, and hapless patients. In fact, the epidemic is due partly to misinformation and spurious reassurances from pharmaceutical manufacturers to the medical community that patients would not develop addictions to opioid pain relievers. Healthcare providers — mostly physicians — ran with this misinformation and actively prescribed these medications at an accelerated rate without adequate patient education and awareness.

Increasing awareness among future physicians

All stakeholders must do more to ameliorate this preventable epidemic. Healthcare providers — especially physicians — have huge roles to play as gatekeepers between manufacturers and patients. To fulfill these roles, they need to be more aware of the addictive side effects of these medications and properly communicate the potential problems to patients.

A big part of the solution is expanded training of our future physicians on how to identify, treat, and manage opioid overdoses and other substance use disorders. The medical community needs to step up teaching doctors about addiction prevention strategies for vulnerable populations and making patient education a higher priority

Such efforts are currently underway. Stakeholders are providing grants to selected medical schools, institutions, and hospitals to integrate SUD education into the standard curriculum of relevant healthcare and health services education programs. This initiative is predicated on the projection that through such efforts, the number of practitioners delivering high-quality, evidence-based SUD treatment will grow. The goal is to prevent and treat SUD and improve access to high-quality health care for individuals who experience or are at risk for SUD, as well as for their families and communities.

Initiatives, Certification, and Collaboration

Prac-Ed grants are a vital resource for medical schools and can be utilized to train and certify medical students in the administration of Naloxone. They can help fund events to further educate the school and its surrounding communities on SUD and how to seek help and improve quality of care. And they can help offer Medication-Assisted Treatment (MAT) waiver training to clinical students to train and certify them to administer MAT for opioid use disorder when they begin practice as healthcare providers.

There are rays of hope, but all hands must be on deck to ensure success, including educating our future physicians about the impact of opioid medications and SUD and how prevention and treatment can improve care and options for all patients, including those from vulnerable communities.

TouroCOM-NY’s Prac-Ed Grant is Funded by Substance Abuse and Mental Health Service Administration (SAMHSA) #6H79FG000126–01M002 for Expansion of Substance Use Disorder Curriculum among Osteopathic Students in Harlem and Middletown campuses.

The Author, Olalekan Ogunsakin, MD, PhD, Assistant Professor of Pathology, is the Program Director of Training, Identification, and Treatment of Substance Use Disorder (TITSUD) Project at TouroCOM-NY.