Should Addiction Education Be Added To Medical School Curriculums?
Vicodin, OxyContin, Percocet – these are all names of common opioid prescription painkillers. The use of opioids became popular in 1806 when German chemist, Friedrich Wilhelm Adam Serturner, created morphine. Another well-known opioid is heroin. When heroin was first developed, it was marketed as a “non-addictive” cough suppressant and medical alternative to morphine. Opiods create a sense of euphoria when taken, causing these medicines to be highly addictive.
Today, approximately 26.4 – 36 million people abuse opioids worldwide, and approximately 2.1 million people in the U.S. alone are addicted to prescription opiates. Studies show that 4 out of 5 new heroin users started out misusing prescription painkillers and moved to heroin because painkillers were too expensive and harder to obtain.
The CDC found the number of prescriptions written for opioid based painkillers has nearly quadrupled since 1999, although, according to statistics, the amount of overall pain for people in the U.S. has stayed the same. In 2014, 18,893 deaths were due to overdose from an opioid prescription painkiller. This number is also 4 times the amount of opioid overdose deaths from 1999. The quick increase of people addicted to, and dying from, prescription opioids caused the Centers for Disease Control and Prevention (CDC) to label opioid addiction as an epidemic. To help curb the pervasiveness of opioid misuse, the CDC established “Guidelines for Prescribing Opiods for Chronic Pain”.
Research shows doctors are currently ill trained to diagnose or treat addiction, even though addiction is labeled as a disease. A study done by The National Center on Addiction and Substance Abuse found that only 1 in 10 people with an addiction to substances other than nicotine received any form of treatment. Comparatively, 70-80% of people with diseases like high blood pressure and diabetes receive treatment. Of the programs available for people suffering from addiction, few of them utilize evidence based care.
The National Center on Addiction and Substance Abuse recommends full integration of addiction medicine into health care systems and medical practice. They believe doctors should treat addiction like any other disease and screen for risk factors and dangerous substance use, leading to diagnosis and treatment when necessary. This integration of addiction medicine into common medical practice begins in medical school.
Currently, medical schools offer only a few hours of lecture on addiction over a 4 year medical education. Given the massive uptick in opioid addiction and overdose, many substance abuse professionals are seeking to change medical school curriculums to include more education on addiction. However, many physicians believe addiction is not a disease, but a personal vice, making modifications to medical school curriculums difficult.
“We’re at the very bottom of a very long uphill road,” says Dr. Anna Lambke, Assistant Professor of Psychiatry and Behavioral Sciences, who specializes in prescription medication addictions.
Nevertheless, it seems as though there is hope on the horizon.
In March of this year, the American Board of Medical Specialties recognized Addiction Medicine as an official subspecialty at its October 2015 Board Meeting. Additionally, the Obama Administration put into effect numerous public and private sector actions to help curb the opioid epidemic.
Actions include encouraging medical schools to sign pledges agreeing to change their curricula to include more addiction education, increased funding for medical centers to expand their addiction treatment programs, and increased training for pharmacists to dispense naloxone, a drug used to mitigate the effects of opioid medication, without needing an individual prescription.