Op-Med is a collection of original articles contributed by Doximity members.
The opioid crisis has taken medicine by storm with patients more likely to abuse and overdose on narcotics now more than ever. Today, drug overdose is the leading cause of accidental deaths in the United States. And by now it’s no secret: one of the key factors many people attribute to the crisis is the overprescribing of opioids by physicians.
Prescription-related opioid abuse is at an all time high. A March 2016, JAMA Perspective article entitled Risks of Relief – The CDC Opioid-Prescribing Guideline by Dr. Thomas Frieden stated that “Overall, one out of every 550 patients started on opioid therapy died of opioid-related causes. These deaths occurred a median of 2.6 years after their first opioid prescription.” Moreover, a poll from the National Safety Council found that 99% of physicians prescribed highly addictive opioid medicine for longer that the three-day period recommended, and 23% prescribed at least a month’s worth of opioids. In addition, 74% of doctors incorrectly believe morphine and oxycodone, both opioids, are the most effective ways to treat acute pain; yet research shows over-the-counter pain relievers such as ibuprofen and acetaminophen offer the most effective relief for acute pain.
As medical students entering the height of the opioid crisis, we require an in-depth training regarding the use and administration of opioids. We need to know how to effectively manage the pain of our future patients, eliminate prescription abuse and be equipped with the tools and education to understand prescription dependence and addiction. It’s an education that many of our predecessors haven’t been required to attain. But it’s difficult to imagine improving the current crisis without new training. While there has recently been a shift in medical education regarding pain management, medical students are currently not required to complete a clinical rotation in pain management.
One of the key solutions to eliminating the opioid crisis is to promote patient awareness while eliminating unnecessary opioid prescribing. In order to strengthen the physician-patient relationship both patients and physicians must be aware and well educated about opioid use. Moreover, as future physicians, it is crucial for medical students to understand all aspects of current opioid use in medicine. This requires a more expansive medical curriculum that includes prescribing and treating patients with opioids and recognizing opioid abuse. Recently, there have been immense efforts made in this direction. In fact, within the last year, we’ve seen great movements in the fight against the opioid crisis by medical students.
Notably, last year, medical students at Harvard University organized their own clinic on addiction treatment to fill gaps in what they deem a lacking curriculum. The clinic promotes the use of Naloxone, an injection that serves to reverse the life-threatening effects of known or suspected narcotic overdose.
Patient screening and recognizing signs of addiction are key areas of training that medical students miss out on when they opt not to complete a rotation in pain management. Duke University’s medical school plans to increase its use of standardized patients in their expansion of training for the opioid crisis. In fact, dozens of federal grants have been received by US medical schools in order to introduce standardized interviewing methods to help screen patients for drug abuse. Similar programs should be enacted in medical schools nationwide, as they are vital to build physician knowledge and create strong physician-patient relationships – a necessary component in eliminating the opioid crisis.
Medical students are preparing to carry the responsibility of the future of medicine. Eradicating the opioid crisis is a large part of that. Providing them with the necessary tools is key to their contribution.