If the medical profession is increasingly accepting responsibility that it started the country’s opioid epidemic, physicians can play a big role in making amends by getting trained to help treat people who are now addicted, say two doctors.
It’s why they support a proposal that the Accreditation Council on Graduate Medical Education (ACGME) require all residents in clinical specialties to take a course on the appropriate use of buprenorphine and other medications approved by the Food and Drug Administration to treat opioid addiction, say Joshua M. Sharfstein, M.D., and Yngvild Olsen, M.D. in a piece in the JAMA Forum.
“It’s hard to think of a more apt way for the medical profession to make amends for its role in a crisis that has led to a decline in U.S. life expectancy over the last three years,” write Sharfstein, vice dean for public health practice and community engagement at the Johns Hopkins Bloomberg School of Public Health, and Olsen, medical director of the Institutes for Behavior Resources, Inc., an addiction treatment program in Baltimore, Maryland.
While doctors are writing far fewer opioid prescriptions—a decline since 2012 by more than one-fourth—more than 2 million Americans now have an opioid use disorder, they said.
To save more lives from opioid addiction, physicians need training on how to use medications, such as methadone and buprenorphine, they said.
In addition to the ACGME requiring residents take a course, the doctors also called on the council to require that all core faculty in residency training programs apply for and receive the waiver needed to prescribe buprenorphine from the Substance Abuse and Mental Health Services Administration and the Drug Enforcement Administration.
Action is needed because only about 6% of the approximately 1 million physicians in the country have taken the required training to prescribe buprenorphine, they said. In nearly half of the counties in the U.S., there are no doctors authorized to prescribe the drug, while in 38 states, more than three in four programs that provide methadone are at near capacity.
Two-thirds of graduate medical training programs do not support training in prescribing buprenorphine, they said.
While the organization added a general requirement to take effect on July 1, 2019, calling on all residency programs to “provide instruction and experience in pain management for the specialty, including the recognition of the signs of addiction,” the doctors argued for more action. The ACGME has said it will consider additional proposals, including adding a requirement for training in the treatment of addiction, at upcoming meetings.
It hard to think of a more apt way for the medical profession to make amends for its role in the opioid crisis than for the ACGME to require all clinical trainees to learn to use buprenorphine for treatment of opioid addiction @drJoshS @YngvildOlsen https://t.co/QLVGVzW6Fa— JAMA (@JAMA_current) April 17, 2019
The doctors, as a group of medical students and physicians pointed out to the ACGME, said it would be unacceptable if the disease were diabetes and there were gaps in access to insulin and thousands of untrained physicians.