Halting a Crisis: An Opioid Curriculum During COVID-19 Times

While the COVID-19 pandemic claims most headlines these days, it is also having a deadly impact on an area that used to be in the spotlight: opioid overdoses.

“The AMA [American Medical Association] is greatly concerned by an increasing number of reports from national, state and local media suggesting increases in opioid-related mortality,” the association wrote in an issue brief updated Sept. 8, 2020*.

“Around the country, care providers who work with people in addiction recovery said the grim data are supported by what they’re seeing in communities,” said an August 13, 2020 report on NPR: “The longer people had to isolate it was relapse, relapse, overdose, relapse, overdose,” said Jennifer Austin, who coaches people with substance abuse disorder in Ogdensburg, N.Y.”

The reasons for the relapses and deaths are many and complex.

Speaking about the intersection of the pandemic and the opioid crisis at a panel held at the University of  Southern California in July, Adm. Brett Giroir, assistant secretary for the U.S. Department of Health and Human Services, said in the NPR story, “Every indication we have in terms of stress, in terms of surveys about increasing [drug] use during the pandemic, basically everything is pointed in the wrong direction.”

In the midst of this colliding crisis, Stacey Gardner-Buckshaw, Ph.D., an assistant professor in the Department of Family and Community Medicine who has led several opioid grant initiatives for Northeast Ohio Medical University, wants the educational community – and others who could benefit – to know that specialized new medical education exists.

In September 2019 (back when meetings were still in person) NEOMED convened faculty and curriculum leaders from all seven of Ohio’s medical schools for a two-day curriculum summit on opioid medical education. Using a “train-the-trainer” model, they shared their expertise, developing a curriculum and best practices for teaching the content to medical students across all four years of medical school training.

As leaders of the project, which was supported by Ohio Mental Health and Addiction Services (OhioMHAS), Dr. Gardner-Buckshaw and her NEOMED team gathered the content and organized it for easy access within a single online guide. The resulting 36 lessons are now available in modular form, including a summary sheet, sample slide deck, readings and other resources, and contact information for the developers. Exams and other assessment tools are readily available upon request from the author(s) of each module. The curriculum employs many modalities, including engaged and active learning, to fit within a broad array of medical school classes and to appeal to diverse faculty teaching styles.

Each one of the lessons in the guide is organized around one of three main categories: pain management, the interrelated nature of pain and opioid use disorder, and the decision to treat. Each of these categories provides users with a suite of subpages containing the individual lessons with their respective module materials, available as embedded PDFs and as files for users to download.

Community organizations could use this curriculum, too, says Dr. Gardner-Buckshaw.

Curriculum being used at NEOMED

At NEOMED, Dr. Gardner-Buckshaw notes, third-year College of Medicine students are completing Medication-Assisted Treatment (MAT) training to learn about treating opioid use disorder in the Prerequisite to the Clinical Curriculum course. Students become certified in the content so that when they become licensed physicians, they can immediately apply for a waiver to deliver medication and treat patients suffering from addiction.

“This curriculum is available at no cost, and it’s here to be used,” says Dr. Gardner-Buckshaw.

“I hope that all Ohio medical schools will adopt part of this curriculum, and that the next generation of physician leaders and advocates will have the knowledge they need to help protect their community members and their families from the pain of opioid misuse.”

This article continues an ongoing series about the opioid epidemic and how NEOMED is training future physicians and pharmacists to help.