Rutgers New Jersey Medical School says it’s the first or among the first to train and educate its aspiring doctors in the prescribing of the “pain reliever” buprenorphine to counter a heroin or opioid addiction.
“It’s a unique drug in that it has two major components. On one hand, it blocks the receptors. It blocks the opioid system so you try to shoot up, nothing happens. After a while you say this is too much money, too much trouble, too much legal exposure and you don’t use it. The second thing that it does, it activates the system in a mild form, on a 40 percent level, so it satisfies the cravings so the patients do not want to go out there and use again. So it does two things and very, very well, ” said Petros Levounis, chair of the Psychiatry Department at Rutgers New Jersey Medical School.
In 2000, the federal government began allowing doctors to apply for a waiver that requires eight hours of training to prescribe or dispense buprenorphine.
“It’s kind of paradoxical in a way that you don’t need any sort of licensing, other than a DEA number, to prescribe an opioid, but you need this whole training program and a special license to prescribe a treatment for opioid addiction, buprenorphine,” said Dr. Lewis Nelson, chair of the Department of Emergency Medicine at Rutgers New Jersey Medical School.
Nelson says the hope was many primary doctors in private offices instead of clinics would offer the drug.
“Unfortunately, a lot of doctors didn’t want to do this because it brings in sort of ‘the wrong clientele’ into their office practices. To a large extent, buprenorphine has become a clinic-based practice as well,” said Nelson.
The medical school established a task force to combat the opioid epidemic by revising what it teaches. Among the major changes are alternatives to opioids to manage pain and preparing medical students to get certified, not licensed, in prescribing buprenorphine.
“I think it’s really important for every medical school, if there is an epidemic, to be very thoughtful of what you need in the future because our medical students are going to be the workforce of the future. So the more you empower them, the easier it gets to address something that is looming on the horizon, and this one definitely is,” said Rutgers New Jersey Medical School Dean of Education Dr. Sangeeta Lamba.
The revised curriculum on opioid addiction at Rutgers will lead to a first for the medical graduates in May.
“We felt very strongly that we wanted to make sure that the students realized that this is something that they’re gaining an education that they can take to the future with them. So that’s why we decided to do the drug abuse treatment 2000 certification for all our rising senior students, which is the fourth year students. The first one of that will happen in May and it’s a big undertaking because it’s 180 students. To our knowledge no one has done that yet for the entire medical school graduating class,” said Lamba.
Last summer, second year medical school student Pravin Matthew went to Washington D.C. and took part in policy discussions about the crisis. He did it in conjunction with the Joint Commission, medicine’s not-for-profit authority on setting standards. The commission has been blamed for helping to create the addiction epidemic by condoning pain as a fifth vital sign and encouraging doctors to prescribe opioids.
Matthew came back to campus and approached Dean Lamba and joined her task force.
“We worked together to kind of build a curriculum and so far the response has been really positive from my fellow students. They’re really excited that we are one of the very first medical schools in the country who will graduate our medical students with the data 2000 waiver requirements fulfilled,” said Matthew.
Rutgers New Jersey Medical School says the crisis requires innovative approaches to an epidemic three decades in the making.