Better Medical Education: One Solution to the Opioid Crisis

By Klimas, Jan; Fellow, Postdoctoral et al. | The Canadian Press, August 8, 2017 | Go to article overview

Better Medical Education: One Solution to the Opioid Crisis


Klimas, Jan, Fellow, Postdoctoral, Dublin, University College, University of British Columbia, The Canadian Press


Better medical education: One solution to the opioid crisis

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This article was originally published on The Conversation, an independent and nonprofit source of news, analysis and commentary from academic experts. Disclosure information is available on the original site.

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Author: Jan Klimas, Postdoctoral Fellow at Primary Connections, University College Dublin, Postdoctoral Fellow, University of British Columbia

We are in the middle of an overdose crisis in Canada and around the world. Opioid overdose is a complex problem, but opioid addiction can be managed with effective interventions. Nonetheless, many evidence-based interventions are underused, and inadequate medical education is contributing to the problem.

Specialized addiction medicine fellowships for doctors can offer a new and effective way to fight addiction. A recently launched addiction medicine fellowship -- at the University of British Columbia (UBC) and St. Paul's Hospital in Vancouver -- promises to change how addiction is taught in medical schools and beyond.

Historically, treatment of addiction has been in the hands of psychiatrists. Most health authorities have not trained doctors in addiction medicine. But training more doctors more efficiently can help to improve diagnosis and treatment of substance use disorders. It can also help reduce the public health epidemics that can result from improper prescribing of opioid analgesics - an ongoing problem in North America.

As a postdoctoral fellow at the University of British Columbia and researcher at the British Columbia Centre on Substance Use, I recently began to study how to improve addiction medicine education for doctors. This research includes a review of best practices that will help inform an international consultation of experts developing standards for teaching doctors in addiction medicine worldwide.

New treatments, old training

Over the past few decades, addiction science has advanced in leaps and bounds. We have found innovative ways to treat addiction, especially if it's diagnosed early and treated promptly. However, most interventions are underused. Early diagnosis and treatment by medical professionals fail mainly due to a lack of skills and knowledge in addiction medicine. The result is myriad public health problems that stem from untreated addiction and untrained doctors.

Not long ago, for example, medical doctors in several provinces were told by representatives of pharmaceutical companies that OxyContin was not addictive -- a lie that caused a mess to be cleaned up over the next decade.

All of this could be prevented with better training and better use of the interventions that we already have. Among them is buprenorphine/naloxone (also known as Suboxone), which is used to treat addiction to opioids. The new opioid treatment guidelines now recommend it as the first line of treatment for opioid addiction. In the past, it was not covered by provincial medical plans and only a handful of physicians could prescribe it. They needed to have their methadone licences first. New regulations and new guidelines removed these barriers so that more people can access it and other drugs needed to treat opioid addiction.

Global shifts

The situation of addiction training in Europe and elsewhere has changed, but not so dramatically. The Dutch created one of the most complete programs in Europe -- a whole masters degree in addiction medicine. It also shaped the Indonesian national training program. But both the Dutch and the Indonesian models have been inspired by the Canadian models of addiction training. …

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