Three University of Colorado Medical School students want their peers to better understand how to treat opioid addictions and overdoses — and they’ve received support from the Coalition on Physician Education in Substance Use Disorders (COPE) for help put their plans into motion.
Under the supervision of D. Tyler Coyle, MD, MS, Assistant Professor of Psychiatry, the student team – CU School of Medicine doctoral students Tyler Igoe and Alyssa Cole, along with Assistant Program student Morgan Avery medical school – was one of four teams from medical schools nationwide to have their project selected for the COPE 2022 Curriculum Innovation Challenge: Innovative Learning and Teaching About Substance Use/Opioid Use Disorders.
Treat acute and long-term problems
As part of the COPE initiative to integrate addiction medicine content into core practicum rotations and other clinical experiences, the UC team will develop and implement a new curriculum that teaches medical students how to properly administer the opioid overdose reversal drug naloxone and how to use buprenorphine microdose induction to alleviate withdrawal symptoms in people with opioid use disorder (TUO).
“Part of the challenge with addiction medicine is that it’s an evolving field,” says Cole. “People are starting to pay more attention to it, trying new things and looking for new treatments. Even if we had a really strong curriculum, it would need to be constantly updated so that by the time we get into the field and practice, we are up to date. This is what our specific program is centered on.
Designed for fourth-year medical students during the transition to residency phase of their training, the new program will train students in the use of naloxone in patients with opioid overdose. Most commonly given as a nasal spray, naloxone can be taken by the overdosed person or administered by a medical professional or even a lay person who is nearby.
Students will be trained to identify the signs of symptoms of an opioid overdose, describe the mechanism of action of naloxone, administer naloxone to patients, and understand the public health importance of prescribing and dispensing naloxone to people at risk of overdose.
“Naloxone is an example of how harm reduction and public health intertwine with medicine,” says Avery. “It’s something that a lot of clinics offer for free. There are ‘standing orders’ or third party orders, where you can prescribe it to someone knowing that they are not the person who will be using the drug because it is so readily available. And it’s a great tool. We want to arm people with this knowledge, as well as let them know how to educate their patients on how to lobby for policy in their clinics so that everyone who comes forward can have access to naloxone.
Best Tool to Beat Addiction
Naloxone is used in acute situations where people experience opioid overdoses, but for those seeking long-term treatment for opioid addiction, buprenorphine is a commonly used drug that binds to the same receptors as drugs. such as fentanyl, which reduces drug craving and withdrawal. symptoms. The second part of UC’s student COPE program trains students in new strategies for using buprenorphine in patients seeking treatment for OUD.
“Buprenorphine is similar to methadone, but tends to be preferred by many people with opioid use disorder,” Cole says. “There are a lot of hurdles with methadone – you have to go to a clinic every day; it makes some patients drowsy. Many people prefer buprenorphine, but it can precipitate withdrawal symptoms.
By administering microdoses of buprenorphine that slowly replace opioids in the system, providers can help patients avoid withdrawal symptoms, making them more likely to adhere to treatment. The COPE program will teach students how buprenorphine works, why microdosing is effective, and how to identify patients who are eligible for buprenorphine microdosing.
“Being able to communicate to patients that, ‘Look, not only do we not want to rush weaning, but we don’t want you to feel bad during this process’ – that’s something that we as a medical community , thought, and it will help with that,” Igoe says. “I think that’s the kind of thing that’s going to get more buy-in from people who are going through a really tough process.”
As the students work with Coyle to develop the program, which is expected to launch in fall 2023, they also have regular online meetings with COPE staff and the other student teams that have been selected as part of the challenge. program innovation around substance use disorders.
“It’s cool to see where other medical schools are in their journey of teaching addiction medicine and sharing ideas with each other,” says Cole. “It’s a really cool collaborative space.”
Students say they are pleased that their submission was selected by COPE and they look forward to seeing it launched next year to give students the tools they need to manage substance use issues in their residences and beyond. of the.
“This will allow students to be more effective and comfortable in treating patients with opioid use disorder, both in an acute overdose setting, and in managing the transition. if anyone wants to overcome their addiction,” Igoe said. “It will also put our students front and center because it’s such a new thing. Many providers are not yet familiar with the buprenorphine microdosing technique. We can immediately contribute to a team by teaching everyone something new.
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