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Long Island medical schools ramp up opioid education classes 

First-year medical students learn how to use a

First-year medical students learn how to use a naloxone kit at the Zucker School of Medicine at Hofstra/Northwell on Saturday. Credit: Yeong-Ung Yang

As an opioid epidemic that has claimed hundreds of thousands of American lives continues to ravage communities, medical schools on Long Island and nationwide are expanding opioid-related education.

The schools are teaching future doctors how to best communicate with patients about opioids, to determine when — and when not — to prescribe opioids for pain relief, and to understand that opioid use disorder is a health care issue, not a moral failing.

On Saturday, first-year medical students at the Zucker School of Medicine at Hofstra/Northwell began learning about opioid addiction — and how to reverse an overdose — during new-student orientation.

Until several years ago, most medical-school students nationwide received little or no education on addiction to opioids and other substances, said Dr. Sandeep Kapoor, an assistant professor of medicine at Hofstra/Northwell.

"You guys, when you leave the doors of this medical school, you're going to be better prepared than the average person who has been practicing medicine for 30, 40, 10, 5, whatever amount of years," said Kapoor, who has led development of the school’s continuously expanding substance-use curriculum, much of which focuses on opioids. 

The other three medical schools on Long Island — the New York University Long Island School of Medicine, the New York Institute of Technology College of Osteopathic Medicine, and the Renaissance School of Medicine at Stony Brook University — also have robust opioid-education curricula, officials with the schools said.

“There’s the recognition we experienced — as well as all the medical schools across the country — that we needed to increase the amount of education being provided to ensure we could make a dent in the crisis, as well as prevent further crises going into the future, with the next generation of physicians,” said Dr. Kristie Golden, associate director of operations at Stony Brook Medicine, who has worked on curriculum development at the Renaissance School.

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Much of the expansion has occurred in the past five years, said Lisa Howley, senior director of strategic initiatives and partnerships in medical education for the Association of American Medical Colleges, which represents all 154 accredited medical-doctor programs in the United States.

In May, the association convened its first conference focused on the opioid epidemic. Officials from medical schools across the country shared curriculum ideas and best practices and discussed plans for further opioid-education expansion, Howley said.

The association also has run opioid-education webinars and is awarding grants to encourage educational collaborations.

The roots of the opioid epidemic lie in the late 1990s, when doctors began prescribing opioids at greater rates for pain relief after pharmaceutical companies asserted there was little chance of addiction.

“There was a different understanding of the level of risk” of addiction associated with opioids then, Howley said.

Today, medical schools such as NYIT put “more emphasis on the addictive nature of it" and include more discussion of pain-relief alternatives to opioids, said Dr. Jerry Balentine, dean of the NYIT medical school.

At Stony Brook, a committee convened earlier this year to discuss how to expand opioid education across the curriculum starting next month, "so it’s first and foremost in their minds when they graduate,” Golden said. 

At the newly opened NYU Long Island School of Medicine, opioid-related education also is integrated throughout the curriculum, said Dr. Gladys Ayala, senior associate dean for medical education.

One key focus at NYU Long Island, which concentrates on training students to be primary care physicians, the doctors people typically see for routine medical care, is teaching how to get patients to be forthcoming about possible opioid use, Ayala said.

“Physicians need to ask these questions in a nonjudgmental way to elicit information, and patients hopefully will be able to respond appropriately and feel that through their confidential, therapeutic relationship they can discuss these issues with the physician,” she said.

That nonjudgmental approach to opioid and other substance use is crucial, as is the increased focus in curricula on prevention and learning how to gauge people’s risk for substance use disorder, rather than just treating people when they become addicted, Kapoor said. Like other people, physicians and nurses are susceptible to stereotyping and judging people with addictions, he said. 

“This is a health care issue, just like [high] blood pressure,” he said. “We’re trying to humanize this so we can look at it like we look at other chronic illnesses.”

The Hofstra/Northwell curriculum did not begin addressing addiction to opioids and other substances until five years ago, he said. The amount of material on substance use disorder has increased every year since then, to 30 hours this year, including an intensive three-day focus on opioids. 

Much of the opioid education had been in the third year, but second-year Hofstra/Northwell student Matthew Hill, 24, of Northport, lobbied with another student to have some of it included during orientation. That way, first-year students can more effectively communicate with the patients they will start seeing during initial clinical training in a few months, he said.

"It's a hard topic," Hill said. "To have some sort of education and training on it we thought would be useful for these students, so they can have more meaningful conversations with their patients."

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