Nearly 6,000 opioid-related overdose deaths occurred in California in 2021, many due to fentanyl, a synthetic opioid. To address the crisis, a team of researchers in the School of Medicine, or SOM, at the University of California, Riverside, plans to develop and implement a curriculum that offers education on substance use disorders to medical students early and throughout their education.
To facilitate the development of the curriculum, the team has been awarded a grant of $900,000 from the Substance Abuse and Mental Health Services Administration, or SAMHSA, the agency within the U.S. Department of Health and Human Services that leads public health efforts to advance behavioral health.
The curriculum aims to develop students' abilities to address biases and the impact of social determinants on health outcomes, and advocate for high-quality patient care for all communities. By partnering with practice groups, community clinics, and healthcare organizations in Inland Southern California, such as Kaiser Permanente, Riverside University Health Services, and others, our medical school is well-positioned to expand training in behavioral science and substance use disorder care."
Dr. Lisa Fortuna, principal investigator of the grant and chair of the Department of Psychiatry and Neuroscience
Typically, medical students receive only a few lectures on substance addiction over their four years of study. The new curriculum will integrate substance use disorder education into the general medical school curriculum. It will focus on training 720 individuals, including medical students, trainees, and faculty, in substance use disorder care competencies over the three years of the grant. It will also address biases and discriminatory, stereotypical ideas about who do and do not use substances and need treatment.
Fortuna will be joined by a large team of co-investigators across SOM and campus, including Dr. Pablo Joo, the senior associate dean for medical education, and Rosemary Tyrrell, a health sciences assistant clinical professor who directs SOM's Office of Faculty Development. Jennifer Syvertsen, an associate professor of anthropology, will work with the team on using anthropological humanistic approaches to understanding how addictions affect communities.
"We will use a holistic and data-driven approach to address substance use disorder and healthcare disparities in Inland Southern California," said Michelle Porche, a professor of internal medicine at UCR and one of the grant's co-investigators helping to lead a team charged with evaluating the curriculum. "We will emphasize the importance of early and progressive education, hands-on clinical experiences, and strategic partnerships to improve access to quality care for diverse populations."
The title of the grant is "UCR SOM Promoting Access to Treatment and Health Equity (PATH) for Substance Use Care." The PATH curriculum includes goals to build medical student and faculty competencies in treating substance use disorder as a disease, like any other chronic condition. It aims to increase access to evidence-based substance use disorder screening and services and leverage regional healthcare partnerships to educate and retain a diverse physician workforce.
Fortuna explained that the country currently faces a scarcity of physicians across all specialties, including pediatrics and internal medicine, who are trained to treat substance addictions.
"It's why SAMHSA put out a call for proposals for an integrated approach to substance use treatment in medical schools from the first year all the way through residency, rather than have it be a module where students learn a little about substance addiction and then leave medical school without knowing how to treat patients with substance use disorder," she said. "Addiction cuts across many of our communities. In pediatrics, geriatrics, LGBTQ, and women's health, we will include teaching on the diverse contexts and experiences of addictions. In the Inland Empire, where we have a sizeable unhoused population vulnerable to addictions, we are in dire need of physicians who are trained and ready to treat such patients."
The new curriculum development is in keeping with the mission of the UCR medical school of serving the underserved population in Inland Southern California. Following the community-based model of the medical school, Fortuna and her team will partner with local community organizations, such as the Inland Empire Harm Reduction and Hulen Place, that work on harm reduction and health equity. The team also includes researchers in the Department of Anthropology at UCR.
"We hope this curriculum will serve as a model for other medical schools in the country," Fortuna said. "It addresses addiction to not just opioids but also alcohol and nicotine. Our goal is to get our students certified in how to prescribe medications that treat addictions and leave medical school with significant and robust knowledge of how to treat patients."
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