HCOM teaches risks of prescribing opioids Educators push for pain treatment alternatives MARGARET MARY HICKS FOR THE POST
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uring the rise of the opioid crisis, the Heritage College of Osteopathic Medicine found it easier to comply with the 2016 White House request to be teaching opioid prescribing because it was already doing it. The medical school was one of the first of a “small number” of other schools to respond to the 2016 White House request to educate medical students on prescribing opioids, HCOM Dean Kenneth Johnson said. “The opioid abuse epidemic is an issue that’s deeply important to the medical school and to the citizens of Ohio, and it’s something that we have been working on consistently for years,” Johnson said in an email. Some of the topics educators taught before the request included opioid prescribing, addiction medicine and non-opioid alternatives for pain management. Some interventions included osteopathic manipulative medicine, which is a system that focuses on the musculoskeletal system. Alex Myers, a second-year medical student at HCOM’s Cleveland campus, said he has lost friends and classmates to heroin overdoses in his hometown of Painesville. During Health Policy Day, a mandatory exercise for first-year medical students to show how such issues are broader than healthcare, Myers spoke about losing a friend in December to a heroin overdose. “(She was) someone that I used to hang around with when I was in high school, and it didn’t make it hurt any less, because she was … four years younger than me … same as my sister,” Myers said. “And it was kind of startling to see someone that young slip into that and overdose and die.” A deeper understanding of prescribing practices that aided the epidemic is crucial for medical students, Nicole Wadsworth, associate dean of academic affairs for HCOM, said. Through training students about situations in which a patient may be requesting opioid drugs, they must face potential risks with great responsibility. “(Patients) may come to a doctor and say, ‘Look, I am having all of this pain. I just need this pain medicine,’ and it’s not that simple,” Wadsworth said. HCOM focuses on manual medicine, which is a core belief that the body is capable
16 / APRIL 13, 2017
(Patients) may come to a doctor and say, ‘Look, I am having all of this pain. I just need this pain medicine,’ and it’s not that simple.” - Nicole Wadsworth, associate dean of academic affairs for HCOM of self-healing and combating disease without medication. “Since all of our students are trained in manual medicine, that is a better therapy that they are trained in to treat pain,” Wadsworth said. “So (it is) certainly an alternative to opioid pain medication.” Joseph Bianco, assistant professor of social and behavioral medicine in HCOM, said when he teaches his addiction class, the first thing he does is confront stereotypes. “This idea that we tend to judge, and think that the face of addiction is just poor, or people with low morals,” Bianco said. “But really it’s affecting everyone and we need to … figure out how we can all work together and change that.” Additionally, Bianco said he builds awareness, so students can go into those situations with a trauma-informed approach and start from a place of compassion. Myers and Wadsworth both believe it is vital to treat those patients as people who are struggling with a treatable illness. “We preach a lot about empathy, but it’s one thing to speak it and it’s another thing to live it,” Myers said. “I don’t necessarily blame physicians directly for that, but … it’s something that we could definitely work on.” Bianco said HCOM is in the process of revising the curriculum to have an emphasis on interprofessional competencies. Myers said the most important thing he has learned is that doctors should treat people as human beings, not addicts. “There is a lot of stigma associated with addicts and it’s on us,” Myers said. “It’s our job to fight against that.” Emma Ockerman contributed to this report.
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