Sales of prescription opioids and deaths from prescription opioid overdoses have nearly quadrupled in the United States since 1999, according to the CDC. But until very recently, medical schools offered little or no training in addiction medicine, leaving many internists to face challenging patients and clinical decisions on their own.
鈥淏oth pain medicine and addiction have gotten short shrift in medical school, but of the two, addiction has received much less attention,鈥 said Anna Lembke, MD, director of the addiction medicine fellowship and assistant professor of psychiatry and behavioral sciences at Stanford University in California. Medical students learn more about addiction now than they did 20 years ago, 鈥渂ut not much more,鈥 she said. 鈥淎 silver lining of the opioid epidemic, if one can be found, is that medical schools are more interested than ever in teaching how to screen and intervene for addiction, particularly opioid use disorders.鈥
External pressure accounts for some of this shift. In March 2016, the White House asked medical schools to pledge to expand their curricula based on the first-ever CDC guidelines on opioid prescribing. Pledges can be controversial, but this one makes sense, Dr. Lembke said. 鈥淭he medical community, including medical schools, has not responded with the speed and intensity required to meet this crisis. Only when faced with outside pressure from the media, legislation, or public pledges has medicine responded.鈥
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