A July 27 National Public Radio story highlighted an issue the UNLV School of Medicine is determined to avoid: The lack of education on opioid addiction. The story pointed out how little time medical schools spend teaching addiction medicine — sometimes just a single lecture during a student’s first two years in school.
Meanwhile the use of prescription drugs has reached epidemic proportions in the U.S., where 80 percent of the world’s opioids are consumed. Per capita, Nevada has one of the highest rates of both prescription painkiller sales and drug overdose deaths, according to a report from Centers for Disease Control and Prevention. “I think most people are surprised when they find out that the majority of those deaths are due to prescription drug abuse,” said Dr. Barbara Atkinson, founding dean of the medical school.
Addiction is one of five social issues the school is addressing through its teaching, research, and community outreach programs. The others are nutrition and obesity, mental and behavioral health, homelessness, and human trafficking — all of which can lead to significant medical conditions.The school mapped out its curriculum to ensure its future doctors “understand the intricate balance between using medicine to keep patients comfortable during severe pain episodes and the risk of long-term misuse and addiction,” Atkinson said.
It can be a tricky balance — something Atkinson knows from her own experience after knee replacement surgery and its painful recovery process. Wary of the dangers of pain medication, she tapered off her prescription quickly, a little too quickly. “My surgeon helped me understand the importance of taking enough medicine to do the painful physical therapy needed to restore full range of movement,” she said. But he also guided her on the early signs of dependency on the medication. “I was able to complete physical therapy, but still I didn’t quit taking my pain medication for about six weeks.”
Managing pain medication is even harder for individuals whose pain isn’t associated with short-term healing, she noted. Chronic pain due to back injury, cancer, and other diseases is the hardest to control. When prescription drugs are used outside of recommended usages or over long periods, serious side effects can include physical dependency, the need for increasing dosages to achieve the same effect, and increased sensitivity to pain.
“Unlike the medical student highlighted in that NPR story, our students will get much more than a few hours of lectures on pain management and addiction,” she said. “We designed our comprehensive four-year curriculum to ensure our students recognize addiction, prescribe the right amount of pain medication for their patients, and manage their patients’ pain treatment.”