Baker-Polito Administration Announces Groundbreaking Medical School Program to Curb Opioid Crisis

Baker-Polito Administration Announces Groundbreaking Medical School Program to Curb Opioid Crisis

Core competencies to ensure medical students properly trained on prevention and management of prescription drug misuse

BOSTON – Today the Baker-Polito Administration, in partnership with the deans of the Commonwealth’s four medical schools and the Massachusetts Medical Society released a pioneering set of medical education core competencies for the prevention and management of prescription drug misuse. The set of cross-institutional core competencies will ensure that 3,000 enrolled medical students across the Commonwealth receive enhanced training in primary, secondary, and tertiary prevention strategies regarding prescription drug misuse.

“These educational standards represent an innovative and forward-thinking contribution to the state’s multi-faceted strategy to curb the opioid epidemic,” said Governor Charlie Baker. “Massachusetts is again setting a new standard by providing our medical students with a strong foundation in treating those with substance use disorders.”

The Medical Education Working Group on Prescription Drug Misuse was led by State Public Health Commissioner Monica Bharel, MD, MPH and included key representatives from all four Massachusetts medical schools – Boston University School of Medicine; Harvard Medical School; Tufts School of Medicine; and the University of Massachusetts Medical School in addition to the Massachusetts Medical Society and the Department of Public Health. Each school will tailor the core competencies to complement their existing curriculum in order to ensure they are being delivered to all students.

“We must ensure that future generations of physicians are equipped with the requisite skills to successfully prevent, identify, and treat substance use disorders,”said Marylou Sudders, Secretary of the Executive Office of Health and Human Services. “With this enhanced educational foundation, our medical students will be better prepared to provide excellent patient care as our next generation of physicians.”

“We know that substance use disorder is a chronic, progressive, relapsing disease,”said Public Health Commissioner Monica Bharel, MD, MPH. “These concepts embrace the holistic approach to treatment which attends to the multiple needs of the individual, not just substance use.”

Core Competencies for the Prevention and Management of Prescription Drug Misuse

In the appropriate setting, using recommended and evidence-based methodologies, the graduating medical student should demonstrate the independent ability and/or knowledge to:

Primary Prevention Domain – Preventing Prescription Drug Misuse: Screening, Evaluation, and Prevention

1. Evaluate a patient’s pain using age, gender, and culturally appropriate evidence-based methodologies.

2. Evaluate a patient’s risk for substance use disorders by utilizing age, gender, and culturally appropriate evidence-based communication skills and assessment methodologies, supplemented with relevant available patient information, including but not limited to health records, family history, prescription dispensing records (e.g. the Prescription Drug Monitoring Program or “PMP”), drug urine screenings, and screenings for commonly co-occurring psychiatric disorders (especially depression, anxiety disorders, and PTSD).

3. Identify and describe potential pharmacological and non-pharmacological treatment options including opioid and non-opioid pharmacological treatments for acute and chronic pain management, along with patient communication and education regarding the risks and benefits associated with each of these available treatment options.

Secondary Prevention Domain – Treating Patients At-Risk for Substance Use Disorders: Engage Patients in Safe, Informed, and Patient-Centered Treatment Planning

4. Describe substance use disorder treatment options, including medication-assisted treatment, as well as demonstrate the ability to appropriately refer patients to addiction medicine specialists and treatment programs for both relapse prevention and co-occurring psychiatric disorders.

5. Prepare evidence-based and patient-centered pain management and substance use disorder treatment plans for patients with acute and chronic pain with special attention to safe prescribing and recognizing patients displaying signs of aberrant prescription use behaviors.

6. Demonstrate the foundational skills in patient-centered counselling and behavior change in the context of a patient encounter, consistent with evidence-based techniques.

Tertiary Prevention Domain – Managing Substance Use Disorders as a Chronic Disease: Eliminate Stigma and Build Awareness of Social Determinants

7. Recognize the risk factors for, and signs of, opioid overdose and demonstrate the correct use of naloxone rescue.

8. Recognize substance use disorders as a chronic disease by effectively applying a chronic disease model in the ongoing assessment and management of the patient.

9. Recognize their own and societal stigmatization and biases against individuals with substance use disorders and associated evidence-based medication-assisted treatment.

10. Identify and incorporate relevant data regarding social determinants of health into treatment planning for substance use disorders.