Alabama continues to be among the top states for narcotic prescribing, and the opioid crisis is affecting the Mobile community, in particular. According to Dr. Perkins, of all the prescriptions written for Medicare recipients in Mobile, 7.7 percent are for opioid analgesia, compared with the national average of 5.5 percent.
"The need to educate care providers regarding safe and effective use of opioid analgesia is acute given the availability of this medication in the community," Dr. Perkins said.
The training is being integrated into USA's medical education program through the addition of training modules on the screening, identification and management of opioid dependency and misuse in the primary care setting. The modules are required of all learners who rotate through the clinical site, impacting 25 medical students, 18 family medicine residents, and 10 physician assistant students annually.
Screening for opioid misuse is initiated using a validated single-question screen: “How many times in the past year have you used an illegal drug or used a prescription medication for non-medical reasons?" Training care providers includes developing and implementing strategies to counsel or refer individuals who screen positive as appropriate, as well as using alternative medical treatment to combat opioid addiction.
"This dovetails nicely into our currently funded project, 'The Complex Patient in the Primary Care Medical Home,'" Dr. Perkins said. "We have developed educational modules to ensure that all learners are familiar with health literacy, cultural humility, and the principles of the Patient Centered Medical Home."
For family medicine residents, faculty have created self-guided educational content around complex patients, and content related to Medication-Assisted Treatment (MAT) is being incorporated into this effort, Dr. Perkins said.
In the clinical setting, care providers currently screen patients for depression using the Patient Health Questionnaire (PHQ-2). They have begun screening for opioid misuse as well, Dr. Perkins said, and those who screen positive are referred to behavioral health counselors and students embedded in the clinical delivery activities.
"We are excited about the opportunity to improve patient care with the addition of opioid misuse screening and referral for treatment," Dr. Perkins said.
