Imagine you suffer a heart attack but, thanks to modern medical interventions, you survive. Now imagine the follow-up appointment with your primary care physician a few days later. She tells you about a cheap, safe medication that cuts your risk of dying from a second heart attack in half.
But there’s a catch: Your doctor explains that she is not trained to prescribe this medication and would need to obtain a special license to do so. In fact, only one physician in your area has this license, and even with a referral to his clinic, you might have to wait weeks for an intake appointment.
If this happened to a heart attack survivor, it would be an abomination. Why is it, then, that if you replace “heart attack” with “opioid overdose,” this experience is frustratingly common?
Heart attacks and opioid overdoses are both acute exacerbations of chronic medical illnesses and are seen daily in emergency departments across the nation. While every medical student graduates with the preparation needed to treat heart disease, fewer than 6 percent of physicians in the U.S. are trained and certified to prescribe buprenorphine, a medication that has been scientifically proven to halve the overdose death risk for patients with opioid addiction.
Among the several medications that can be used to treat opioid use disorder, buprenorphine is highly effective and can be prescribed in a doctor’s office, making it a critical part of evidence-based addiction treatment and recovery.
Reflecting broader cultural tendencies, American medical communities have long stigmatized addiction as a personal failing, rather than a chronic condition that is both preventable and treatable through appropriate evidence-based care.
Unsurprisingly, the addiction treatment education in medical school curricula has been sparse, leaving physicians in need of supplemental training before prescribing buprenorphine to treat opioid addiction.
As medical students, we refuse to accept the status quo. The Centers for Disease Control and Prevention report that, on average, 115 Americans die each day from opioid overdoses. The numbers climb annually. In our hospitals and clinics, we witness firsthand the devastating effects of opioid addiction on our communities.
We want and need the training to respond. We are ready to be the generation of physicians that reverses this devastating public health emergency.
The good news is that Congress is taking an important step to combat the opioid epidemic by working to enhance medical education on addiction treatment.
A bipartisan piece of legislation introduced by Sens. Maggie Hassan (D-N.H.) and Rob Portman (R-Ohio) — called the Enhancing Access to Addiction Treatment Act — would allow licensed physicians to apply for a buprenorphine prescribing waiver by demonstrating that their medical school meets certain standards for training graduates to treat opioid addiction.
This measure would establish a much-needed supply of physicians entering the workforce ready to prescribe buprenorphine without extra training.
Importantly, the bill also provides funding to medical schools and residency programs to expand addiction education more broadly, as buprenorphine is only one component of effective care.
We're calling on our elected leaders in the House and the Senate to move swiftly to pass this crucial piece of legislation, to empower our generation of physicians and those who follow to fight the epidemic of opioid overdose.
We are proud that some institutions of medical education, including our own, are leading the charge to integrate training on addiction treatment into our curricula, but urgency remains.
Evidence-based treatment for opioid addiction needs to be a standard competency for physicians, not an optional supplement.
Helen Jack (Harvard Medical School), Siva Sundaram (Harvard Medical School), Melanie Fritz (Boston University School of Medicine) and Colleen Zorc (Boston University School of Medicine) are medical students and members of the Student Coalition on Addiction, which tweets at @MassSCA.