The magnitude of the current opioid crisis is such that virtually no one in the medical field can claim ignorance. Opioids are all around us, and they are wreaking havoc on people of all ages. Family medicine has a role to play in bringing an end to what could arguably be one of the most critical crises in modern medicine.
To that end, family medicine doctors are being encouraged to undergo training that will allow them to prescribe buprenorphine. According to the National Alliance of Advocates for Buprenorphine Treatment, buprenorphine is “an opioid medication used to treat opioid addiction in the privacy of a physician office.” It is viewed by many in the medical industry has the best hope for getting a handle on opioid abuse.
New Doctors Are Unprepared
The push for buprenorphine training among family medicine practitioners is especially important in preparing new doctors to deal with opioid addiction. Older doctors that have been practicing for decades are more likely to undergo buprenorphine training because they have already seen so many patients in need of treatment throughout their careers. New doctors just getting started do not have the advantage of hindsight.
Unfortunately, a study published in the Annals of Family Medicine journal suggests that new doctors are unprepared to treat opioid patients with buprenorphine. Their study, based on the 2016 National Family Medicine Graduate Survey, showed that just 28.6% of family medicine residencies include addiction medicine as a required part of the curriculum. Just 31.2% of residencies could claim at least one graduate who had obtained a buprenorphine waiver within the previous 12 months.
In addition to residents, the survey accounted for already-practicing family physicians. That portion of the study showed that roughly 10% of family medicine doctors had received buprenorphine training during residency. Some 7% reported already providing buprenorphine treatment to patients.
The numbers clearly show that there are not enough new family medicine doctors undergoing buprenorphine training prior to establishing their practices or moving on to a group practice. The survey does not address locum tenens physicians in detail, but it must be assumed that new doctors heading straight to locum work are not prepared at any higher rate.
Ending Addiction through Treatment
Ongoing debate over who is to blame for the opioid crisis offers lots of different targets from drug companies to doctors and the government. At this point however, laying blame is not going to solve the problem. The opioid crisis demands creative solutions that offer current opioid addicts real hope while preventing future opioid users from becoming addicts.
One way to address existing addiction is to offer medical treatment. That’s the whole point of buprenorphine treatment. It is designed to gradually bring an end to opioid use by steering patients away from the drugs they are abusing. The strength of buprenorphine as a treatment for opioid abuse is the fact that it is only a partial opioid agonist that produces less euphoria and has a lower potential for misuse and dependence.
Family medicine doctors should be aware that the FDA requires mandatory training before prescribing the drug. Why? Because if buprenorphine is used improperly, it could make an existing addiction worse. The goal is to use the drug to treat opioid addiction, not enhance it. Proper training is required to do it right.
Family medicine does have a place at the table as various stakeholders work to bring an end to the opioid crisis. New doctors getting ready to finish up their residencies can be part of the solution by undergoing the required training in order to obtain a buprenorphine waiver.