“The nation is the United States of drugs,” said Kevin Kunz, MD, executive vice president of The Addiction Medicine Foundation, in opening remarks at a meeting of local, state, and national addiction experts at the University of Tennessee Health Science Center Thursday. “There is nothing so disabling in our country as substance abuse and addiction.”
UTHSC hosted the meeting, along with The Addiction Medicine Foundation and the national Substance Abuse and Mental Health Services Administration, to bring together health care leaders from across the Southeast to discuss ways to strengthen the addiction workforce, a key component in battling the substance abuse epidemic.
Under the direction of David Stern, MD, formerly Robert Kaplan Executive Dean of the College of Medicine, UTHSC has been at the forefront of addiction medicine. Stern, who is now the vice chancellor for Health Affairs for Statewide Initiatives at UTHSC, helmed the launch of the UTHSC Center for Addiction Science, which combines evidence-based diagnosis and treatment, education including an addiction medicine fellowship, and research. Last fall, The Addiction Medicine Foundation named it the first Center of Excellence in Addiction Medicine in the country for combining all these elements to tackle substance abuse.
In his new role, Dr. Stern is taking on the workforce issue, proposing to state and federal leaders that the university establish and train a statewide network of addiction medicine Fellows in the best practices for prevention and treatment of substance abuse of all kinds, including drugs, alcohol, and nicotine.
“Our goal is to expand our fellowships (currently UTHSC has two) to 10 Fellows, and take them from all over the state from our various residency programs, have them come and take the standardized curriculum in Memphis for a year, and then send them back out in the state,” he told the group. “The idea is to give them a generous fellowship stipend and loan forgiveness in return for going out and populating a network of addiction medicine physicians that will practice and establish clinical pathways, become change agents, educate, and also staff a rural medicine network.”
Addiction clinicians, researchers, and educators from Mississippi, North Carolina, Alabama, and Kentucky attended the meeting to share approaches, get ideas, and draw plans for working together to battle the drug, alcohol, and nicotine addictions that are contributing factors in the vast majority of deaths in the country.
While overdose is the leading cause of death in the United States for those under the age of 50, it is not the sole focus of the epidemic. “The crisis of the opioid epidemic is a time to look at everything,” Dr. Kunz said. “Opioids have our attention, but alcohol and nicotine are also addictive.”
The group agreed that because addiction medicine is the newest specialty in medicine, the time is right to focus on how physicians are trained to diagnose and treat the problem. Traditionally, physicians have received little training in addiction care.
Dr. Kunz said UTHSC, with its addiction medicine fellowship program, is the logical place to hold a discussion of workforce training. “This is the right setting, because Tennessee has done what other states are looking to do,” he said. “The goal here is to have the successes in Tennessee be shared with other states.”
Dr. Stern welcomed the opportunity to collaborate with leaders in other states. He described his proposed Tennessee Addiction Medicine Network as a change agent for physicians in the state, and offered it as model for other southern states.
“Tennessee can make a very big difference in the health care workforce,” he said. “We are thinking that with a combination of addiction medicine fellowships, creating a Tennessee Addiction Medicine Network, and a program for peer counselors, we can effectively approach the education of a workforce.”
Karen J. Derefinko, PhD, MS, assistant professor in the UTHSC Department of Preventive Medicine and director of the National Center for Research for The Addiction Medicine Foundation, said addiction medicine fellowships are starting around the country, and evidence of their effectiveness is emerging.
“What we want to do is track the training needs and workforce development as these programs begin to emerge,” she said. “Tracking will show us the strengths of the existing programs; it will give us an idea of the commonalities between the programs. In addition, it will show us the development and the reach of the individuals trained. We are finding already that there is a high demand for doctors trained in addiction medicine.”
The group concluded the meeting vowing to work together more closely in battling addictions. They also received a show of support from Stephanie McCladdie, regional administrator of the national Substance Abuse and Mental Health Services Administration.
“We recognize the great work you are doing at the University of Tennessee Health Science Center, and we look forward to working with everyone at the table,” she said.
Communications Coordinator Jackie Denton contributed to this story.