University of Buffalo: New Modes of Addiction Therapy

Buffalo is putting itself at the leading edge of a national movement to change the way doctors get trained to handle patients with addictions.

In the latest turn of events, the University at Buffalo has received a $900,000 federal grant to lay the groundwork to develop standards and courses for physician training in addiction medicine.

This news follows the recent decision by nine medical institutions, including UB, to start the first accredited residency training programs in addiction medicine.

Physicians who complete medical school and a primary residency, during which they learn a specialty, can then choose to spend a year studying how to recognize and treat addiction.

The need is considered great. Accidental drug deaths in the United States involving prescription opioids alone more than tripled from 4,000 in 1999 to 13,800 in 2006.

Currently, only one medical specialty—psychiatry—offers additional specialized training and certification in addiction treatment. Otherwise, doctors-in-training have little opportunity to learn about the subject in medical school.

“We need to develop standards for the way we train physicians in addiction medicine and bring the latest research findings into the course work,” said Dr. Richard D.

Blondell, director of addictions research and professor of family medicine in the UB School of Medicine and Biomedical Sciences.

The American Board of Addiction Medicine wants to accredit enough residency programs to meet the criteria for acceptance as a subspecialty recognized by the American Board of Medical Specialties.

Eventually, Blondell and others want recognition from the Accreditation Council for Graduate Medical Education to make addiction medicine another primary residency program that doctors could enter after medical school.

The grant from the National Institute on Alcoholism and Alcohol Abuse will fund physicians and researchers in UB’s Department of Family Medicine to establish a National Addiction Medicine Residency Assistance Council. The council will consist of leaders in the field of addiction medicine who will develop written curricula and national standards for graduate medical education programs.

Blondell said there is a need to broaden addiction medicine training to other medical fields, such as family doctors and emergency physicians.

“The grant is designed to address the spectrum of addictions, from alcohol to illicit substances and prescription drugs,” he said.

Blondell is chairman of the Residency Accreditation Review Committee of the American Board of Addiction Medicine Foundation.

When it comes to gaining recognition, addiction medicine faces challenges.

It is not as highly compensated as other areas of medicine. There currently is no funding stream through Medicare to help pay for specialty training in hospitals, as there is for recognized specialties.

Different institutions take different approaches to treating addictions, making it difficult to find consensus on training standards. Moreover, Blondell said many people attach a stigma to addicts that spills over to affect the doctors who treat them.

“It’s easy to say we should train more physicians,” he said. “But someone has to create the specialty and find a way to pay for it.”

Calls for more physician training have increased with the growing concern over prescription painkiller abuse.

State and federal officials at a recent forum in Buffalo called for adoption of a real-time system to track painkillers and improved education programs.

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