Every day, more than 115 people in the United States die from an opioid overdose.
In Michigan alone, there were 18.5 opioid-related deaths per 100,000 in 2016, compared with the national rate of 13.3 deaths. That was up from 7.1 in Michigan in 2012.
Central Michigan University's Juliette Perzhinsky, associate professor of medicine in the College of Medicine, wants to help change those statistics by training CMU medical and physician assistant students effectively on the treatment of pain and possibility of addiction.
She aims to do that as project leader on a $433,500 three-year grant recently received from the U.S. Substance Abuse and Mental Health Services Administration to expand access to medication-assisted treatment, or MAT, for patients with opioid use disorders.
She has several objectives:
• Help health providers earn the required MAT Drug Addiction Treatment Act waiver to prescribe the most common anti-withdrawal medication used for outpatient treatment, buprenorphine. Just 2.2 percent of physicians in the U.S have one.
• Increase the number of medical and physician assistant students completing the MAT DATA training requirements.
• Increase the number of faculty practitioners who have MAT DATA waivers and provide MAT for patients.
A statewide impact
"This is going to be a much bigger benefit for the people of Michigan than it will ever be to the College of Medicine because of the impact it will have on the number of people being treated for opioid use disorders," said Tina Thompson, the college's senior associate dean of academic affairs. "This will give us the opportunity to graduate not only medical students with their MAT training already completed, but physician assistants, as well."
The advantage to the collaboration with The Herbert H. & Grace A. Dow College of Health Professions, she said, is that a broad range of graduating practitioners, because of their MAT training, will be aware of and be inclined to use alternative drugs for treatment.
The goal is to give students early exposure to the issue of opioid abuse and the training to fight it with the hope that when they graduate, they will be more receptive to engaging with patients suffering from opioid addiction, Perzhinsky said.
"This is not a one-and-done initiative." — Tina Thompson, senior associate dean of academic affairs for the College of Medicine
Training, help for the real fight
The training of current faculty is key, Thompson said. The first group of trained faculty will then train other faculty members, thus increasing the number of students who will be trained.
"That makes the program self-sustaining," she said.
Perzhinsky's plan for the DATA waiver training involves a partnership with the American Society of Addiction Medicine to deliver eight hours of training for practicing physicians and student doctors, four hours of that in a classroom. For physician assistants, training is 24 hours of online and classroom work.
Medical students will be trained during their six-month comprehensive community clerkship rotations with doctors who practice MAT.
"The advantage to that is they will get to see MAT being done in a real clinic with real patients," Perzhinsky said.
Perzhinsky has a lot to accomplish in three years, but she has help.
John Hopper, an addiction medicine physician from Integrated Health Associates who also is on staff at St. Joseph Mercy Hospital in Ann Arbor, will begin teaching College of Medicine faculty and students.
He will work with John Lopes, CMU certified physician assistant and director of the MAT initiative for the Physician Assistant Education Association; and Wendy Biggs, a family medicine practitioner at CMU Health in Saginaw, Michigan, and director of the clerkship program.
She also hopes to collaborate with such groups as the Central Michigan Regional Rural Health Network to build a network of clinicians who will supplement on-campus faculty in teaching MAT.
Passion for those addicted
Perzhinsky is passionate about helping those addicted to opioids, which is the reason the College of Medicine leaders chose her to be in charge of the grant, Thompson said.
"People stigmatize those who suffer from opioid addiction," Perzhinsky said. "But whether it comes from being prescribed an opioid and getting addicted or by purposely taking them for a high, it still is a disease that a person is suffering from.
"It's no different than a smoker who becomes addicted and develops chronic obstructive pulmonary disease, or a person who becomes diabetic because of not taking care of his or her health.
"The brain that gets addicted to substances doesn't care where that drug or nicotine comes from."
Thompson sees this collaboration between the two colleges as just the start.
"Once we get this grant, it opens the door to future grants like this," she said. "This is not a one-and-done initiative."