By Francie Williamson, Communications Coordinator, Department of Psychiatry

Students in the medical and physician assistant programs at University of Iowa will soon be learning more about addiction medicine.

Andrea Weber, MD ‘12, MME ‘15, Res ’18, clinical assistant professor of psychiatry and assistant director of the UI Addiction and Recovery Collaborative, says the intent is for more students at the Carver College of Medicine (CCOM) to learn about addiction-related topics, such as prescribing buprenorphine or taking an effective substance use history without judgement or stigma.

The curriculum changes are possible due to a three- year, nearly $450,000 grant from the federal Substance Abuse and Mental Health Services Administration (SAMHSA). Weber says some of the curriculum changes have already happened.

“Every student now spends at least a half a day in the medicines for addiction treatment (MAT) clinic,” Weber says. “They get to see how buprenorphine is utilized in clinic and see people in various stages of recovery, which I think in itself is helpful to students. Instead of seeing people only using substances chaotically, they also get to see people in remission and doing great.”

Future of the program

Starting next semester, Weber says, the substance use disorder case conference during the psychiatry clerkship that now lasts for one hour will be extended to two hours so there is more information on buprenorphine in addition to the patient interview experience. During their emergency medicine clerkship, students will take didactics covering withdrawal syndromes, as well as working with toxicologists and emergency room-based addiction treatment providers.

“I think starting now into July of 2022, there’s going to likely be even more going on,” Weber says, “such as taking topics already covered and tweaking them a bit, even by maybe five or 10 minutes, and maybe adapting them so they’re more substance use related.”

The hope is that soon after graduation, upon receiving their Drug Enforcement Agency (DEA) numbers, CCOM students will be able to qualify for a buprenorphine waiver, and making them able and more willing to begin prescribing the drug without having to take any additional training.

This is important because there are very few providers nationally who are certified to prescribe buprenorphine, a first-line treatment for opioid use disorder. In Iowa alone, it is estimated that 12,000 people have an opioid use disorder, but of more than 7,000 DEA-licensed providers in Iowa, only 194 are certified to prescribe medications for addiction treatment, and no providers in 65 of Iowa’s 99 counties hold a waiver to prescribe buprenorphine.

Sought by students

The addition of more addiction medicine to the curriculum is something in which CCOM students have shown interest.

In November 2020, a petition was circulated asking the college to integrate MAT education and Drug Addiction Treatment Act (DATA) 2000 waiver certification into CCOM’s curriculum. Nearly every member of the M4 cohort ended up signing the petition.

Mitchell Hooyer, MD ’21, who now is an emergency medicine resident at University of Michigan and was one of the petition’s chief authors, says they decided on a petition because CCOM really prides itself on listening to its students.

“It’s kind of surreal that we had this discussion a year ago this month, and then we turned it around into a petition and here we are, we’re actually funding something that I think will make an actual, measurable difference,” Hooyer says.  

Weber says she ended up using a lot of the language in the petition in her application for the SAMHSA grant.

“In large part, I think this grant happened because this class of students said, ‘hey, we want this,’” Weber says. “I really give them credit for very effectively advocating for it and bringing it to the leadership’s attention.”

• In other news, Andrea Weber was awarded the Association of Medicine and Psychiatry (AMP) Roger Kathol Award for demonstrating sustained excellence in integrative care. She was nominated by Vicki Kijewski and received the award during the AMP Annual Meeting on October 2.