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"Addiction medicine" attracts a new generation of idealistic physicians: shots

Dr. Hillary Tamar, who is in her second year of family medicine in Phoenix, is one of a new generation of doctors dedicated to the treatment of addiction.

Jackie Hai / KJZZ

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Jackie Hai / KJZZ

The Surgeon General's office estimates that more than 20 million people have a substance disorder. Meanwhile, the country's drug overdose crisis shows no signs of slowing.

However, there are not enough physicians specializing in the treatment of addiction ̵

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The now over 60 scholarship programs offer physicians a year or two a postgraduate training in clinics and hospitals to evidence-based approaches where they to Learning addiction treatment.

Such programs attract a new generation of idealistic physicians – idealists such as Drs. Hillary Tamar.

Connecting to Needy Patients

Tamar, who was in Phoenix's second year of family medicine, did not think about addiction medicine when she began her first medical studies in Chicago.

"As a medical student, you honestly do your ER rotation, the patients are referred to as" seeking pain "and it's bad." Tamar says. "And that's all you do about it."

But in her fourth year, she was randomly assigned to a rotation at a rehab facility in southern Arizona.

"I got in touch with people One way I could not connect with another specialty," recalls the 28-year-old.

Working with patients there changed the understanding of addiction to addiction, she says, and showed her the potential for physicians to change lives.

"They can spend all their time tracking the acquisition of a substance, being brothers, sisters, daughters, and making breakfast again for their children," she says. "It's really powerful."

When Tamar has finished her residence, she is planning a scholarship in addiction medicine. She sees addiction medicine as primary care as a way to build lasting relationships with patients – and a way to focus on more than one diagnosis.

"I love seeing addicts on my schedule, even if they're pregnant and on meth," she says. "More room to do good – it's exciting."

Create a program and they will come

Doctors with Tamar enthusiasm are urgently needed Anna Lembke, Medical Director of Addiction Medicine at Stanford University School of Medicine and a longtime researcher in this field.

"Ten years ago," says Lembke, "I could not find a medical student or resident interested in addiction medicine if I was under a rock, they just were not there."

But Lembke sees a change in the emerging generation of doctors who are taking to the field because they are interested in social justice.

"I now have medical students residents knocking on my door and emailing me, everyone wants to know more about the addiction," says Lembke.

Historically, the path to addiction medicine was psychiatry.

But this model began to change in 2015, when the American Board of Medical Specialties – considered the gold In the US, it was a standard in physician certification – recognized addiction medicine as a recognized sub-specialty and opened training for physicians from many other medical fields ,

Until then, Lembke said there was no way to get addiction grants approved by the National Accredited Accreditation Council for Medical Graduate Education. This made it difficult to recruit young talents – and to secure the funding of their scholarships.

Last year, ACGME began the accreditation of the first series of addiction medicine scholarship programs.

"We have a huge gap between needs and available physicians to provide this treatment," says Lembke.

"At least the medical community has begun to consider not only their role in triggering this opioid epidemic, but also the way they need to solve the problem," she says.

Build it, and they will come

Luke Peterson completed his residency in family medicine in Phoenix in 2016; there were no scholarships for addiction medicine in Arizona.

He moved to Seattle to complete a one-year scholarship at the Swedish Cherry Hill Family Medicine Residency. There he learned, among other things, how pregnant women should be treated, who have recovered from drug use.

"I really had to do a scholarship if I wanted to be effective and teach others how to do the same thing," says Peterson, who helped found an addiction medicine scholarship program in Arizona. Its program is located in Phoenix, Arizona, at the University of Arizona Medical School and its teaching hospital, operated by Banner Health and the Phoenix VA.

Arizona's two addiction grants received ACGME accreditation last year – a hallmark of the programs Peterson says is a desirable choice for the budding physician.

Not every physician who intends to treat the substance disorder needs a scholarship, he says. His goal is actually to integrate addiction medicine into the primary care.

However, a specialist can serve as a referral center and resource center for local physicians.

For example, doctors may learn from a specialist such as Peterson to offer such drug-based treatment as buprenorphine.

Public health executives are pushing for more doctors to be trained for evidence-based treatments such as buprenorphine, which has been shown to reduce the risk of death in people recovering from an opioid overdose

"If we educate physicians more and Helping them will make them feel better when they are looking for addiction, "says Peterson.

Peterson's own path to addiction started during a rotation with a family doctor in rural Illinois.

"At moments that most doctors find uncomfortable – maybe a patient comes to ask for painkillers, and you see the negative side effect – he does not shy away from that situation," says Peterson. "He addressed it directly."

It was a formative experience for Peterson – one that other young doctors should have. And he acknowledges the urgency.

"In 20 or 30 years," says Peterson, "these medical students will look back at my current generation of doctors, and we will be judged on how we responded to this epidemic." In the same way, he and his colleagues are now looking back how doctors handled the HIV epidemic.

One of the first steps to curb the epidemic is that there are enough local doctors who know how to respond.

Many of today's medical students, such as Michelle Peterson (no relation to Luke), say they also feel the calling.

Michelle Peterson, a medical student in Phoenix, says she already knows she wants to be a specialist in addiction medicine – and a source for other primary care physicians.

Will Stone / KJZZ

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She is in her freshman year at the University of Arizona's College of Medicine and has been interested in her work at an outpatient treatment center for addiction.

She says she already learns about addiction in her classroom, and doctors in the field and doctors hear other classmates fall in love.

"It's definitely not just me," she says. "There are quite a few people who are really interested in addiction."

It's a trend that she and her mentors will hopefully continue.

This story is part of the NPR Report Partnership with KJZZ and Kaiser Health News an editorially independent intelligence service of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

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