Addiction Medicine Training
Our longitudinal curriculum in Addiction Medicine has expanded over the past 5 years as our community has been impacted by the national opioid epidemic. It is a priority for our program to graduate residents who are comfortable managing patients with substance use disorders in all settings; ambulatory, inpatient, obstetric and in the community.
All residents complete a 2 week Substance Use Disorders rotation in their first year that includes clinical experiences in outpatient buprenorphine clinics, a local methadone clinic, the New Beginnings Clinic for pregnant and postpartum women with SUD, and several local homeless services programs. In addition, residents will review core readings in addiction medicine and have 1:1 time with addiction medicine trained faculty to discuss readings, cases and values related to care of patients with substance use disorders. Residents will also receive motivational interviewing training from behavioral medicine faculty and attend a peer recovery meeting.
During all inpatient rotations, residents apply this skill set caring for patients with active substance use disorders in the hospital. Treatment is often initiated in this setting including buprenorphine or methadone maintenance therapy for treatment of opioid use disorders and medical treatment of alcohol withdrawal syndrome. Training emphasizes the medical and social complications of substance use disorders in the inpatient setting.
At the end of R1 year, residents complete 4 in-person hours of the required 8 to receive a DEA waiver to prescribe buprenorphine. Residents are encouraged to complete the remaining 4 hours online to receive their X-waiver. The majority of residents complete the full 8 hour training prior to graduation and the vast majority of core residency faculty hold an X-waiver.
As R2’s and R3’s residents will continue to rotate through our buprenorphine programs with a greater degree of independence in patient management. In addition, interested residents are assigned stable buprenorphine maintenance patients to follow in their own continuity clinics with support from clinic case managers. Residents may also elect to gain additional experience in the care of patients with substance use disorders during elective time attending local or national conferences, spending additional time in local drug treatment programs and with local addiction medicine providers. Current residents and faculty are also actively developing a more formalized street medicine program and inpatient addiction medicine consultative service that should be launched within the next 2 years.