{"id":4333,"date":"2023-01-10T13:00:10","date_gmt":"2023-01-10T18:00:10","guid":{"rendered":"https:\/\/blogs.shu.edu\/magazine\/?p=4333"},"modified":"2025-01-28T09:18:15","modified_gmt":"2025-01-28T14:18:15","slug":"urgent-care","status":"publish","type":"post","link":"https:\/\/blogs.shu.edu\/magazine\/2023\/01\/urgent-care\/","title":{"rendered":"Urgent Care"},"content":{"rendered":"
Federal grants help healthcare students get critical training to fight the opioid overdose epidemic.<\/div><\/div>\n

By Kevin Coyne<\/p>\n

Maybe you\u2019ve read the obituaries and noticed how many are for people who seem much too young to die \u2014 24, 34, 44 \u2014 and then saw where memorial donations were suggested to go: to an addiction recovery center.<\/p>\n

Overdose.<\/p>\n

Maybe you\u2019ve paid a condolence call after the untimely death of somebody in your circle of friends and neighbors and stood at a wake nodding sadly with little more to say than, \u201cI\u2019m so sorry, I didn\u2019t know.\u201d<\/p>\n

Overdose.<\/p>\n

Or maybe you\u2019ve buried a member of your own family, racked by questions for which there are no simple answers: What signs did I miss? What else could I have done? Why, why, why?<\/p>\n

Overdose.<\/p>\n

More than 107,000 people died of drug overdoses in the United States in 2021, the most ever recorded. Read that number again: 107,000 dead. We lost from overdoses in a single year almost twice as many Americans as we lost in all the years of fighting in Vietnam. It\u2019s a number that has grown relentlessly every year, and that has reached a brutal threshold where it is almost inescapable.<\/p>\n

\u201cWe all know someone,\u201d says Kathleen Neville, associate dean for graduate studies and research at the College of Nursing. \u201cWe may not talk about it, but the bottom line is, we all know someone.\u201d<\/p>\n

Most of those deaths are from overdoses of synthetic opioids \u2014 drugs that are effective both at relieving pain and at producing a euphoric high that is devastatingly addictive. The spread of opioids over the last decade, most lately and lethally in the form of illegally produced fentanyl, has created what Neville describes as \u201ca major healthcare epidemic that continues to worsen.\u201d It is an epidemic that the healthcare system needs more weapons to help fight, and she had an idea about how to sharpen one of those weapons.<\/p>\n

Opioid addiction \u2014 opioid use disorder, or OUD, in the language of the field \u2014 is powerful, but not invincible. A combination of counseling, behavioral therapy and drugs that is known as medication-assisted treatment, or MAT, can sate the addictive cravings.<\/p>\n

\u201cMAT is the gold standard at this point,\u201d Neville says. But there are more people who have addiction issues who need this treatment than there are healthcare professionals available to provide it. Physicians, nurse practitioners and physician assistants must complete special training and receive a waiver from the federal Substance Abuse and Mental Health Services Administration (SAMHSA) before they are permitted to prescribe the medications.<\/p>\n

\u201cThey can prescribe an opioid, but not the treatment,\u201d Neville says, noting the irony.<\/p>\n

In the face of this problem, the necessary MAT training is now part of the standard curriculum at the Interprofessional Health Sciences campus in Nutley. Neville is the principal investigator for a federal grant helping to provide medical students at Hackensack Meridian School of Medicine, nurse practitioner students at the College of Nursing and physician assistant students at the School of Health and Medical Sciences the training they need to fight opioid abuse.<\/p>\n

The first students to complete the training graduated this spring \u2014 433 more foot soldiers in the war against addiction.<\/p>\n

\u201cThis whole grant is about getting all of our students on board to be able to prescribe after graduation,\u201d Neville says. \u201cIt needs to be embedded in the curriculum, that opioid use disorders are a disease that warrant being treated as a disease. The stigma\u2019s got to go away. It\u2019s not weak moral character. Some people are very prone to addiction.\u201d<\/p>\n

When Neville was a young nurse, working with adolescent cancer patients at Columbia Presbyterian Hospital and studying for a master\u2019s at New York University, she thought of addiction as what she saw on the streets of Manhattan. That\u2019s how a lot people thought of addiction then, before the waves started breaking on their own streets.<\/p>\n

By 2013, she was a professor in the School of Nursing at Kean University and consulting with hospitals to get nurses more involved in research when she started work on a study: What were nurses\u2019 attitudes toward patients with substance abuse disorders?<\/p>\n

\u201cI\u2019ve always been very interested in the emotional and psychological aspects of illness,\u201d she says. Her doctoral research turned into a book: \u201cMature Beyond Their Years:
\nThe Impact of Cancer on Adolescent Development.\u201d<\/p>\n

\u201cMaybe that\u2019s why I went into adolescent oncology as a beginning nurse,\u201d she says.<\/p>\n

Nurses, she found in her study, tended to be \u201cmistrusting,\u201d even \u201cfearful,\u201d of patients they regarded as addicts. \u201cI\u2019m hoping that tide has changed a little bit,\u201d she says. \u201cI think by educating, we\u2019re changing it.\u201d<\/p>\n

That\u2019s one of the key lessons of the MAT training to fight opioid use disorder. \u201cThe nonjudgmental attitude of the provider is so important,\u201d she says. \u201cIf society views a person with an OUD as less than desirable, chances are that person with the OUD has their own deprecating view of themself and they are less likely to seek treatment.\u201d<\/p>\n

Soon after Neville arrived at Seton Hall in 2018, the University and Hackensack Meridian Health were awarded a three-year grant from SAMHSA to establish the training program: 24 hours of online classes for nurse practitioner and physician assistant students, and 10 hours of clinical experience at places that treat patients with addictions. (Medical students take a more condensed course of eight hours.)<\/p>\n

\u201cOne of the earlier modules we had was about the changes in brain chemistry, and the reward pathways in the brain that keep someone addicted to opioids,\u201d says Rebecca Fiedler-Giordano, a third-year nurse practitioner student who works as a cardiovascular nurse in Denver. \u201cYou definitely learn to appreciate how hard it is for people to get on the other side of addiction.\u201d<\/p>\n

She saw that, too, in her own life \u2014 a friend of her husband who died of an overdose \u2014 and in her first clinical rotation for the nurse practitioner program, even before the subsequent one she did for the MAT training. It was at a federally qualified health center in Denver that served a large homeless population. Tuesdays were MAT days, when she shadowed a nurse practitioner who was seeing patients who were taking suboxone or naltrexone, medications prescribed to treat opioid addiction.<\/p>\n

\u201cA layperson might think, \u2018OK they\u2019re not going to be doing heroin or oxycodone, but they\u2019re going to be on this other medication for years at a time,\u2019 so initially there\u2019s a little bit of skepticism,\u201d says Fiedler-Giordano, whose experience in the MAT program has led her to consider working in a similar clinic after graduation. \u201cSome people think of addiction and they say, \u2018Well, why don\u2019t you just go cold turkey?\u2019 but you can see how that doesn\u2019t work for a lot of people. This medication is really what people need to rewire their brains.\u201d<\/p>\n

Daniela Arriagada, a physician assistant student who grew up in Elmwood Park, had also seen the cost of addiction before starting the program \u2014 several classmates who died of overdoses of heroin or prescription opioids. \u201cBut I was really surprised to learn that it\u2019s much more common than just what I\u2019ve seen,\u201d she says. \u201cI thought it was because I lived in such an urban area where it has that negative connotation that there\u2019s a lot of drugs involved. But going to different towns all over New Jersey, towns with the white picket fences, you think nothing\u2019s happening there, but it is, just a little bit more behind closed doors.\u201d<\/p>\n

Arriagada did her MAT clinical hours at Broadway House for Continuing Care in Newark. \u201cThat definitely brought the program together for me,\u201d she says. \u201cYou\u2019re seeing the patient and the outcome, and you\u2019re getting to apply your interviewing skills and your knowledge of medications and resources and treatment.\u201d<\/p>\n

One patient she saw was nearing the end of her third stay in the residential treatment program at Broadway House \u2014 a middle-aged woman who grew up around addiction, and who has struggled with it herself since she was a young teenager. \u201cIt\u2019s important not to be judgmental, because they\u2019re here for a reason,\u201d says Arriagada, who studied neuroscience as an undergraduate at Rutgers. \u201cThey\u2019re trying to take action and make a change in their life, and they need someone to support them. It\u2019s not a moral failing, it\u2019s a physical addiction. It\u2019s an actual mental condition. It\u2019s not that someone chooses to be addicted \u2014 it\u2019s that your brain chemistry is completely altered.\u201d<\/p>\n

\"\"<\/a>
Daniela Arriagada at
the Broadway House,
Newark, N.J.<\/figcaption><\/figure>\n

Addiction treatment is one career path Arriagada is considering after graduation; but producing more specialists like that is not the primary goal of the program. The goal is to enable more clinicians all across the healthcare system \u2014 especially in primary care \u2014 to treat addiction as thoroughly as they treat cancer, heart disease or any other chronic illness. Last year, Seton Hall was awarded a second three-year grant from SAMHSA to expand the program to students at Monmouth University, as well as to address health disparities in medically underserved cities with high overdose rates. By the end of this grant another 1,050 foot soldiers will be joining the fight.<\/p>\n

And now Neville is expanding her mission even farther. She was recently chosen as a Fulbright UK Scholar, and in September, after addressing the newest group of students who are taking the MAT training, she left for Scotland, which has by far the highest overdose death rate in Europe. She will be surveying and interviewing nursing students at Edinburgh Napier University to learn what their attitudes are toward people with opioid use disorders. \u201cWhat I did at the College of Nursing I\u2019m extending it to Scotland,\u201d she says. \u201cI\u2019m going international now.\u201d<\/p>\n

Kevin Coyne is a freelance writer based in New Jersey.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

Federal grants help healthcare students get critical training to fight the opioid overdose epidemic.<\/p>\n

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