Naloxone

Training medical students in addiction medicine can help in the opioid crisis

Better medical education is one solution to the opioid overdose crisis, but our new study suggests that few students have direct experience of overdose management although many have been exposed to patients using opioids.

Every year, more people die in Ireland due to opioid overdoses than in car accidents. Over 200 overdose deaths occur annually in Ireland. Naloxone is an effective treatment; lay people can use it. We surveyed 243 undergraduate medical students doing their final professional completion module before graduating from University College Dublin. This survey showed that medical students commonly encounter patients with opioid use disorders and want more naloxone training in the medical school.

Overdose prevention and management, including naloxone provision, should be a priority for health education.

A total of 197 (82.1%) completed the survey. Just under half were male, and most were aged under 25 (63.3%) and of Irish nationality (76.7%). The students felt moderately prepared to recognise opioid use disorder, but felt less prepared to manage other aspects of opioid use disorder care. Most had taken a history from a patient with an opioid use disorder (82.8%), and a third had witnessed at least one opioid overdose. Although 10.3% had seen naloxone administered, most had never administered naloxone themselves (98.5%). Half supported wider naloxone availability; this was lower than support rates among GPs (63.6%) and GP trainees (66.1%).

Over half of the medical students supported wider naloxone availability and its lay distribution to address the growing overdose problem in Ireland.

Most students had taken a history from a patient with an opioid use disorder and a third had witnessed at least one opioid overdose.

Few students had direct experience of overdose management although many met patients using opioids.

High level of student exposure to patients using opiates suggests we have an opportunity to increase addiction content in medical curricula.

Educate students

Medical school offers limited addiction medicine education. Medical graduates may not be adequately prepared to diagnose and manage opioid use disorders and emergency drug overdoses.

Tobin, H., Klimas, J., Barry, T., Egan, M., Bury, G. (2017, In Press) Opiate Use Disorders and Overdose: Medical Students Experiences, Satisfaction with Learning and Attitudes toward Community Naloxone Provision. Addictive Behaviors.