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Taking a team approach to the opioid epidemic

Erie County Health Commissioner Gale Burstein reported some grim statistic regarding the opoid crisis, but also several successful local initiatives. Photo: Meredith Forrest Kulwicki

By ELLEN GOLDBAUM

Published November 10, 2017

“We came together as a team of professionals to change how we delivered care to these patients who are very vulnerable to begin with and mistrustful — sometimes with good reason — of the system.”
Paul Updike, medical director of substance abuse services
Catholic Health System

The opioid epidemic killed 64,000 people in the U.S. in 2016 — more than those killed in motor vehicle accidents before seatbelts were required, and more than died from HIV before antiretroviral drugs were developed.

Those were the stark figures Erie County Health Commissioner Gale Burstein reported to a packed and attentive auditorium on Thursday at UB’s second annual Fall Interprofessional Forum. It was attended by nearly 800 UB health sciences students in three consecutive sessions that ran from 10 a.m. to 8:30 p.m.

Hosted by the School of Pharmacy and Pharmaceutical Sciences and sponsored by the UB Office of Interprofessional Education, “Confronting Opioid Dependence: An Interprofessional Strategy” gave UB’s health professions students in 10 different programs of study an opportunity to work together on an urgent public health problem.

“We are dedicated to ensuring that our students graduate from UB as interprofessional collaborators with a strong moral compass and who are able to perform competently on a team to deliver health care that is safe, effective and equitable,” Patricia Ohtake, assistant vice president for interprofessional education, said in her opening remarks.

The IPE emphasis is a hallmark of health professions education today and is designed to give students in all the professions a chance to collaborate with, and learn from, one another.

Ohtake says the opioid crisis is a textbook example of a situation that requires a collaborative approach, with many patients requiring care from physicians, dentists, nurses, social workers, pharmacists, public health workers, occupational and physical therapists, lawyers and health care managers.

After the welcome from Ohtake and Michael Cain, vice president for health sciences and dean of the Jacobs School of Medicine and Biomedical Sciences, keynote presentations followed from Burstein and Paul Updike, medical director of substance abuse services for the Catholic Health System.

Burstein provided a grim picture, but also noted that several local initiatives, including more than 3,000 calls received by the county’s addiction hotline and greatly increased training for medical providers, are starting to have positive effects.

Updike noted that hospitals like Sisters of Charity are seeing a dramatic increase in the incidence of newborns addicted to drugs, suffering from neonatal abstinence syndrome. This is in part, he said, because opioid addiction is a disease of the young, thus affecting many of childbearing age. He described his work with pregnant women who are addicted, and said a major piece of helping them get better is educating hospital providers and staff about addiction.

“We found there was a widespread feeling among staff that these patients are trouble. There was quite a bit of bias, a lot of it was classic ignorance,” he said.

The decision was made then to educate every staff person who came into contact with a patient.

“We came together as a team of professionals to change how we delivered care to these patients who are very vulnerable to begin with and mistrustful — sometimes with good reason — of the system,” Updike said. “We changed the way we delivered care to these patients.” The result was a significant improvement in outcomes for both mothers and babies.

After the keynote addresses, students broke up into small, interprofessional teams and spent several hours discussing a specific patient case and how each of them could use their professional knowledge and skills to contribute to the patient’s care.

The forum and other events sponsored by the Office for Interprofessional Education are based on strong collaborations between the Jacobs School of Medicine and Biomedical Sciences, the School of Pharmacy and Pharmaceutical Sciences, the School of Nursing, the School of Dental Medicine, the School of Public Health and Health Professions, and the School of Social Work.

Interprofessional education is required for all pre-licensure professional students in these schools.

Cain noted that when he was in medical school, the only people he learned alongside were other medical students. “But all of a sudden when you graduate, you are working with people from all these other disciplines,” he said. “Why not let them appreciate as students what these other providers do and how they’ll interact with them? That’s the value of interprofessional education.”