New program makes the addiction crisis a priority

The School of Medicine’s Section of General Internal Medicine has established the Yale Program in Addiction Medicine, a multidisciplinary clinical, educational, and research program. The program is intended to enhance Yale’s portfolio of state-of-the-art addiction research and patient care, while increasing the pipeline of physicians trained in evidence-based strategies to tackle the opioid crisis and other addiction-related health issues.

The program will emphasize research on topics that include improving the recognition of, and access to treatment for, substance use disorders in primary care, emergency departments, and hospitals; addressing the quality of addiction treatment; and technology-based prevention in youth.

The Yale Program in Addiction Medicine includes collaborations with Yale School of Public Health and the Departments of Emergency Medicine and Psychiatry. Its director is David A. Fiellin, M.D., professor of medicine (general medicine), of emergency medicine, and of public health.

“Since the use of opioids, tobacco, alcohol, marijuana, and other substances is common in general medical settings, and often goes undetected and untreated, we need a medical system that does a better job of making sure that all health care professionals implement effective prevention, screening, treatment, or referral practices, and treat addiction as they do other medical conditions,” Fiellin says.

The establishment of the program comes at a time when addiction to opioids and other substances is widely seen as a crisis. Drug overdose deaths nearly tripled during 1999–2014, according to the Centers for Disease Control and Prevention. From 2014 to 2015, the death rate from synthetic opioids increased by 72.2 percent, and heroin death rates increased by 20.6 percent. Death rates rose across all demographic groups and regions, and in many states.

Yale School of Medicine was one of the first medical institutions to establish an accredited fellowship program in addiction medicine. It began accepting trainees in 2015.

In addition, Patrick G. O’Connor, M.D., the Dan Adams and Amanda Adams Professor of General Medicine and chief of general internal medicine, and Gail D’Onofrio, M.D., chair and professor of emergency medicine, led the effort to make addiction medicine an official medical subspecialty in 2016. This landmark change will increase the number of physicians in a variety of primary care and other medical specialties, including psychiatry, to be trained and certified as specialists in addiction prevention and treatment.

“The current opioid epidemic, along with the high prevalence of a variety of substance use disorders, demands innovative and creative approaches in prevention, treatment, and medical education,” says O’Connor. “Yale is uniquely positioned to provide national leadership in this critical area.”