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UAB Addiction Scholars Program Helps Reduce Stigma, Improve Outcomes

Staff in certain areas of a hospital are experienced in working with patients who struggle with addiction and overdoses, but many other medical professionals have a limited understanding in this complex area. As the nation’s opioid crisis continues to worsen, it is more important than ever for staff at every level to understand the warning signs, emergency procedures, and questions to ask when faced with a patient who has an addiction.

As part of our observance of National Recovery Month in September, it’s worth highlighting some of the things UAB Medicine is doing to address this common problem seen in hospitals nationwide. In 2017, UAB Medicine launched an Addiction Scholars Program that recruits hospital physicians, nurses, social workers, and therapists to participate in a 15-month curriculum about addiction medicine. The courses are taught by UAB Addiction Recovery experts and feature formal training designed to prepare medical professionals in a wide variety of clinical areas for patient addiction issues.

Curriculum projects focus on improving care for patients with addiction, patient education upon hospital admission, early identification of addiction in pregnant women, linking patients to continued care after emergency room visits for overdoses or withdrawal symptoms, and staff education to spread knowledge to even more hospital employees.

Sharing Their Experiences

To learn more about how the UAB Addiction Scholars Program works and what its participants are getting out of it, we interviewed four of the program’s current scholars to share their perspectives and relevant applications in their chosen medical professions. Trisha Shockley, a nurse with Psychiatric Emergency Services in the UAB Emergency Department, became interested in the UAB Addiction Scholars program primarily due to the high percentage of patients with substance use disorders that she sees in her daily work.

“The program was wonderful, and I feel it gave me greater insight into this particular population,” Shockley says. “I am very excited to now be able to offer intranasal naloxone kits in the ED to those at risk of opiate overdose. The families have been especially grateful. Each project done by the scholar groups has made a positive impact in the treatment of addiction.”

Another program participant, Ronnie Mathews, is a hospitalist and physician advisor for care transitions and also encounters patients with addiction problems regularly.

“The care for these patients is very difficult and complex,” Mathews explains. “It is difficult to remain empathetic and not have a negative feeling when interacting with these patients. I saw the Addiction Scholars Program as a way to better equip me to take better care of these patients.”

Mathews says the program has helped him in his work by educating him in how other medical professionals handle addiction-related situations and by making these professionals available to discuss cases.

“Seeing the passion that some of them continue to have after years of working in this field is very impressive,” Matthews said. “It is easy to get burned out caring for this patient population, but hearing the recovery stories of a few patients was also very motivating to keep doing what I can to help.”

More specifically, Mathews says he has found that motivational interviewing is an important skill needed for caring for patients with addiction and something he should add to his practice.

“Using this technique, the provider can help patients move along in their state of change so that they will be willing to consider treatment,” Mathews explains. “Learning about this technique and now being able to utilize it has greatly helped me provide better care to these patients. It's reassuring knowing that this can always be used on patients, no matter their current state.”

Addiction During Pregnancy

Social workers, such as Lauren Padalino in UAB’s Labor and Delivery and Mother Baby units, also are benefitting from additional addiction in light of the high number of patients battling addiction during pregnancy.

“Perceptions by staff toward patients and the negative stigma associated with addiction made these patients feel alone and scared, in addition to feelings of guilt and shame,” Padalino says. “The Addiction Scholars Program offered the opportunity to educate staff and patients that addiction is a disease and should be treated as such. It offered the opportunity to change the mindset of staff, families, and patients to better serve this vulnerable and underserved population.”

Padalino says the program encourages her to share information with colleagues in an attempt to change the negative stigma surrounding addiction, particularly during pregnancy.

Thus far, Padalino says she has gained a better understanding of addiction as a disease and how both short-term and long-term drug use affects the brain.

“I’ve learned that Jefferson County and the state of Alabama are in dire need of additional resources,” she says. “During the course of the program, I changed jobs from inpatient labor and delivery social worker to the medical social worker for the Comprehensive Addiction in Pregnancy Program (CAPP). The education provided during the Scholars Program was invaluable.”

Decision vs. Disease

Kathy Langley, a UAB Addiction Scholars participant who teaches adult/gerontology acute care nurse practitioners at the UAB School of Nursing, recognizes that addiction is a growing issue both nationwide and close to home and that too many providers are poorly equipped to care for these patients in a safe and effective way. She has a personal interest in addiction medicine; a family member struggles with the disease, and that reality has given her a unique perspective.

“I know that as a provider, it is easy to get frustrated in caring for a patient with an addiction, and clinically, they can be difficult to treat,” Langley says. “However, as a family member of an addicted person, I feel that I have empathy in knowing that sometimes these patients are doing all they can do. They are truly dealing with a disease and not just simply an addiction.”

In her current position, Langley has been able to teach the concepts of addiction in her current curriculum and integrate challenging cases into learning activities with her students. She says this serves to “equip them with the ability to better recognize high-risk patients, understand high-risk consequences such as withdrawal, and reduce provider-imposed stigma.”

As with Padalino, Langley’s big takeaway from the program is recognizing addiction as a disease and not simply a choice.

“Initially, the decision to use a substance may be just that – a decision,” Langley says. “However, there are neurophysiologic changes that begin to take place in the brain, which ultimately affects the pathways that allow one to make decisions as well as experience pleasure. The brain then becomes a diseased organ, just like someone with heart disease.”

Click here to learn more about UAB Addiction Recovery, or call 205-975-7350.