The Yale School of Medicine has established a new program in addiction medicine, a multidisciplinary clinical, educational and research initiative designed to further Yale’s efforts in addiction research and patient care.
The Yale Program in Addiction Medicine will provide a forum for researchers, educators and clinicians across campus to collaborate in the field of addiction medicine. Led by medical school professor David Fiellin, the program is designed to assist Yale faculty in more efficiently addressing problems related to addiction — particularly in general medical settings such as primary care locations and emergency rooms.
“The designation of a program in addiction medicine under Dr. Fiellin’s leadership helps bring three areas of excellence in addiction medicine at Yale — research, education and clinical care — under one entity,” said Jeanette Tetrault, a medical school professor who will run several of the program’s initiatives.
Tetrault said the recognition of addiction medicine as an official medical subspecialty about a year ago by the American Board of Medical Specialties paved the way to establish universally recognized experts in the field of addiction medicine, who can address substance use and addictive disorders.
Similarly, she said, the creation of the program supports Yale’s efforts in addiction medicine and will help other recognize the importance of the field.
Fiellin noted that many incorrectly believe addictive disorders do not pertain to medical physiology and neurobiology, and that this program will expose people to the vast array of scientific knowledge available to address addiction.
One of the major initiatives of the program will be a fellowship in addiction medicine certified by the American Board of Medical Specialties, Fiellin said. These physicians can then provide clinicians who have backgrounds in other areas with the specialized knowledge to deliver care in addiction medicine.
“Having these specialists and experts around, we can then create other educational initiatives to arm primary care physicians, emergency room physicians and trainees in medicine with the knowledge, attitudes and skills to recognize and treat addiction in those settings,” said Tetrault, who will be directing the Addiction Medicine Fellowship.
Tetrault will also run the Addiction Medicine Program, a formalized initiative to train residents and health profession students — including medical students, nursing students and physician associate students — in addiction medicine.
Through the program, primary care internal medicine residents will study addiction medicine as part of their curricula, Tetrault explained.
Other educational and clinical efforts include a specialized clinic in the primary care centers at Yale New Haven Hospital and the hospital’s St. Raphael campus. Fiellin said the clinic will allow medical professionals to work together with addiction medicine specialists to learn how to perform the appropriate assessment and treatment of patients with addictive disorders.
“It’s important to have these types of programs,” he said. “We hope to expand the access and use of treatments in settings where patients feel a little more comfortable, such as when they see their primary care physician or when psychiatry services are available.”
Addiction treatment services have historically been limited to specified rehabilitation and treatment centers such as the Substance Abuse Treatment Unit of the Connecticut Mental Health Center in New Haven, which is co-run by the medical school.
Through a consultation service, the Program in Addiction Medicine will also link patients to addiction treatment services, as well as initiating the treatment of patients with opioid-use disorder. The program’s founders also hope to address common risks of addiction treatment, such as overdoses on medications like naloxone, according to Fiellin.
The medical school’s Section of General Internal Medicine has been developing the program over the past two years, Fiellin said, and the growth in addiction medicine research and patient care at Yale was an impetus to its creation.
“At this point, we’ve reached a critical mass of individuals at Yale working in addiction medicine across a variety of disciplines, so we wanted to formalize and provide some structure and leadership to these efforts through this program,” he said.
Fiellin added that the current opioid epidemic is indicative of the need for the work the program will accomplish.
“It’s as important to educate trainees in medicine as patients and the lay public about misconceptions of addiction,” Tetrault said. “Addiction doesn’t discriminate. Anyone can develop this disease, and unfortunately, stigma is a big driver right now for patients not to seek treatment.”
Amy Xiong | amy.xiong@yale.edu