Minnesota medical students want updated teaching on opioids

A group of Minnesota medical students is hoping to inspire ground-up change in the way doctors prescribe opioids by teaching their peers about the risks that come with these addictive painkillers and pressing for better training in medical management of pain.

While clinical groups are trying to identify Minnesota doctors who overprescribe opioids, better training could help the next generation of physicians avoid the problem, said Tom Schmidt, a second-year student at the University of Minnesota Medical School. Rising opioid use has produced a surge in overdose deaths that federal health officials have declared an epidemic.

"We really want to make sure students know the downstream impact of opioid prescribing and the history of how this happened," he said.

Schmidt is among 26 medical students taking part in Hands on Advocacy, a student-led project created in partnership with the Minnesota Medical Association.

Deaths from overuse and misuse of opioids have continued to rise, despite heightened attention in recent years and new prescribing guidelines from the U.S. Centers for Disease Control and Prevention and other organizations.

In Minnesota, 402 deaths were linked in 2016 to either prescription opioids such as hydrocodone or illicit versions such as heroin — twice the number from a decade earlier, according to a Star Tribune review of state death records.

The share of these deaths caused by common prescription painkillers is shrinking; more people are dying from abuse of heroin and from fentanyl — a more potent opioid that is both legally prescribed and illicitly manufactured and distributed.

Painkiller prescribing is likely to decrease further under guidelines proposed by the Minnesota Department of Human Services. And on Thursday, 13 of Minnesota's largest medical providers agreed to pursue common standards for prescribing opioids to a first-time patient after an injury or surgery.

Many people who die from illicit opioids first become addicted while using prescription painkillers, said Tracy Marko, a fourth-year U medical student, which underscores the need for continued efforts to reduce inappropriate prescribing.

Students at the U's medical schools in Minneapolis and Duluth, and at the Mayo Clinic in Rochester, are talking with faculty and administration about adding more information about pain and opioid management to their lessons. The group also wants to increase awareness about disposal sites where unused prescription opioids can be discarded, and about the increasing availability of naloxone — a so-called rescue drug for someone with an opioid overdose.

Marko said prescription opioids still have a place, particularly in the treatment of acute pain after injuries or surgeries, and for patients with critical illnesses.

"We're not trying to take opioids away entirely," she said. "We just want to make sure they're used responsibly."

Jeremy Olson • 612-673-7744