Addiction medicine fellowship program aims to improve access to care in rural western NC

By ANJALI PATEL

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    ASHEVILLE, North Carolina (WLOS) — The Mountain Area Health Education Center (MAHEC) is training a new class of physicians to be leaders in the field of addiction medicine.

Right now, MAHEC is in the second class of its Addiction Medicine Fellowship Program, which trains physicians to provide addiction treatment services in rural and underserved areas, where they’re needed the most.

Kendrick White is one of two of this year’s fellows. White said he’s known for a long time that addiction medicine is what he wanted to specialize in.

“Almost everyone has been impacted or knows someone impacted with addiction so that’s certainly a motivating factor, knowing the number of people you can impact,” White said. “It’s a chronic disease that affects all walks of life. No one can really be shielded from it in a sense.”

The program provides one year of specialized training across a variety of settings.

“They work with our obstetricians and see women who have opioid use disorder and substance use disorder and they train there,” said Carriedelle Fusco, a family nurse practitioner who is also the co-director of MAHEC’s Office-Based Opioid Treatment Services. “They work at the VA, seeing people with substance use disorder and chronic pain, and they work in community clinics learning to write things like methadone. Our residents spend time at Mission, especially working with people with mental health issues.”

With the growth of the opioid crisis, Fusco said it “was just a natural process” to create a fellowship dedicated to addiction medicine. A couple of years ago, Fusco said MAHEC got funding from the Health Resources and Services Administration (HRSA) to help launch the program.

She said MAHEC’s first class of Addiction Medicine Fellows graduated this July and are already making an immense impact. She said one of them works in the mountains and the other fellow is creating an opioid treatment program for an indigenous community in Alaska.

She said MAHEC officials realized it was important to train family medicine residents to treat opioid use disorder and other substance use disorders because in many rural mountain communities, primary care is the only healthcare immediately available.

“That’s how we’re going to continue to work on treating and managing and helping folks who are dealing with the disease of addiction — is training our providers to recognize it and treat it where they are, not sending them somewhere out of their own community for treatment,” Fusco said. “So we see primary care as the starting point to get treatment for substance use disorder. Opioid use disorder or alcohol use disorder are chronic diseases and we treat chronic diseases in primary care.”

Alarming preliminary data shows North Carolina is on track this year to break its previous record of 3,132 suspected overdose deaths in 2020.

“There’s a lot of work left to do and unfortunately, COVID really threw some gasoline on that fire,” Fusco said.

It’s physicians like Kendrick White who are going to do that work where it’s needed the most.

“Addiction has historically been seen as a psychiatric issue and been seen by a psychiatrist or other specialists,” White said. “So this fellowship is about trying to break down that barrier and just integrate addiction medicine into primary care so it’s more easily accessible and seen as any other chronic disease, because we manage it the same as we manage diabetes.”

MAHEC is already recruiting for its next class of Addiction Medicine fellows, which will begin in July.

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