The Meharry Comprehensive Health Center houses the Family Medicine Clinic and cared for over 15,000 primary care visits over a five-year period (2013-2018), with 7.8% of patients over age 65 and 40% underinsured. This clinic serves as the key training site for Family Medicine residents.
Meharry Medical College faculty will develop a curriculum on substance use disorder and chronic pain management based on the SAMHSA pain management program utilizing Department of Health training materials to educate residents on substance use disorder as well as opioid misuse risk, and appropriate management and referral of identified patients. Residents will administer SBIRT to all their panel patients, and the Opioid Risk Tool will be administered to all chronic pain patients, and to those receiving narcotics.
Family Medicine residents will administer SBIRT, a 2- question pre-screen developed for use in primary care practices. As follow-up for those with positive SBIRT screens, the Drug Abuse Screening Test (DAST), and the Alcohol Use Disorder Identification Test (AUDIT) each containing 10 questions, are administered. Providers will discuss the findings of the specific screening instruments with the patient, giving individual feedback on the patient’s responses and enhancing motivation to change and will negotiate a plan to address the identified substance use concerns, including referral for further counseling. For chronic pain patients and those receiving narcotics, the Opioid Risk Tool will be administered by the provider. Meharry faculty will supervise residents and assist with appropriate management of patients identified for substance use disorder, those on chronic narcotic therapy, as well as those patients identified at high risk for opioid misuse. Residents will be monitored for opioid risk assessment with chart review by a quality care assistant.