AILSA CHANG, HOST:
The U.S. surgeon general estimates that more than 20 million Americans have a substance abuse problem, but there aren't enough doctors to treat them. Will Stone of member station KJZZ in Phoenix looks at new efforts to train more doctors as addiction specialists.
WILL STONE, BYLINE: Hillary Tamar wasn't thinking about addiction medicine when she started medical school in Illinois. And her early experiences seeing how some doctors dismissed patients who struggled with substance use did not necessarily encourage her.
HILLARY TAMAR: Because as a medical student, honestly, you do your ER rotation. People label a patient as pain-seeking, and it's bad. And that's all that you do about it.
STONE: But in her fourth year of school, she just happened to be assigned to a rehab facility. Working with those patients showed her how doctors with the right training can help patients heal and rebuild their lives.
TAMAR: They can go from spending all their time pursuing the acquisition of a substance to being, like, brothers and sisters, daughters, fathers making breakfast for their kids again. It's really powerful.
STONE: Tamar's now in the next stage of her medical career, a family medicine residency based here in Phoenix. Afterward, she plans to do an extra year of in-depth training, known as a fellowship, in the subspecialty of addiction medicine. Tamar sees addiction medicine as a natural fit for doctors in primary care. Both fields emphasize forming long-term relationships with patients focused on more than just a single diagnosis.
TAMAR: I love when I see addiction patients on my schedule. Even if they're pregnant and on meth, like - I don't know - more room to do good. Like, it's exciting.
STONE: Doctors with Tamar's enthusiasm are sorely needed and, until recently, tough to find according to Dr. Anna Lembke. She directs Stanford University's Addiction Medicine Fellowship. We spoke via Skype.
ANNA LEMBKE: You know, even 10 years ago, I couldn't find a medical student or a resident interested in learning about addiction medicine if I looked under a rock. I mean, they were just not out there.
STONE: It's entirely different now. Students are hounding Lembke to learn more.
LEMBKE: At least the medical community has begun to wake up and to consider not only their role in triggering this opioid epidemic but also the ways in which they really need to step up to help solve the problem.
STONE: In 2015, the medical establishment recognized addiction medicine as a bona fide subspecialty open to many kinds of doctors. This also meant addiction fellowships could get official accreditation and government funding. There are now more than 60 fellowships nationwide. But doctors like Lembke say the country needs double that number to deal with the ongoing epidemics. That's especially true in a place like Arizona. Dr. Luke Peterson had to leave Phoenix to get the training.
LUKE PETERSON: So anybody who wanted to do addiction medicine, we've had to go out of state.
STONE: After finishing his training in family medicine, Peterson moved to Seattle for a year, where he learned how to treat pregnant women who are in recovery.
PETERSON: It was just an incredible experience working with these moms, seeing their successes and being a part of that.
STONE: Peterson decided to come back to Arizona with his new skills. And now he's helping to start one of the new fellowships here. Not everyone who treats addiction needs that extra training, but Peterson says a fellowship also creates a hub, a place where doctors in the community can ask questions. In 2017, drug overdoses killed more than 70,000 Americans. That's more deaths than even the worst years of the AIDS epidemic.
PETERSON: And in 20, 30 years from now, those medical students are going to look back at my current generation of doctors, and we will be judged on how we respond to this epidemic.
STONE: And that begins with making sure there are enough doctors on the ground who know how to respond. For NPR News, I'm Will Stone in Phoenix.
CHANG: This story is part of a partnership with NPR, KJZZ and Kaiser Health News.
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