The University of Tennessee College of Medicine’s Addiction Medicine offers an outpatient clinic for people dealing with addiction issues while providing training for future doctors to help those in recovery.
The University of Tennessee College of Medicine plays an important role in training the region’s future medical professionals.
But the school also serves the needs of the community, a mission driven by its Dean, Dr. David Stern. One of Stern’s objectives when he joined the college was to serve the very vulnerable communities and tackle health disparities.
One of those issues is addiction medicine. Today, the University of Tennessee Addiction Medicine offers an outpatient clinic for people with a number of addiction issues, from alcohol and drug addictions to co-occurring mental health disorders and other addictive behaviors.
Treatment areas include alcohol, nicotine, medication-assisted treatment, opioids and heroin, cocaine and amphetamines, and behavioral addictions such as gambling, gaming, food, sex and Internet.
Addiction medicine “crosses socioeconomic barriers, gender barriers and cultural barriers,” Stern said. “If one wanted to create a service this is the one. The faculty of the college with 800 doctors I want to see it have an impact. … We need to have more physicians who understand how to treat patients with addiction.”
A move to create the center started in full about a year ago.
Dr. Daniel Sumrok is a physician trained in family medicine and obstetrics. His background has taken him to underserved communities in West Virginia’s Appalachia region and with Navajo reservation residents in Arizona. Working in addiction medicine isn’t something he sought out; rather, it’s something he said came to him.
“It’s something that couldn’t be ignored,” he said. “It’s systemically been ignored by the rest of medicine for a long time. When I was 50 I was too old to stay up late in labor. Everyone I knew was addicted to cigarettes or alcohol. I told a military colleague who had retired that it seems like everybody is addicted. He said, ‘Why don’t you do something about it?’”
Sumrok said he didn’t know what to do, so he stuck his toes in timidly in the water. He was trained in the drug buprenorphine that is used for opioid addiction, which the U.S. Food and Drug Administration approved in 2002. It took about a year to accumulate 30 patients, although he said he could’ve done that in two days with the proper focus.
“I was clearly making a difference in areas of people’s lives that matter,” he said. “I felt really useful as a physician. This was addressing something that was new and interesting.”
Of course the idea of focusing on addiction probably wasn’t fully accepted.
“They thought I must’ve short-circuited,” Sumrok said. “But I really meant it. I meant it because it’s such a cognizant issue to adult illnesses. I call it the medicine of poor people but addiction isn’t just illness of poor people.”
But the university’s leadership listened. Stern wanted to make sure the medical school serves the needs of the community. He already had been part of meetings in Washington on the subject.
Sumrok later joined Stern and others in Nashville. The drive to Middle Tennessee provided Sumrok an opportunity to discuss his plans with Stern. By the time they made the return drive back to Memphis later that day, Stern agreed to add a fellowship in addiction medicine with a caveat. He said he wanted community outreach and treatment across all demographics: urban, suburban and rural.
“I said, ‘Yes sir,’ and haven’t looked back,” Sumrok said. “This was a fantasy that mainstream medicine would pick this up 10 years ago. We talked about it almost under our breaths and in little side rooms. Now people realize it has such an impact on public health.”
The next step was the medical college’s creation of a physician fellowship. The fellowship began July 1 with the first two fellows. It’s the only program in the country with two. And all residents after finishing medical school have the opportunity for addiction training.
Stern said the hope is to expand by two fellows next year. The growing number of fellows through the years ideally will train others – medical students, residents and attendees – in how to identify patients with substance abuse disorder and treat them, rather than identifying it and not knowing what to do.
Sumrok credits Stern’s leadership for the program.
“I’m 63. I’m not a spring chicken. So for me at the end of my career to do a thing so important to the community it’s a real privilege to have a guy like Dr. Stern,” Sumrok said. “And it’s such an obvious need in this community. The fact is, treatment works. Some of the information I’ve found is treatment saves lives, saves families, it saves communities in a big way. I couldn’t be more enthusiastic about doing this.”
Sumrok’s career in many ways has pointed to this work. Back in West Virginia he often dealt with issues of poverty and obesity. And while in medical school at Marshall University, a new diagnosis came out called post-traumatic stress disorder.
Sumrok did a lot of research on PTSD and connections to substance abuse and sleep problems. That knowledge flows into his work in Memphis, specifically as he wonders what trauma a person with substance dependence has undergone.
“What I’ve found is Memphis has significant types of trauma,” Sumrok said. “If you live in a household where you’re told every day you’re wrong about something or verbally abused, that’s pretty significant trauma. The longer you’re exposed to trauma the more severe it is. Imagine growing up every day. You can’t feel secure. You’re afraid if you go in the street.”
Stern said it’s vital for the city’s future to have more trained addiction doctors who are skilled in substance abuse disorders that come from those traumatic situations. Currently the need for those doctors far exceeds the workforce that’s available.
“Most doctors aren’t trained in the use of evidence-based guidelines,” he said. “Resources are limited to high-income brackets. American addiction centers are expensive. I wanted it available for all classes of payers.”
The first office is located behind Methodist University Hospital on Eastmoreland Avenue. Patients come to Sumrok in a variety of ways. Word of mouth keeps bringing in more people dealing with a variety of addictions. The hope is patient referrals from other doctors will grow.
To prevent addiction, Sumrok said children must be raised in a more secure environment. Those traumatic events in childhood increase the possibility adults will develop health issues such as diabetes or liver disease.
A couple of challenges exist in furthering the focus at UT, although Stern said the one of people coming forward and admitting to having a substance abuse problem isn’t a hard one to overcome.
“People do come forward,” he said. “Addiction destroys families and lives. The problem is always when you treat everyone it’s an economic problem of how do you afford to do this and keep it sustainable. For me it’s having multiple revenue resources.”
So fundraising remains a priority.
Ultimately Stern wants to see a center of excellence created, much like a cancer center. In fact, he said the model for addiction science is how a cancer center has multiple disciplines working as a team to treat a patient.
“I’m looking to evolve addiction science to follow that model,” he said, adding that everyone from orthopedists who prescribe pain medication to emergency medicine that deals with detox episodes must be involved.