The vision of the UNC Addiction Medicine Fellowship is to expand capacity for addiction treatment in North Carolina, with emphasis on training physicians in team-based care with an understanding of how to provide high quality addiction treatment to underserved populations. The fellowship is designed to prepare graduates for careers in community-based or academic Addiction Medicine. Graduates will have obtained competence in patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and system-based practice at the level expected of a new practitioner and will be well-prepared for the addiction medicine board exam. Graduates from the program will have evidenced accomplishment of these goals as measured by evaluation of skills, knowledge, and attitude by various means during the fellowship.
Diversity, Equity and Inclusion
The culture of the University of North Carolina at Chapel Hill (UNC) Addiction Medicine Program (AMP) is to create an environment that is safe and accepting to all people, particularly focused on trauma-informed care and harm reduction. The UNC-AMP recognizes the need to expand cultural sensitivity to include minority populations as an area for development, particularly given the historic and current systemic barriers that occlude Black, Indigenous, and Persons of Color (BIPOC) and LGBTQI people from accessing life-saving addiction treatment. The UNC-AMP is committed to exploring and understanding systemic racial disparities and how these disparities impact care for BIPOC/LGBTQI people. The UNC-AMP is taking action by focusing on two areas: 1) enhance education of UNC-AMP faculty and staff through participation in the UNC School of Medicine’s Diversity, Equity and Inclusion certificate course; and 2) creation of referral pathways for the prison and jail systems of NC to transition people to addiction treatment upon release from incarceration. By taking these steps, the UNC-AMP seeks to expand knowledge about treatment disparities and to expand access to care for those from diverse backgrounds.
The following offers a wide array of training opportunities in addiction medicine with goal of teaching fellows about systems of care and collaborating across disciplines and professions. The fellows will work with physicians in Family Medicine, Anesthesia, Psychiatry, Pediatrics, OB/GYN and Preventive Medicine, while also working alongside Peer Support Specialists, Nurse Practitioners, Nurses, Psychologists and Case Managers. Some of the training opportunities include working on an Inpatient Addiction Consult Service, Medically Supervised Detox Unit, Inpatient Pain Service and an Opioid Treatment Program. The fellows will also have opportunity to participate in implementation projects, one of which is integrating Peer Support Services coupled with medical management of substance use disorders in an inpatient setting.
Addiction Treatment in North Carolina
A central focus of the UNC Addiction Medicine Fellowship is examining addiction treatment in a larger context. North Carolina is significantly impacted by the opioid epidemic and as such, many innovative projects are underway to expand the capacity for addiction treatment statewide, incorporating critical linkages between inpatient and outpatient care as well as facilitating connections between the Addiction Medicine Specialist and Primary Care. The Addiction Medicine fellows are integrally involved in some of these initiatives.
NC Substance Treatment And Recovery Network (NC STAR Network)
Beginning in 2017, The University of North Carolina at Chapel Hill (UNC) initiated a hub and spoke treatment model to expand access to care for people with opioid use disorder (OUD) and other substance use disorders (SUD). UNC served as the hub and provided care for patients with high-acuity treatment needs and began making partnerships with community health centers, the spokes, who in turn were able to accept referrals from UNC for stabilized patients. In March 2020, this hub and spoke model expanded in partnership with the Mountain Area Health Education Center (MAHEC), sponsored by the Foundation for Opioid Response Efforts (FORE), such that MAHEC became a 2nd hub and began offering specific OUD/SUD training to the spokes. In 2022, NC Department of Health and Human Services (NC DHHS) partnered with UNC to further expand this effort statewide. This model was then named the NC STAR Network and East Carolina University (ECU) joined the network as an additional hub.
The NC STAR Network is aligning closely with the requests set forth by the Bipartisan Policy Center in their report published in April 2022. The specific areas of focus are: 1) Infrastructure; 2) Initiation of Medications for Opioid Use Disorder (MOUD); 3) Engagement in Care; 4) Retention in Treatment; and 5) Harm Reduction. All focus areas described will maintain an emphasis on serving underserved populations, including but not limited to: uninsured/under-insured, pregnant/parenting, justice involved, BIPOC, and rural populations.
Inpatient Addiction Treatment for patients hospitalized with infections from IV Drug use
The NC Department of Public Health sponsors a project to provide Peer Support counseling, harm reduction services, and addiction treatment to patients hospitalized at UNC with infections from IV Drug Use. The addiction fellows are integrated into this work through their participation on the inpatient addiction consult service, serving the addiction treatment needs of this population, and work closely with case management and peer support specialists. Addiction fellows engage with patients while they are in the hospital, provide medication management for their substance use disorders, and then have the opportunity to see their patients in our outpatient clinic upon discharge.