Editor’s note: PGDF’s Advisory Council (AC) is comprised of experts from across the field of addiction. In this series, we invite AC members to share their expertise and experience with PGDF constituents.

Joseph Skrajewski, MA, MFTI, is executive director of Medical and Professional Education at the Hazelden Betty Ford Foundation. He leads the Summer Institute for Medical Students (SIMS), Professionals in Residence (PIR) program, Addiction Medicine Fellowship, and Course on Addiction and Recovery Education (CARE) / Aquifer Addiction, while also overseeing program design, development and medical education partnerships. Joseph collaborates on multiple initiatives with the White House Office of National Drug Control Policy (ONDCP), National Institute on Drug Abuse (NIDA), National Institute on Alcohol Abuse and Alcoholism (NIAAA), Substance Abuse and Mental Health Services Administration (SAMHSA), American Society of Addiction Medicine (ASAM) and the Addiction Medicine Foundation (AMF). He serves on the board of the Desert Chapter of the California Association of Marriage and Family Therapists and as an Adjunct Clinical Instructor of Family Medicine at the University of Southern California’s Keck School of Medicine. He has presented all over the world on numerous topics related to addiction, and is a person in long-term recovery himself.

Consider the incredible ‘ripple effect’ of providing evidence-based addiction education for professionals; thereby equipping them to take this knowledge to use in their practices or within medical, nursing, pharmacy and legal school environments. This was the background and thought process leading to the creation of Hazelden Betty Ford’s world-renowned Summer Institute for Medical Students (SIMS) and Professionals in Residence (PIR) programs.

Dr. James W. West, a pioneer in addiction treatment, developed the SIMS and PIR programs in the 1980’s. These innovative programs immerse legal, health care and medical professionals in the treatment process and allow them to interact for weeklong sessions with patients and families. I was honored to take the helm to launch expanded educational programs and initiatives in 2009.

While the program started as Medical Education, it quickly expanded to encompass both the Medical and Professional Education (MPE) programs. In 2017, more than 1,500 participants from the United States, Canada, Europe, Asia and the Caribbean attended the programs, with that number increasing yet again as we wind down 2018.

Medical and Professional Education at the Hazelden Betty Ford Foundation encompasses four distinct programs:

Summer Institute for Medical Students (SIMS)

Through the SIMS program, participants learn about the science of addiction as well as the spirit of recovery. These life-changing lessons include:

• learning about addiction as a bio-psychosocial-spiritual disease and about how effective treatment addresses the whole person;
• understanding how Twelve Step programs are used in treatment and become part of the lifetime recovery prescription; and
• experiencing the treatment process and seeing the human being behind the disease.

Through the generous support of Hazelden Betty Ford Foundation donors, the SIMS program is offered at no cost to accepted applicants. This year, over 400 applicants applied for the 195 SIMS scholarships.

Medical students have the opportunity to ‘see’ the human being behind the disease—that these are individuals who have made a decision that took them down a different path. The goal is to show the students that there is hope—that our patients do, in fact, realize success and go on to live beneficial, healthy lives.

In 2014, the Betty Ford Center merged with Hazelden Foundation to become the Hazelden Betty Ford Foundation. This opened new possibilities for the SIMS program.

SIMS was running at full capacity for the program at the Betty Ford Center in Rancho Mirage, but through the merger, there was an opportunity to expand the program to the Hazelden campus in Center City, Minnesota. This led to the ability to accept more applicants and offer flexibility through additional sessions. It made it much more convenient for the medical students.

Professionals in Residence (PIR)

The PIR program is designed for health care and mental health providers, addiction and school counselors, social workers, and criminal justice professionals – on all levels of expertise. The program offers the opportunity to learn, side-by-side, with expert clinicians and patients in treatment. Professionals benefit from learning new perspectives on addiction and approaches to treatment.

Participants in the SIMS and PIR programs, in returning to school or work, have the tools and expertise to share what they’ve learned about addiction and recovery, by educating colleagues, raising awareness, developing outreach programs, influencing curricula, and effecting real change in their communities and fields of expertise.

Addiction Medicine Fellowship

As the reputation of the SIMS program grew, the MPE team found that they were turning away hundreds of applicants each year due to program capacity. The Eisenhower Medical Center (located near the Betty Ford Center), had initiated a Family Medicine and Internal Medicine Residency which provided an ideal opportunity for expanding the MPE program by offering a rotation in addiction medicine at the Betty Ford Center.

Around this same time, the American Board of Addiction Medicine (ABAM) began accrediting addiction medicine fellowships. As there were no accredited programs on the West Coast at that time, we collaborated with our medical team to create an Addiction Medicine Fellowship curriculum in 2012, and we were granted accreditation in Spring 2013.

A yearlong program, the Addiction Medicine Fellowship equips physicians to be specialists in all aspects of addiction medicine. With a focus on patient care, fellows now rotate among the Hazelden Betty Ford Foundation’s detoxification and inpatient units, day treatment, pain management program, family and children’s programs, and adolescent program.

Course on Addiction and Recovery Education (CARE) / Aquifer Addiction

In an effort to encourage more participation in addiction education, I collaborated with industry experts, A. Thomas McClellan, founder of the Treatment Research Institute (TRI), a not-for-profit research and development institute in Philadelphia, and John Boop, former president of the foundation at the Betty Ford Center. The ensuing discussion focused on how to effectively expand the outreach of the program—primarily through grants and fundraising—to create a medical education curriculum on addiction that could be marketed globally.

Through a private grant, the team raised $1.2 million, designated to address the widely recognized need for substance use disorder education in medical schools. The MPE team partnered with the Treatment Research Institute (TRI), the American Society of Addiction Medicine (ASAM), and Aquifer (formerly known as MedU) to create 14 interactive videos on addiction topics and 6 interactive case studies on addiction, available for medical schools all over the world. Other industry experts also embraced the opportunity to participate in this important endeavor.

Developed initially for medical students, the Course on Addiction and Recovery Education (CARE) / Aquifer Addiction online curriculum provides educational resources on a spectrum of topics such as Pain Management and Liability for Addiction; Pregnancy and Alcohol Abuse; Cannabis Use in Adolescents; Alcohol Withdrawal; Dermatology and Stimulant Use; and IV Heroin Use and HIV.

With lectures and interactive sessions facilitated by leading speakers in the addiction field, including Tom McLellan of TRI, Dr. Ben Nordstrom of Dartmouth, Dr. Jeffrey Goldsmith of ASAM, Dr. Sharon Levy of Harvard, Dr. Mark Schwartz of Princeton House, Dr. Nora Volkow of NIDA, Dr. George Koob of NIAAA and others, the CARE curriculum offers a worthwhile and comprehensive package on addiction.

The Hazelden Betty Ford Foundation has a long-standing commitment to education, not only for patients and their families, but also in providing support for caregivers and others who are working directly with people in addiction. This legacy continues through the Medical and Professional Education program.

To watch this program grow to offer SIMS, PIR, residency rotations, an accredited fellowship, and the CARE / Aquifer Addiction interactive online curriculum for medical schools across the country has been such a rewarding experience. Much of the work now involves working with students and schools to take the SIMS information back to their universities, communities, and clinics. They then set up student-driven addiction workshops or awareness events where our role is to speak and facilitate conversations on advances in addiction education.

Where do we go from here?

As we know, the time for change is long past due and we all need to do everything we can to advance medical and professional education on addiction. Drug overdose deaths hit the highest level ever recorded in the United States last year, with an estimated 200 people dying per day, according to a recent report by the U.S. Drug Enforcement Administration. Most of that was the result of a record number of opioid-related deaths. With preliminary figures showing more than 72,000 people dying in 2017 from drug overdoses across the country, we need to come together to help keep our patients, families and friends alive long enough to help them find a better way of life.

The Hazelden Betty Ford Foundation is a force of healing and hope for individuals, families and communities affected by addiction to alcohol and other drugs. It is the nation’s largest nonprofit treatment provider, with a legacy that began in 1949 and includes the 1982 founding of the Betty Ford Center. With 17 sites in California, Minnesota, Oregon, Illinois, New York, Florida, Massachusetts, Colorado and Washington, the Foundation offers prevention and recovery solutions nationwide and across the entire continuum of care for youth and adults. It includes the largest recovery publishing house in the country, a fully accredited graduate school of addiction studies, an addiction research center, an education arm for medical professionals and a unique children’s program, and is the nation’s leader in advocacy and policy for treatment and recovery.