Dr Siva Sundaram

Addiction used to be someone else’s problem. Doctors graduating today are eager to take it on

June 12, 2019

Siva Sundaram got his first lesson in addiction before he started medical school, when he worked at a wilderness program for teenagers who suffered from substance use disorders.

During his two years there, he came to realize the kids were just like him, struggling with the same problems of identity, peer pressure, and independence — and that people with addiction are no different from those with other illnesses.

That insight served him well when he arrived at Harvard Medical School in 2015, just as the ground was shifting in medical education. Governor Charlie Baker that year had called on the state’s four medical schools to ensure their curriculums addressed pain medications and addiction treatment.

Sundaram and other students from all four medical schools proved central to that effort, advocating for improvements and helping to revise the curriculums.

Doctors graduating this spring from the medical schools at Harvard, Tufts, Boston University, and the University of Massachusetts are among the first fully trained to recognize and treat addiction. Notably, many are prepared to prescribe buprenorphine, considered a critical but underused tool in combating opioid addiction.

Medical schools historically regarded addiction as someone else’s problem, not the job of medicine, said Sundaram, who is heading to a residency in psychiatry at the University of California San Francisco. “For my generation of students, we feel a great sense of opportunity to do things better,” he said.

Among those who joined the curriculum effort was Jamie Lim at Boston University.

“We see people struggling with these disorders on a day-to-day basis — on the street and also seeing them in the hospital,” said Lim, who graduates this year and will stay in Boston for his pediatrics residency. “I feel like I learned medicine through the lens of addiction. Addiction really teaches you to be nonjudgmental, very forgiving, and makes you aware of a lot of social determinants of health.”

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