Every day, more than 130 people in the United States die after overdosing on opioids, according to the National Institute on Drug Abuse. More than 20 percent of patients who are prescribed opioids for chronic pain misuse them. The opioid crisis does not discriminate by race, gender, age, or socioeconomic status.
Three years ago, Dr. Amy McKeever, PhD, RN, CRNP, WHNP-BC, an associate professor in the M. Louise Fitzpatrick College of Nursing and an advanced women’s health nurse practitioner in obstetrics and gynecology, saw the growing need to educate her students about substance use disorders, particularly the opioid epidemic. A women’s health nurse practitioner for more than 25 years, Dr. McKeever teaches in the undergraduate, graduate, and doctoral programs, and when not teaching and engaged in research, provides comprehensive women’s healthcare at a birth center.
McKeever was inspired to develop this course while overseeing students in a clinical setting in the hospital. She recognized that the students had significant knowledge gaps and lacked experience in navigating conversations with patients, nurses, and the interdisciplinary healthcare team, on issues related to opioid use and misuse.
“Given this is such an epidemic in healthcare and at the forefront of patient care issues, I realized that more time was needed in the curriculum to address these issues,” McKeever noted.
Her Villanova Nursing seminar, “The Opioid Crisis in America,” meets weekly for two hours and provides students with the time needed to grasp the magnitude of the growing issue of opioid use in the community and out on the streets. McKeever’s goal with this course is to introduce her students to the many issues that surround addiction including the social dynamic of substance use disorder; how and why it began in women; and the many emotions—including guilt and shame—that affect not only the individual, but also the family structure. Her students learn how to interact with and screen a patient, as well as how to deal with someone who comes into an emergency room or operating room suffering from an overdose.
“These issues are so prevalent in the community that even places such as libraries have the opioid reversing medication Narcan to help someone who is overdosing,” McKeever said. “I thought if community members are getting trained on Narcan, then clearly more work that needs to be done in Villanova’s nursing curriculum.”
McKeever uses a variety of content sources in the course. She brings in a number of guest lecturers, including a nurse who works in recovery at a crisis center and addresses the screening assessment and the detox process; a medical doctor who has treated patients at the women’s prison at Riker’s Island; first responders who work in stressful environments; a military police officer; a certified addiction counselor; and members of a family who have lived through a sibling or child’s addiction. Students also watch a video of a scientist who studies addiction and the brain—and approaches it as a brain disease.
One guest speaker who has presented in the class is a parent who talks about their child’s trajectory from the onset of opioid abuse and full addiction, up to the time of death. “It’s a very informative and empowering discussion for everyone,” McKeever noted.
In addition, McKeever provides a historical perspective on opioid use and how it has evolved from Egyptian times to the Victorian era and the early 1900s when there was a prevalence of opioids, and emerging again during the Vietnam War era. She notes that women have historically been targeted for opium use for reproductive health and mental health needs.
McKeever also covers the 1980s, focusing on the crack cocaine epidemic and mass incarceration. “We look at how OxyContin evolved and we talk a lot about Fentanyl because that’s what my students are going to experience in the future [as they move into various healthcare settings],” she says. “In class, my students watch a video of an actual drug overdose and see how it’s treated in an emergency room.” Their assignments are also targeted toward that type of exposure—getting students more comfortable with subject matter that may be sensitive in nature—so they don’t fear it.
As part of their coursework, students must watch a film of their choice and do a film reflection about the drug use depicted, sharing their new knowledge with the class. Sometimes students choose an issue that's been reported on in the media or that's happened in Hollywood. They’ll talk about complementary and alternative pain management options after using opioids, or topics such as safe injection sites, recovery houses, and policy. Another key area covered in the course is screening tools for opioid use, such as the Prescription Drug Monitoring program, a databank in which practitioners are given a national provider number.
McKeever’s course also includes some important overlap from theory into clinical practice. Students participating in certain clinical groups during their health promotion or community health experience visit sites such as recovery centers, where they teach health promotion. In these rotations, students work with healthcare staff to develop education classes or programs on topics related to what a patient needs to do now that they’re in recovery. This can include health screening, nutrition care, dental care and vaccines.
“I developed this seminar because I want my students to be well-equipped with the understanding of the science of addiction as a disease,” said McKeever. “I want them to understand the stigma associated with substance use disorder and I want them to be sensitive to that stigma. My hope is that when they encounter individuals that are suffering with substance use disorder, that they have a better understanding and are better equipped to communicate and support these individuals and their families.”
“Captivating Courses” is a feature introducing readers to some of the unique classes offered at Villanova University. Numerous courses across the University’s six schools and colleges provide students the opportunity to examine interesting and relevant topics. These features will give you a glimpse into some of these courses and the experiences they provide students. Find all of the Captivating Courses here.