The opioid epidemic has left an indelible mark on the lives of millions. From rural towns to urban centers, the staggering number of lives lost and people affected by opiates are stark reminders of the urgent need for knowledge, understanding, and action. Seeing this need, the Human Biology leadership team recognized the importance of educating students on the opioid epidemic and put out a call to the community in search of faculty who would be interested in teaching an upper-division course on the subject.
At that time, Professors Michael Ostacher and Windy McNerney were teaching their popular lower-division psychology course on addictions (Psyc 83), a class McNerney created as a result of student demand for education in mental health and addiction. They were also deeply involved in the Wu Tsai Neurosciences Institute’s Neurochoice Initiative, a program devoted to addiction research at the neural circuits, people, and policy levels. Seeing an opportunity to bring this initiative into the classroom, Ostacher and McNerney proposed a course that explores how understanding the neurological basis of addiction could change the way policy is used to tackle this crisis.
Their class, HumBio 163, The Opioid Epidemic: Using Neuroscience to Inform Policy and Law, launched in the spring of the 2018-2019 academic year, and its interdisciplinary nature has attracted students with a range of academic concentrations. Ostacher brings his perspective as a doctor who runs a clinic that treats people with opiate use disorder, and McNerney shares her expertise as a scientist who specializes in the biochemistry of mental health. Students learn about topics ranging from the physiological (effect on the brain, tolerance, withdrawal) to the sociopolitical and demographic (harm reduction, access to treatment, disparities).
Students study the neuroscience behind use and addiction, explore the factors contributing to varying susceptibility among individuals, compare current treatment methodologies, and discuss and devise potential policy proposals and solutions to mitigate the consequences of this epidemic. The objective is that students take what they learn and apply their knowledge to address the crisis within their communities.
As they learn more about opioid addiction, students are sometimes surprised by common misconceptions. For some, the class provides a new perspective on the disease, challenging their views on drug use, distribution, willpower, or self-care. Students are also often surprised by the complexity of the opioid issue and how deeply intertwined it is with factors such as societal norms, race, poverty, neuroscience, and politics. “One of the first things we say is that whenever we talk about both the opioid epidemic and medicine, everything we say is inherently political, even things like naming people as addicts versus people who live with addictions or people who use drugs, make for a heightened awareness,” Ostacher said. “It’s important for the students to understand that everything must be understood in a political context but also that we expect them not to repeat what we say but to formulate their own opinions.”
Navigating a class on a heavy and at times controversial topic can be challenging, especially when students have differing opinions. Ostacher and McNerney strive to ensure that their classroom discussions are a space to listen, acknowledge, and respect one another. “This is a difficult and controversial topic. We’re talking about drugs and race and class, those are inherently controversial,” McNerney noted. “Everybody has a different history, experience, and opinion and we welcome these opinions with love and respect because that's how you start a dialogue.” Echoing this, Ostacher explained that he and McNerney emphasize the value of these open face-to-face conversations and acknowledge the roles race, class, and privilege play in healthcare disparities and the social determinants of health. There is power not only in listening to diverse and unique views and experiences but also in making space for and learning from each other.
In a time when the opioid epidemic continues to claim lives and devastate communities, education emerges as a powerful tool for change. Ostacher, McNerney, and the HumBio 163 course play a crucial role in educating students about the crisis while fostering understanding, empathy, and inspiring action. “Almost everybody knows people who use opiates. There's a party culture on campus that is involved with opiates; students on campus have died from opiate overdoses; and students have family members who have problems related to addictions and drug use,” Ostacher reflected. “Just by taking this class, the students are exhibiting a kind of bravery in confronting this, which I think is not often asked of students but is incredibly important and powerful.”
The impact of the class has extended beyond the classroom walls. Inspired by the course, HumBio alumnus Max Moss ‘21 and Nicole Ticea ‘21 proposed a Narcan program on campus. Joined by fellow HumBio alumna Vilina Mehta ‘22, the trio founded the Campus Opioid Overdose Prevention Project (CO-OP) to raise awareness about the opioid epidemic and train community members to recognize and respond to overdoses. Their efforts have led to the widespread availability of Narcan, fentanyl test strips, training, and resources across Stanford’s campus. “It is so inspiring to see people go out there and make a difference,” McNerney shared. “It is the best part of teaching this class by far!” Ostacher and McNerney hope that in gaining a deeper understanding of the multifaceted and complex nature of addiction and opioid use, students will continue to be inspired to demand or make change.
Michael Ostacher is a professor of psychiatry and behavioral sciences at Stanford Medicine. He also serves as the site director for the Addiction Medicine Fellowship at the VA Palo Alto Health Care System, the medical director of the Pharmacology of Addiction Recovery Clinic, the director of the Bipolar and Depression Research Program, the director of Advanced Fellowship Training in Mental Illness Research and Treatment for MDs for the VISN 21 MIRECC, and the site director at the VA Palo Alto for Advanced Fellowship Training for Stanford. His primary research interests are in large clinical trials, mental health and addiction, and the implementation of evidence-based mental health practices. In addition to HumBio 163, Ostacher co-teaches Psyc 83, Addictions in our World: From Physiology to Human Behavior, with McNerney.
Windy McNerney is a clinical associate professor (affiliated) of psychiatry and behavioral sciences at Stanford Medicine whose primary interest is in the neurophysiology and biochemistry of brain and mental health diseases (especially degenerative diseases, depression, TBI, PTSD, and addiction). She is collaborating with researchers to integrate brain imaging and biochemical markers in hopes of better understanding these diseases. She also is taking a lead role in investigating the biochemistry of magnetic brain stimulation. In addition to co-teaching Psyc 83, Addictions in our World: From Physiology to Human Behavior, McNerney serves on Human Biology’s Curriculum Committee.