The idea is simple but powerful: medical students from the Michigan State University College of Osteopathic Medicine (MSUCOM) help high school students in metro Detroit and Macomb County to understand the dangers of substance use.
The results – as seen in a paper published in a recent issue of Frontiers in Public Health, written by Carolina Restini, PharmD, Ph.D., and associate professor in the MSU Department of Pharmacology and Toxicology in MSUCOM, with former and current MSUCOM medical students – are impactful, not only for the teens themselves, but also for MSUCOM students who volunteer in the community outreach program.)
The experience was especially meaningful for one recent MSUCOM graduate who came back to speak to students about vaping awareness at Dakota High School in Macomb, where he himself graduated in 2013. Michael Naddaff, D.O., (Class of 2024), is now a second-year family medicine resident at McLaren Oakland Hospital in Pontiac, Mich. While in high school, he struggled with his mental health, including depression and suicidal thoughts.
“I almost didn’t make it through high school,” he said. “To come back and talk to students 11 years later, it was incredible. It was just great to come back to a place that I thought I wasn’t going to advance from and just be there for kids, be an example. It felt like a full circle moment.”
The MSU College of Osteopathic Medicine Substance Use Prevention (SUP) program is the brainchild of Dr. Restini. For several years, she has worked to provide opportunities for medical students to practice the concepts they learn in the classroom by serving, learning and collecting data from the community.
The MSUCOM SUP research paper focused specifically on educating adolescents about opioids and e-cigarettes, or vaping. Studies show that one in seven high school students has misused opioids at some point in their lifetime, while those ages 18–25 comprise the highest percentage of people (24% or 8.3 million people) who used e-cigarettes or other devices to vape nicotine in 2022. The Substance Use Prevention program calls upon MSUCOM students to educate teenagers about risk factors; effects on the lungs, the heart and other vital organs; causes of overdose; the science of addiction and more through interactive presentations and case studies.
“It's not just saying, ‘This is bad for you,’” Dr. Restini emphasized. “Our med students talk about clinical cases of young people using drugs and what happens in terms of physiology, biochemistry and pathology. They talk about epidemiology and the biomedical sciences behind addiction.
“So, we empower these high school students with a critical view by conveying the message founded on evidence and science in a way that they can understand and then they feel they own the knowledge.”
According to the journal article, high school students at four metro Detroit and Macomb County high schools who participated in the MSUCOM SUP intervention reported having considerably more confidence in their knowledge of opioids and e-cigarette misuse. While 9% rated their opioid knowledge as “a lot” or “a great deal” pre-intervention, that number dramatically increased to 52% post-intervention. For e-cigarettes, 20% of the teens rated their knowledge as “a lot” or “a great deal” pre-intervention, compared to 53% post-intervention.
“This paper was published this year, but it comes from several years of community services,” Dr. Restini said. “And it serves as proof that we are not only generating information, health literacy and empowering the community, but also publishing and communicating our data to the scientific community through public health.”
While Dr. Restini is encouraged by MSUCOM SUP’s short-term impact, work is underway to develop protocols to measure its effects over the long term.
Engaging teens through science and interaction
Esha Garg, a fourth-year MSUCOM student (class of 2026), got involved in the program during her first few months of medical school and eventually became the MSUCOM SUP cochair.
“The reason they took it seriously, in my opinion, is that we weren’t just telling them not to do x, y or z,” Garg explained. “We were showing them case studies and actual medical images of normal lungs compared to those affected by vapes. We would talk about the impact of opioid addiction on the brain. We were showing them solid, scientific proof. And we tried to present it in a way that they could relate to it. We didn’t just tell them these substances are bad, we showed them, and they could see why they’re addictive.”
The relatively narrow age gap between the osteopathic medical students and high school students was likely another helpful factor in getting the message across.
“We always introduced ourselves by using this format: ‘Hi, I’m Esha, I went to Northville High School. I graduated in 2019,’” Garg explained “So, if I was talking to a student who was going to graduate in 2024, that’s not that big of an age difference. I’m sure they saw us more as older siblings rather than parental figures, which probably had a bigger impact.”
What’s more, MSUCOM students didn’t talk at the teens but engaged with them. They would ask high schoolers questions during and after presentations through Bingo games and other fun, interactive techniques. Students even used a spinning wheel to win prizes, such as candy or MSU swag.
A mutually beneficial partnership
Charlene McGunn, Ph.D., executive director of the Chippewa Valley Coalition for Youth and Families in Macomb County, worked with Dr. Restini to bring MSUCOM students into area high schools. The Coalition is a federally funded community anti-drug coalition focused on preventing and reducing youth substance use and preventing youth suicide.
“We create partnerships with law enforcement, courts, agencies, churches. And this partnership with MSUCOM allows a real-life connection with health care,” Dr. McGunn said. “I do think it’s made a difference. We want to educate our students to move forward and provide factual information in informal ways with their peers, like at parties and other real-life situations. So, this allows our students to feel more informed, but it also promotes their resiliency to avoid the use of drugs because they are educated.”
In addition to the intervention at Dakota High School, the substance use prevention program was conducted at several high schools, including Chippewa High School in Clinton Township, Romeo High School and Benjamin Carson High School of Science and Medicine in Detroit (which has since been renamed Crockett Midtown High School of Science and Medicine).
Dr. McGunn said this kind of community engagement programming has mutual benefits.
“Our students benefit from hearing the information from people they think are credible,” she said. “It’s one thing for a teacher to tell them something. It’s another thing for someone who’s in medical school to tell them about the dangers and pharmacological conditions that occur with drugs, to talk about the brain, etc. It’s much more impactful for them. But it also prepares med students for the real world of practicing in the community. It puts them directly with kids so they can hear what they say and understand how they think.”
Learning, training and presenting
John Karns, D.O., graduated from MSUCOM in May and is now in residency in interventional radiology at the University of Texas at San Antonio. He took part in the substance use intervention during program during his second and third years of medical school and agrees that he and his peers gained valuable insight from the face-to-face interactions with teens.
“When teaching students, you learn just as much from them as they learn from you,” Dr. Karns said. “I learned that you can really make a difference in educating and engaging with a community, more so than what people think. I felt like we really engaged and connected with many students and made a difference. It’s made me want to continue to be involved in community outreach.”
Dr. Karns and some of his peers were able to build on their experience by presenting their findings at a national conference in Washington, D.C. According to Dr. Restini, MSUCOM students are cycled into the community outreach program and trained by MSU faculty and experts from the National Institute on Drug Abuse (NIDA).
“And when they are prepared to talk to high school students, we have rehearsal, so they are all on the same page,” Dr. Restini said. “They are using the same terminology, the same approach, the same dynamics to make it consistent in a way that we can collect data to measure the impact of our actions towards substance use prevention among teens. Our protocols guarantee that we don't have biases because of lack of personal training.”
Passionate leadership
Dr. Restini is also the founder and director of the Foundry for Innovative Research and Education (FIRE) Program, another initiative that bridges community service with medical education and research. Thanks to more than five community partnerships, osteopathic medical students and D.O. trainees collaborate with public schools, senior centers and MSU faculty from multiple disciplines.
FIRE allows medical students to serve while they learn by transforming real-world experiences into meaningful research. More than 20 student-led research projects are currently underway, allowing MSUCOM students to collect data on issues, such as health literacy and social determinants of health.
“Dr. Restini has worked so hard for this,” Garg said. “Her passion is so strong. She constantly finds opportunities for us to present our research and to do different things with the research. She is the backbone of this community outreach program, and it wouldn’t have been possible without her.”
A doctor living a dream by giving back
Now 30, in addition to SUP, Dr. Naddaff has also made presentations to Dakota High School’s medical careers program, which introduces students to career opportunities in health care. He plans to keep participating in community outreach programs when he completes his goal of becoming a family primary care physician, attending to the needs of an underserved community.
“I’d love to continue the cycle of helping other people reach their dreams. It’s not about trying to persuade, or force or scold people,” Dr. Naddaff said of substance use education and prevention. “It’s really just to provide information – to get people to think about the consequences. Even if it means having just one person using those resources, that’s a job well done.
“I’m just so grateful and thankful to be a doctor,” he added. “It’s the equivalent of winning the lottery. I just somehow got that winning ticket. I’m truly living a dream every day.”
by Lynn Waldsmith
The idea is simple but powerful: medical students from the Michigan State University College of Osteopathic Medicine (MSUCOM) help high school students in metro Detroit and Macomb County to understand the dangers of substance use.
The results – as seen in a paper published in a recent issue of Frontiers in Public Health, written by Carolina Restini, PharmD, Ph.D., and associate professor in the MSU Department of Pharmacology and Toxicology in MSUCOM, with former and current MSUCOM medical students – are impactful, not only for the teens themselves, but also for MSUCOM students who volunteer in the community outreach program.)
The experience was especially meaningful for one recent MSUCOM graduate who came back to speak to students about vaping awareness at Dakota High School in Macomb, where he himself graduated in 2013. Michael Naddaff, D.O., (Class of 2024), is now a second-year family medicine resident at McLaren Oakland Hospital in Pontiac, Mich. While in high school, he struggled with his mental health, including depression and suicidal thoughts.
“I almost didn’t make it through high school,” he said. “To come back and talk to students 11 years later, it was incredible. It was just great to come back to a place that I thought I wasn’t going to advance from and just be there for kids, be an example. It felt like a full circle moment.”
The MSU College of Osteopathic Medicine Substance Use Prevention (SUP) program is the brainchild of Dr. Restini. For several years, she has worked to provide opportunities for medical students to practice the concepts they learn in the classroom by serving, learning and collecting data from the community.
The MSUCOM SUP research paper focused specifically on educating adolescents about opioids and e-cigarettes, or vaping. Studies show that one in seven high school students has misused opioids at some point in their lifetime, while those ages 18–25 comprise the highest percentage of people (24% or 8.3 million people) who used e-cigarettes or other devices to vape nicotine in 2022. The Substance Use Prevention program calls upon MSUCOM students to educate teenagers about risk factors; effects on the lungs, the heart and other vital organs; causes of overdose; the science of addiction and more through interactive presentations and case studies.
“It's not just saying, ‘This is bad for you,’” Dr. Restini emphasized. “Our med students talk about clinical cases of young people using drugs and what happens in terms of physiology, biochemistry and pathology. They talk about epidemiology and the biomedical sciences behind addiction.
“So, we empower these high school students with a critical view by conveying the message founded on evidence and science in a way that they can understand and then they feel they own the knowledge.”
According to the journal article, high school students at four metro Detroit and Macomb County high schools who participated in the MSUCOM SUP intervention reported having considerably more confidence in their knowledge of opioids and e-cigarette misuse. While 9% rated their opioid knowledge as “a lot” or “a great deal” pre-intervention, that number dramatically increased to 52% post-intervention. For e-cigarettes, 20% of the teens rated their knowledge as “a lot” or “a great deal” pre-intervention, compared to 53% post-intervention.
“This paper was published this year, but it comes from several years of community services,” Dr. Restini said. “And it serves as proof that we are not only generating information, health literacy and empowering the community, but also publishing and communicating our data to the scientific community through public health.”
While Dr. Restini is encouraged by MSUCOM SUP’s short-term impact, work is underway to develop protocols to measure its effects over the long term.
Engaging teens through science and interaction
Esha Garg, a fourth-year MSUCOM student (class of 2026), got involved in the program during her first few months of medical school and eventually became the MSUCOM SUP cochair.
“The reason they took it seriously, in my opinion, is that we weren’t just telling them not to do x, y or z,” Garg explained. “We were showing them case studies and actual medical images of normal lungs compared to those affected by vapes. We would talk about the impact of opioid addiction on the brain. We were showing them solid, scientific proof. And we tried to present it in a way that they could relate to it. We didn’t just tell them these substances are bad, we showed them, and they could see why they’re addictive.”
The relatively narrow age gap between the osteopathic medical students and high school students was likely another helpful factor in getting the message across.
“We always introduced ourselves by using this format: ‘Hi, I’m Esha, I went to Northville High School. I graduated in 2019,’” Garg explained “So, if I was talking to a student who was going to graduate in 2024, that’s not that big of an age difference. I’m sure they saw us more as older siblings rather than parental figures, which probably had a bigger impact.”
What’s more, MSUCOM students didn’t talk at the teens but engaged with them. They would ask high schoolers questions during and after presentations through Bingo games and other fun, interactive techniques. Students even used a spinning wheel to win prizes, such as candy or MSU swag.
A mutually beneficial partnership
Charlene McGunn, Ph.D., executive director of the Chippewa Valley Coalition for Youth and Families in Macomb County, worked with Dr. Restini to bring MSUCOM students into area high schools. The Coalition is a federally funded community anti-drug coalition focused on preventing and reducing youth substance use and preventing youth suicide.
“We create partnerships with law enforcement, courts, agencies, churches. And this partnership with MSUCOM allows a real-life connection with health care,” Dr. McGunn said. “I do think it’s made a difference. We want to educate our students to move forward and provide factual information in informal ways with their peers, like at parties and other real-life situations. So, this allows our students to feel more informed, but it also promotes their resiliency to avoid the use of drugs because they are educated.”
In addition to the intervention at Dakota High School, the substance use prevention program was conducted at several high schools, including Chippewa High School in Clinton Township, Romeo High School and Benjamin Carson High School of Science and Medicine in Detroit (which has since been renamed Crockett Midtown High School of Science and Medicine).
Dr. McGunn said this kind of community engagement programming has mutual benefits.
“Our students benefit from hearing the information from people they think are credible,” she said. “It’s one thing for a teacher to tell them something. It’s another thing for someone who’s in medical school to tell them about the dangers and pharmacological conditions that occur with drugs, to talk about the brain, etc. It’s much more impactful for them. But it also prepares med students for the real world of practicing in the community. It puts them directly with kids so they can hear what they say and understand how they think.”
Learning, training and presenting
John Karns, D.O., graduated from MSUCOM in May and is now in residency in interventional radiology at the University of Texas at San Antonio. He took part in the substance use intervention during program during his second and third years of medical school and agrees that he and his peers gained valuable insight from the face-to-face interactions with teens.
“When teaching students, you learn just as much from them as they learn from you,” Dr. Karns said. “I learned that you can really make a difference in educating and engaging with a community, more so than what people think. I felt like we really engaged and connected with many students and made a difference. It’s made me want to continue to be involved in community outreach.”
Dr. Karns and some of his peers were able to build on their experience by presenting their findings at a national conference in Washington, D.C. According to Dr. Restini, MSUCOM students are cycled into the community outreach program and trained by MSU faculty and experts from the National Institute on Drug Abuse (NIDA).
“And when they are prepared to talk to high school students, we have rehearsal, so they are all on the same page,” Dr. Restini said. “They are using the same terminology, the same approach, the same dynamics to make it consistent in a way that we can collect data to measure the impact of our actions towards substance use prevention among teens. Our protocols guarantee that we don't have biases because of lack of personal training.”
Passionate leadership
Dr. Restini is also the founder and director of the Foundry for Innovative Research and Education (FIRE) Program, another initiative that bridges community service with medical education and research. Thanks to more than five community partnerships, osteopathic medical students and D.O. trainees collaborate with public schools, senior centers and MSU faculty from multiple disciplines.
FIRE allows medical students to serve while they learn by transforming real-world experiences into meaningful research. More than 20 student-led research projects are currently underway, allowing MSUCOM students to collect data on issues, such as health literacy and social determinants of health.
“Dr. Restini has worked so hard for this,” Garg said. “Her passion is so strong. She constantly finds opportunities for us to present our research and to do different things with the research. She is the backbone of this community outreach program, and it wouldn’t have been possible without her.”
A doctor living a dream by giving back
Now 30, in addition to SUP, Dr. Naddaff has also made presentations to Dakota High School’s medical careers program, which introduces students to career opportunities in health care. He plans to keep participating in community outreach programs when he completes his goal of becoming a family primary care physician, attending to the needs of an underserved community.
“I’d love to continue the cycle of helping other people reach their dreams. It’s not about trying to persuade, or force or scold people,” Dr. Naddaff said of substance use education and prevention. “It’s really just to provide information – to get people to think about the consequences. Even if it means having just one person using those resources, that’s a job well done.
“I’m just so grateful and thankful to be a doctor,” he added. “It’s the equivalent of winning the lottery. I just somehow got that winning ticket. I’m truly living a dream every day.”
by Lynn Waldsmith