Stitching a solution to the addiction epidemic: A longitudinal addiction curricular thread across four years of medical training

Content Analysis for a Statewide Substance Use Disorder and Pain Management Curriculum for Health Professional Students (ALAHOPE)

OBJECTIVES

Alabama's health professions schools have many common goals when it comes to educating their students about substance use disorder (SUD) and pain, but a statewide consistent SUD and pain management curriculum does not exist in Alabama. The ALAbama Health professionals' Opioid and Pain management Education (ALAHOPE) project set out to create an interprofessional curriculum around SUD and pain management that all Alabama health professions schools can use to promote consistent evidence-based teaching and a patient-centered approach around these two topics. An adapted form of the Kern model of curriculum development was used to guide the project. The first dimension of this model is problem identification, which requires identifying the desired future state. One of many assessments performed to identify the desired future state was an analysis of six external curricula. The purpose of this assessment was to critically document and analyze existing SUD and pain management curricula to inform the ALAHOPE curriculum content.

METHODS

The learning objectives and detailed content topics of each curriculum were documented and categorized into content topics. These broad topics were used as one piece of a cross-thematic analysis of several future state assessments that led to the development of broad curriculum goals for the ALAHOPE curriculum project.

RESULTS

Common trends found in the analyzed curricula included learning objectives not being all-inclusive or not matching the actual curricula content, combining SUD and pain management content, and including the risks of treating pain with controlled substances in content solely created for pain management.

CONCLUSIONS

These results can be used to help inform other SUD and pain management educational content.

Preparing for the future of medical education: A case series of traditional and virtual clinical rotations in addiction medicine spanning the COVID pandemic

Background: Substance use accounts for more than 400,000 deaths annually in the United States and overdose rates surged during the COVID pandemic. While the pandemic created increased pressure for better prepared providers, it simultaneously placed restrictions on medical training programs. The purpose of this educational case series is to assess the feasibility of a virtual addiction medicine training program and conduct a qualitative evaluation of medical student attitudes toward caring for people with substance use disorders, both before and after their addiction medicine training experience. Methods: We conducted a qualitative analysis related to course content focused on strengths and limitations of in-person and virtual training modalities. Individual quotes were evaluated and content themes were developed after a thorough review of all codes and detailed examination of interviewee quotes. Results: The primary themes that emerged were (1) Addiction medicine content is important to improve care of patients with substance disorders and is not fully addressed in undergraduate medical education (2) In-person and virtual training contain unique strengths and weaknesses and (3) Students perceived that both experiences provided positive and needed training in addiction medicine that shifted perspective and enhanced confidence to practice. Conclusions: Remote training via virtual lectures and patient visits may enhance training opportunities for students with limited exposure to addiction medicine patients and faculty with addiction medicine expertise. There is a need to further refine virtual care for patients with SUDs and virtual training to meet the needs of patients and learners across the country.

Substance Use Disorders and COVID-19: Multi-Faceted Problems Which Require Multi-Pronged Solutions

COVID-19 shocked health and economic systems leaving millions of people without employment and safety nets. The pandemic disproportionately affects people with substance use disorders (SUDs) due to the collision between SUDs and COVID-19. Comorbidities and risk environments for SUDs are likely risk factors for COVID-19. The pandemic, in turn, diminishes resources that people with SUD need for their recovery and well-being. This article presents an interdisciplinary and international perspective on how COVID-19 and the related systemic shock impact on individuals with SUDs directly and indirectly. We highlight a need to understand SUDs as biopsychosocial disorders and use evidence-based policies to destigmatize SUDs. We recommend a suite of multi-sectorial actions and strategies to strengthen, modernize and complement addiction care systems which will become resilient and responsive to future systemic shocks similar to the COVID-19 pandemic.