Abstract

Background: The use of both prescription and illicit opioids among adolescents and young adults (AYA) is increasing. Barriers to effective treatment of opioid use disorders among AYA range from patients leaving against medical advice to decreased knowledge and experience of providers caring for those with opioid dependence. No formal curricula for residents on AYA opioid use disorder and management have been implemented despite rapidly increasing use in this population.Objective: To develop a brief curriculum for trainees who encounter AYA that will increase knowledge and skills to treat opioid use in the AYA population. Methods: Twenty-six pediatric and family medicine interns participated in this pilot study. The multimodal curriculum included standardized patient encounters, case-based learning sessions, didactics, and high-fidelity simulations. The curriculum encompasses five individual sessions, each with a different theme: motivational interviewing, naloxone administration, opioid withdrawal medications, complex overdoses, and infectious complications of intravenous drug use. A pre-survey was administered prior to the curriculum and a post-survey was administered at the conclusion to assess its effectiveness in improving knowledge for this specific population and increasing comfort levels providing medical interventions in AYA patients with opioid use disorders.Results: Trainee comfort levels increased significantly in all four domains as measured by the average Likert scale, including interviewing AYA about opioid use (2.5 (standard deviation (SD) 1.2) to 4 (SD 0.9), p<0.0001)), prescribing medication for opioid use disorder (1.3 (SD 0.5) to 2.8 (SD 1.3), p<0.0001)), treating acute opioid overdose (1.5 (SD 0.8) to 3.7 (SD 0.9), p<0.0001)), and treating infectious complications of intravenous drug use (1.7 (SD 0.8) to 3 (SD 1.1), p <0.0001)). The Chi-square test showed similarly significant increases in comfort levels.Conclusions: Early trainees who provide care to young adults benefit from opioid education specific to this population. Participants described increased knowledge and comfort in interviewing and treating this vulnerable patient group.

Highlights

  • Use of both prescription and illicit opioids has increased among adolescents and young adults (AYA) in the past two decades [1]

  • Early trainees who provide care to young adults benefit from opioid education specific to this population

  • No formal curricula for pediatric residents on AYA opioid use disorders and management have been implemented in a residency program as noted via literature searches on PubMed and the MedEdPortal

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Summary

Introduction

Use of both prescription and illicit opioids has increased among adolescents and young adults (AYA) in the past two decades [1]. Barriers to effective treatment of opioid use disorder among AYA include higher rates of attrition from inpatient detoxification programs and decreased knowledge and experience of providers caring for those with opioid dependence [3,4]. The use of motivational interviewing has been reported to have a positive effect on adolescent substance abuse and has been established as an effective strategy for AYA, regarding both lifestyle measures and substance abuse [9-. The use of both prescription and illicit opioids among adolescents and young adults (AYA) is increasing. No formal curricula for residents on AYA opioid use disorder and management have been implemented despite rapidly increasing use in this population

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