Addiction Training Research Articles

Professional Development Needs in a Predominantly Rural State

<p>Mental health professionals working in rural states experience significant challenges in supporting the mental health needs of their community members. Thus, it is imperative for the professional organizations that serve these practitioners to understand their professional development needs. Members of professional organizations seek to ensure a competent and healthy workforce. In the present study, the researchers focused on identifying the training needs, interests, and preferences of mental health professionals, including professional counselors, marriage and family therapists, and social workers in Wyoming. A statewide needs assessment completed by 258 participants indicated a strong need for ethics, trauma, and addictions training using accessible formats, including online webinars and annual conferences.</p>

Pain and Addiction: The Distribution of Supply and Demand During the Opioid Epidemic.

A considerable portion of the opioid epidemic has been driven by physician-prescribed opioids for pain management. Thus, policies to address the epidemic must consider not only the resources available to manage addiction but those to manage acute and chronic pain as well. For the period 2017 to 2019, the authors sought to describe the distribution, by state, of indicators of the supply of resources to address pain and addiction (graduate medical education subspecialty training in pain and addiction, number of board-certified pain and addiction specialists, number of opioid treatment centers), as well as indicators of the demands for those services (opioid prescriptions, opioid overdose deaths), to identify states that seem to suffer from a mismatch between supply and demand. It was also sought to examine the relationships between these treatment resources and indicators of the magnitude of the opioid epidemic, through an exploratory correlational analysis. The resulting model may inform public policy by suggesting areas in need of greater graduate medical education training and more pain and addiction specialists and by suggesting hypotheses about the impact of these specialists on outcome that are worthy of further study.

Demonstrating the Efficacy of Incorporating Peers Into Addiction Training for Internal Medicine Residents.

Objective: Although internists frequently care for patients with substance use disorders (SUDs), they do not receive training that is adequate for the task. The resultant deficiencies in care are compounded by widespread stigma toward SUDs that exists within medicine. However, research demonstrates that sharing personal perspectives and experiences of living with an SUD generate empathy and change attitudes toward this disorder. The objective of this study was to improve internal medicine residents' attitudes with an educational seminar that incorporates perspectives from patients with SUDs and their families.Methods: The study was conducted with internal medicine residents at Weill Cornell Medical College from February 2019 to August 2019. The study used a cross-sectional, longitudinal survey design. Attitudes were measured using a validated Medical Condition Regard Scale (MCRS).Results: A total of 31 internal medicine residents participated. Results showed significant increases in MCRS scores, both from pre- to post-seminar and 6 months after the seminar. For alcohol use disorder, mean (SD) MCRS score increased from 3.80 (SD = 0.69) to 4.60 (SD = 0.87) to 5.00 (SD = 0.68) (P < .001). For opioid use disorder, mean MCRS score increased from 3.30 (SD = 0.92) to 4.36 (SD = 0.99) to 4.62 (SD = 0.70) (P < .001).Conclusion: The study demonstrates that long-term attitudes toward patients with SUDs may be modified through training that integrates peer-based perspectives.

Program development and implementation outcomes of a statewide addiction consultation service: Maryland Addiction Consultation Service (MACS)

Background: As the opioid epidemic continues, there is a mounting sense of urgency to improve access to high-quality early identification and treatment services. However, the need is outpacing capacity in many states and effective solutions to support primary care and specialty prescribers to identify and treat more patients with opioid use disorders are still emerging. This paper describes one state’s approach to increase access to medication for opioid use disorders (MOUD) through development and implementation of a statewide addiction consultation service: Maryland Addiction Consultation Service (MACS). Methods: Program components include a warmline, outreach and training, and resource and referral linkages for prescribers based on related consultation service models and documented barriers to prescribing MOUDs. Results: Initial implementation outcomes indicate service components are being adopted as intended and by the target audience; many prescribers who engaged with the service have their buprenorphine waiver (44%) but do not have any additional formal addiction training (57%). Also, statewide penetration is promising with prescriber engagement in 100% of counites, however only 33% of counties in engaged in all four types of MACS services. Most calls (61%) originated from urban counties. Conclusions: The MACS program increases access to specialty addiction medicine consultation and training through use of technology. MACS can serve as a model for other states looking to bridge the gap in access to addiction treatment.

Structured online training for university students to deliver peer-led addiction counselling for young drug abusers in China: Effect on improving knowledge, attitude, confidence, and skills

ObjectivesTo measure the effect of a structured online training programme on improving the knowledge, attitude, confidence, and skills of university students to deliver peer-led addiction counselling to young drug abusers. MethodsA structured training programme was designed for university students with a background in health-related disciplines. Pre- and post-training evaluations were conducted for 245 university students with health-related backgrounds who completed the training programme. The participants’ knowledge of and attitudes towards drug abuse and their confidence in delivering addiction counselling were evaluated and compared before and after the training. Counselling skills were assessed using a simulated standardised case. ResultsA paired test indicated that after attending the training programme, the participants’ knowledge of and attitudes towards drug abuse and their confidence in delivering addiction counselling were significantly improved. Most of the trained participants demonstrated satisfactory counselling skills. ConclusionParticipation in a one-day structured addiction training programme significantly improved students’ knowledge of and attitudes towards drug abuse and their confidence and skills to deliver addiction counselling. Practice implicationFuture research should elucidate the implementation of the counselling skills in terms of the counselling outcomes and successful referral. The clients’ health outcomes should be assessed to reflect the peer counsellors’ skills.

Interprofessional Chronic Pain and Addiction Training on an Emergency Department Observation Unit.

Interprofessional Chronic Pain and Addiction Training on an Emergency Department Observation Unit.

The role of social work and peer support workers in addressing the opioid crisis

ABSTRACT Peer-led interventions to address the opioid crisis are on the rise. This brief report discusses the historical and contemporary social work role and Peer Support Workers (PSWs) by exploring the literature. The authors illuminate the lack of social work addiction training within higher education, highlighting practical strategies that social workers can use as interventions. Moreover, the work explores social work’s role in maximizing the PSW workforce to address Hispanic and Black communities most impacted by opioid overdoses. Combining PSWs with clinical social worker’s roles will enhance recovery while addressing vital psychosocial issues.

The Development and Implementation of a Hospitalist-Directed Addiction Medicine Consultation Service to Address a Treatment Gap.

Hospitalizations related to the consequences of substance use are rising yet most hospitalized patients with substance use disorder do not receive evidence-based addiction treatment. Opportunities to leverage the hospitalist workforce could close this treatment gap. To describe the development, implementation, and evaluation of a hospitalist-directed addiction consultation service (ACS) to provide in-hospital addiction treatment. Six hundred fifty-bed university hospital in Aurora, Colorado. Hospitalists completed buprenorphine waiver training, participated in a 13-part addiction lecture series, and completed a minimum of 40hours of online addiction training. Hospitalists participated in shadow shifts with an addiction-trained physician. Dedicated addiction social workers developed relationships with local addiction treatment services. Physician-related metrics included education, training, and clinical time spent in addiction practice. Patient and encounter-related metrics included a description of ACS care provision. Eleven hospitalists completed an average of 95hours of addiction-related didactics. Once addiction training was complete, hospitalists spent an average of 30days over 12months staffing a weekday ACS. Between October 2019 and November 2020, the ACS completed 1620 consultations on 1350 unique patients. Alcohol was the most common substance (n = 1279; 79%), followed by tobacco (979; 60.4%), methamphetamines/amphetamines (n = 494; 30.5%), and opioids (n = 400; 24.7%). Naltrexone was the most frequently prescribed medication (n = 350; 21.6%), followed by acamprosate (n = 93; 5.7%), and buprenorphine (n = 77, 4.8%). Trauma was a frequent discharge diagnoses (n = 1564; 96.5%). Leaving prior to treatment completion was commonly noted (n = 120, 7.4%). The ACS completed 47 in-hospital methadone enrollments. The hospitalist-directed ACS is a promising clinical initiative that could be implemented to expand hospital-based addiction treatment. Future research is needed to understand challenges to disseminating this model into other hospital settings, and to evaluate intended and unintended effects of broad implementation.

Towards competency-based medical education in addictions psychiatry: a systematic review.

BackgroundCurrent curriculum guidelines for addiction training in psychiatry need to be adapted to the competency by design framework to integrate clinical skills in addiction.ObjectiveWe conducted a systematic review to identify curricular and educational interventions to build competency among psychiatry residents and fellows in addiction psychiatry.MethodsWe followed the PRISMA guidelines, searching five databases from inception to August 2020 for relevant evaluation-type studies exploring addiction psychiatry competency among psychiatry residents and fellows. We appraised study quality using the Joanna Briggs Institute's risk of bias tool for observational designs.ResultsFrom 1600 records, 17 studies met inclusion criteria. Addiction psychiatry competencies spanned themes involving core knowledge development; attitudinal, communication and leadership skills; screening, assessment, diagnosis; management; and special populations. Examples of effective educational interventions to enhance addiction competency include specific modules for substance use disorders and integrated clinical rotations that simultaneously combine multiple types of skills. Lived experience improved trainee attitudes towards addiction psychiatry.ConclusionsWhile there is current evidence supporting strategies for developing competency in addiction psychiatry, the lack of studies measuring sustained competence over a longer-term follow-up period and the absence of randomized controlled trials limit the overall strength of evidence in this review. Current psychiatry entrustable professional activities (EPAs) involving addiction only partly overlap with curriculum training guidelines and studies identified in this review. These EPAs need to be better identified for training programs, competence in those EPAs better delineated for residents and preceptors, and evaluations should be done to ensure that adequate competence in addictions is attained and sustained.

Resource Document Calls for Improved Residency Training on SUDs

Resource Document Calls for Improved Residency Training on SUDs

Addiction Medicine After COVID-19: The Imperative of a Trained Workforce

Addiction Medicine After COVID-19: The Imperative of a Trained Workforce

Psychiatry Trainees' Attitudes, Knowledge, and Training in Addiction Psychiatry-A European Survey.

Background: Although psychoactive substance use disorders (PSUDs) are a domain of mental health, addiction psychiatry is only formally recognized as a subspecialty in a few European countries, and there is no standardized training curriculum.Methods: A 76-item questionnaire was developed and disseminated through an online anonymous data-collecting system and hand-to-hand amongst psychiatric trainees from the 47 European countries of the Council of Europe plus Israel and Belarus.Results: 1,049/1,118 psychiatric trainees from 30 European countries completed the questionnaire. Fifty-nine-point nine percent of trainees stated to have training in addictions. Amongst the trainees who described having training in addictions, 43% documented a not well-structured training and 37% an unsatisfactory training, mainly due to poor acquired knowledge. Overall, 97% of trainees stated that addiction represents a core curriculum for their training. Overall, general adult psychiatric trainees reported a better knowledge in addictions, compared to trainees in child and adolescent psychiatry.Conclusion: Despite a growing spread of PSUDs in European countries, addiction psychiatry is a relatively poorly trained field within psychiatry training programs. Further research should investigate reasons for poor training and timings of the educational activities to optimize experiential education training in addiction psychiatry.

Social Work Education and Training in Mental Health, Addictions, and Suicide: A Scoping Review

ABSTRACT Social workers have an important role in the field of mental health, and social work programs have a responsibility to prepare students for practice in the field. This scoping review mapped and synthesized the literature on mental health, addictions, and suicide in social work education and training. We found 51 articles that examined social work education in addictions (n=23), suicide (n=17), and mental health (n=7), and some articles (n=4) focused on more than one area. Most articles were empirical studies that used quantitative methods, and only one article did not examine social work education in the United States. The studies showed variability in teaching methods, format of training programs, extent to which theory and practice were linked, and the integration of culture and diversity in the programs. The articles contained recommendations to increase teaching students about mental health, addictions, and suicide in all social work programs. Studies also recommended training for faculty and field instructors, using simulation-based learning methods, including competencies in training programs that target knowledge, skills, values, and beliefs; identifying a theoretical framework; integrating culture and diversity; and evaluating training programs. The article discusses implications for best practices in social work education in mental health, addictions, and suicide.

Simulation Methods as a Tool to Enhance Medical Student Education and Combat Stigma in Addictions

Individuals with substance use disorders are besieged by stigma, within their community and also the broader social context. This stigma may also pervade interactions with health care professionals, preventing individuals with SUD from seeking treatment for medical and/or psychiatric conditions. Given the current opioid crisis, providers must be equipped with the skills to diagnose and treat individuals with SUD, as well as the ability to communicate in an empathic, nonjudgmental manner. While training in addictions has often been absent from medical school curriculum, increasing numbers of programs are incorporating such training. Simulation methods have been underutilized in mental health and addiction training. The present study sought to examine learner knowledge, perceptions, and confidence in treating patients with SUD and build upon existing findings regarding the utility of simulations in addictions. Although research in this area is scant, the existing evidence supports the value of simulations to enhance clinical skills, learner confidence, and perceptions of individuals with SUD. Results of the present pilot study appear to support previous findings. Simulation training methods appear to be a viable option to train providers to identify and treat individuals with SUD, while potentially combating stigma and increasing provider confidence and empathy.

Training Health Services Psychologists for Research Careers in Addiction Science.

Addiction is a growing public health crisis, yet comparatively very few health services psychology programs include formal training in addiction science (Dimoff, Sayette, Norcross, 2017). Health services psychologists (i.e., psychologists who integrate psychological science and practice to understand development and functioning; APA, 2015) are well-suited to study and treat addiction, and doctoral level training is an ideal time to prepare future health services psychologists to do so. One possible barrier to incorporating addiction science training is the necessity of a multidisciplinary approach to study and treat addiction and related health behaviors. We focus primarily on clinical science training and argue for a multi-faceted approach to doctoral training in addiction science that would prepare trainees for research careers. The proposed training model emphasizes the importance of mentorship, coursework, grant preparation, responsible conduct of research, prevention, intervention, and treatment, and invited speakers and conference attendance. Each of these components is discussed with an emphasis on addiction science. We offer suggestions for incorporating portions of this training model for programs with few addiction science related resources. We also discuss the importance of enhancing diversity and inclusion in addiction training and offer brief recommendations on this topic.

Moving the needle to promote education and training in substance use disorders and addictions: Special issue introduction.

Moving the needle to promote education and training in substance use disorders and addictions: Special issue introduction.

Education and Training in Substance Use Disorders and Addictions: The University of New Mexico Integrated Training Model.

This paper describes SUD/addictions training at the University of New Mexico. Coordinated and integrated academic, research, and clinical training resources are described, with an emphasis on the integration of resources across multiple training domains. Academic training resources in the Psychology Department include core clinical courses, basic science courses, and opportunities for students to develop expertise in health or quantitative psychology. Other academic resources come from affiliated departments and colleges such as Sociology, the College of Population Health, the College of Education, and Health Sciences. Research training resources are available within the Psychology Department, affiliated Departments and Colleges, and specialized research centers including the Center on Alcoholism, Substance Abuse, and Addictions, and the Mind Research Network. A network of community partners provides additional research sites. Clinical training resources are provided through a specialized alcohol treatment clinic and a diversity clinic within the Department, opportunities for students to serve as research clinicians, and community practicum sites supervised by on-site doctoral level psychologists or Departmental faculty. The UNM training program provides one model for graduate training in SUD/addictions. Keys to the program are the presence of multiple SUD/addictions clinical faculty member with active research programs, willingness to mentor students in research and clinical work, and basic science faculty whose research is relevant to addictive behaviors. Other critical elements include systematic development of clinical training opportunities, effective collaborations with community agencies for research and clinical training, meaningful research partnerships with other academic departments and specialized research centers, and external funding for training activities.

Supporting the Use of Medications for Addiction Treatment in US Drug Courts: Opportunities for Health Professionals.

: Drug courts are specialty courts that offer treatment services as alternatives to incarceration for defendants struggling with problems related to substance use. These courts have become major access points in the United States for the treatment of substance use disorders, but drug court participants often have limited access to medications for addiction treatment (MAT). A growing chorus of advocates and organizations have called for expanding access to MAT in drug courts, and health professionals may wonder how to join in these efforts. This article reviews practical ways in which individual health professionals might support access to MAT in drug courts, including working with drug courts, fighting public stigma against MAT, contributing to research on MAT in drug courts, and expanding addiction training among clinicians.

Addiction Training of Child Welfare Professionals in Ontario: Key Informant Perceptions

Substance use and addiction constitute a prominent factor contributing to families becoming engaged in the child welfare system. Nine key informants, four supervisors and five front line staff, from five different child welfare organizations across Ontario, Canada provided insights into the training they have received during their careers and what additional training they would value to enhance their ability to deal with this issue. The importance of this was highlighted as the majority of service users on participants’ caseloads were reported to have addiction issues. Study participants also reported that the training they had received from their organizations did not fully prepare them to work with this issue that was so prominent in their clients’ lives. All nine key informants indicated that they required additional training and education to better meet the primary mandate of child welfare: to keep children safe.

Social work education and training in mental health, addictions and suicide: a scoping review protocol

IntroductionSocial workers are among the largest group of professionals in the mental health workforce and play a key role in the assessment of mental health, addictions and suicide. Most social...