Addiction Education Research Articles

Evaluation of an Experiential Curriculum for Addiction Education Among Medical Students

Undergraduate medical education about addictive disease can take many forms, but it is unclear which educational methods are most effective at shaping medical students into physicians who are interested in and competent at addressing addiction. The purpose of this study was to evaluate the efficacy of the Betty Ford Institute's Summer Institute for Medical Students (SIMS), a week-long program aimed at educating medical students about addiction through a combination of traditional didactic and novel experiential sessions. A written survey assessing beliefs, attitudes, and practices related to addictive disease was administered to physicians who previously participated in SIMS (n = 140) and to physicians matched for year of graduation from medical school who did not participate in SIMS (n = 105). Compared with their peers, and controlling for sex, age, year of graduation from medical school, specialty, personal experience with addiction, and training in talking to patients about substance use, physicians who participated in SIMS were more likely to believe that they could help addicted patients, find working with addicted patients satisfying, be confident in knowing available resources for addicted patients, believe that addiction is a disease, and be confident in speaking to patients about substance use. Physicians who participated in SIMS were not more likely to practice addiction medicine or to view talking to patients about substance use as clinically relevant. Undergraduate medical educational interventions combining traditional and experiential programming may render participants better equipped than peers receiving only traditional education to address addiction as physicians.

Interdisciplinary Collaboration in Addiction Education

Interdisciplinary Collaboration in Addiction Education

Genetics and Genomics: Unraveling New Opportunities for Addiction Treatment and Education

Almost 15% of Americans have tried cocaine (as cited in Volkow, 2010a), about 10 million people in America have tried methamphetamines (NIDA, 2011), and marijuana use ranks the highest in America when compared to 17 other countries (as cited in Volkow, 2010b). Clearly substance abuse and addictions is an ongoing challenge in our country. New research in genomics offers key insight into understanding substance abuse disorders and the possibility of novel treatment modalities. Progress in the fi eld of genomics has come a long way since 1865 when Mendel fi rst discovered the laws of genetics. We have moved from understanding the sequence of a single strand of DNA to sequencing the entire human genome in 2003, and now international studies of genetic variations across multiple populations. With this ever growing knowledge about the human genome come limitless opportunities for utilizing this information for the treatment of addictions. In this editorial, we will give an overview of genomics, discuss the latest genomic fi ndings as they relate to addictions treatment, the role of nurse educators in incorporating genomics into course curriculum, and social and ethical challenges involved with genomic medicine and research. The human genome is estimated to contain 30,000 genes, and the functions are still unknown for over 50% of the genes that have currently been discovered. A gene is a segment of DNA containing all of the information needed to encode for a specifi c protein. The order of base pairs in a gene determines which protein it encodes for. While the process to translate genes to proteins occurs naturally in the body, sometimes mistakes can happen. Mutations in the genome can occur which can affect how the gene is expressed, by changing the corresponding protein and its function. Mutations called polymorphisms, considered to occur in at least 1% of the population, are largely responsible for determining risk for disease, and differences between how humans respond to treatment. The most common mutations are single nucleotide polymorphisms (SNPs) and copy number polymorphisms(CNVs) where

Attitudes about Addiction: A National Study of Addiction Educators

The following study, funded by the National Institute of Drug Abuse (NIDA), utilized the Addiction Belief Inventory (ABI; Luke, Ribisl, Walton, & Davidson, 2002) to examine addiction attitudes in a national sample of U.S. college/university faculty teaching addiction-specific courses (n=215). Results suggest that addiction educators view substance abuse as a coping mechanism rather than a moral failure, and are ambivalent about calling substance abuse or addiction a disease. Most do not support individual efficacy toward recovery, the ability to control use, or social use after treatment. Modifiers of addiction educator attitudes include level of college education; teaching experience; licensure/certification, and whether the educator is an addiction researcher. Study implications, limitations, and directions for future research are discussed.

Practice strategies to improve compliance and patient self-management.

Failure in treating opioid dependence is costly to the patient, the employer, managed care organizations, and the overall health care system. Opioid dependent patients tend to be less productive at work and in society and utilize a great many health care resources. Optimizing outcomes is essential. To introduce the benefit of integrated strategies and patient support in the treatment of opioid dependence. Health Analytics is currently studying the benefit of HereToHelp, a behavioral support program in which registered nurses or addiction treatment counselors with specialized training in addiction education provide information and encouragement to patients receiving pharmacologic treatment for opioid dependence. A total of 470 physicians in 41 states have been enlisted to participate in this patient support study. The study hypothesis is that patients who receive behavioral support and encouragement will be more compliant with their opioid replacement therapy, leading to better outcomes. Additional treatment strategies are also being developed to minimize the risk of abuse and diversion. Prodrugs and vaccines are also being investigated. A coordinated team approach is essential in treating pain patients and opioid-dependent patients. Offering behavior modification in addition to pharmacotherapy and utilizing strategies such as prescription monitoring programs, pain contracts, and screening are all vital components necessary for positive outcomes.

An Examination of Canadian Social Work Program Curriculum and The Addiction Core Competencies

The Canadian Centre on Substance Abuse, in conjunction with key Canadian stakeholders, has developed a guideline outlining 18 core competencies for those working with clients with addiction issues. The curriculum of Canada's 35 faculties and schools of social work were examined using the core competencies to determine the extent of addiction education received by undergraduate and graduate social work students. All social work addiction courses were elective offerings, although faculty teaching in this area did express a desire to shift the focus of addiction studies away from elective to core course offerings. The majority of competency-based education at the faculties and schools of social work is taught at a generalist level, and graduate schools of social work teach fewer core addiction competencies than undergraduate. Although competency-based education is generally viewed positively and adopted at faculties and schools of social work, only one third of addiction courses matched with the 18 core competencies developed through the auspices of the Canadian Centre on Substance Abuse.

Teaching thoughtful practice: Narrative pedagogy in addictions education

Preparing practitioners for this rapidly changing and demanding health care environment is challenging. A surge in knowledge development and scientific advancement has placed a priority on technical skill and a focus on content driven educational processes that prepare students for evidence-based practice. However, the most difficult health care scenarios require thinking-in-action and thoughtfulness as well as didactic knowledge. It is our contention that interpretive educational methods, like narrative pedagogy, will promote judgment-based practice that includes use of evidence and delivery of thoughtful care. In this article, we describe and interpret a narrative approach to addictions content and teaching thoughtful practice. We present our pedagogical process, including observations and field notes, to show how interpretive pedagogies can be introduced into nursing curricula. By presenting this process, the reader is invited to consider interpretive methods as a way to inspire and habituate thoughtful practice and judgment-based care.

Meet the President

The new President of American Association of Col-leges of Pharmacy (AACP) is Jeffrey (Jeff) N. Baldwin,PharmD, Vice Chair and Professor of Pharmacy Practiceat the College of Pharmacy, The University of NebraskaMedicalCenter.Hereceivedabachelorofscience(BS)inpharmacyfromtheStateUniversityofNewYorkatBuf-faloSchoolofPharmacy,andthencompleteda doctorofpharmacy (PharmD) at the University of Kentucky Col-legeofPharmacyandaconcurrenthospitalpharmacyres-idencyatAlbertB.ChandlerMedicalCenterinLexington.Jeff has served as a faculty member at The University ofNebraska Medical Center College of Pharmacy sincereceipt of his PharmD and completion of his residency.He participated in the development of the Nebraskaentry-level PharmD program that was initiated in 1976and serves on the college’s curriculum committee.During his career, Jeff has been a leader in the de-velopment of pediatric pharmacy practice and educationandcontinuestoprovidedidacticandexperientialeduca-tion in this area. Jeff’s interest in health professional ad-diction education and recovery assistance is evidencedthroughmorethan20yearsofinvolvementintheUniver-sity of Utah School on Alcoholism and Other Drug De-pendencies and 10 years of service to AACP as chair ofthe special interest group (SIG) on Substance Abuse Ed-ucation and Assistance. He teaches a didactic substanceabuse course and a quasi-experiential addiction recoverycourse as part of his college’s elective curriculum.Jeff has served the profession for many years withactive participation in AACP, the Nebraska PharmacistsAssociation, where he served as President, the AmericanPharmacists Association, the American Society ofHealth-Systems Pharmacists, and other organizations.Heco-chairstheNebraskaPharmacistRecoveryNetworkand is co-founder of the Heartland Pharmacist RecoveryNetwork. Jeff has been active in AACP throughout hiscareer, serving as chair of the Pharmacy Practice sectionand on a number of AACP committees. He has receivedmany awards and recognitions for his accomplishmentsincluding the Teacher of the Year award; recognition asa Fellow by the American Pharmacists Association andtheAmericanSocietyofHealth-SystemsPharmacists;theBowlofHygeia,aUniversityofNebraskaMedicalCentercampus award for community service; and other recog-nitions for service to the profession.Colleagues describe Jeff as a role-model clinician,a natural and engaging classroom teacher, and a recog-nized leader in the community. He is particularly dedi-cated to nurturing young people and guiding them on theroad to healthy, wholesome, others-centered lives.Jeff has been a Boy Scout leader for more than 25years. He was in charge on June 11, 2008, when a violenttornadotorethroughtheLittleSiouxScoutRanchinnorth-westernIowa,levelingbuildingsandcausingthedeathof4scouts.Whilepersonallydevastated,hiscalmandpurpose-fulactions,alongwiththeguidanceofotherscoutleaders,ensured the safety of the remaining scouts in the storm’saftermath and helped them put their learned skills intoactiontoassisttheinjuredandconductanorganizedevac-uation of the battered camp. The pride Jeff takes inthe maturity and leadership exhibited by these youngmen...traits they had mastered by watching and learningfrom him...has helped him move forward in the monthsafter the unspeakable tragedy. For his sustained and sig-nificant contributions to the Boy Scouts of America, Jeffwas recognized with the Silver Beaver Award, one ofthehighesthonorstheorganizationbestowsonavolunteer.Jeff is blessed with his very supportive wife of39 years, Sue, and credits much of his success to her.He has 2 children, Paul and Greg, and 4 grandchildren,Elizabeth, Patrick, Shannon, and Sean.

Survey on Addictions: Toward Curricular Change for Family Nurse Practitioners

The purpose of this paper is to describe the results of a survey of advanced practice nurses (APNs) to determine the activities they perform related to caring for patients with addictions and or co-occurring mental health disorders, the amount of addictions education in their graduate programs, and their perceptions of the value of addictions education for their role. Data were obtained from 233 APNs in New York State using a tool adapted from a previous job analysis survey. APNs reported the greatest amount of experience in history taking for various types of addictions and co-occurring mental health disorders and least amount of experience in performing objective exams, using standardized screening tools, ordering related diagnostic tests, prescribing pharmacological treatments, and making referrals for addiction treatment. Respondents reported a mean of less than three hours addictions education in their graduate programs in contrast to their high perceived importance of this clinical area.

Training Programs: A Methodological Note

On a daily basis, professionals working in areas such as mental health, social deviance, addiction, and special education face complicated and stressful situations. The purpose of the present article is to elucidate further the notion of situational factors as a central axis in the training of these professionals and to propose a methodological manner for selecting situations relevant to their future tasks. The training program developer has to consider what is appropriate in light of the kinds of situations workers will have to cope with and then decide what skills and knowledge need to be acquired. The training program should revolve around the role the professional is expected to fulfill at a given agency or organization in specific situations. A description of the process of selecting the appropriate situations is presented.

Education Resources Needed to Support the Teaching of Evidence-Based Practices

ABSTRACT The Northwest Frontier Addiction Technology Transfer Center surveyed addiction educators, providers and policy makers in Northwest states and Hawaii to define teaching resources and barriers in the teaching of evidence-based practices for the preparation of addiction professionals. The top three teaching resource needs were example student learning activities that support building competencies, science to service trends, and teaching tools that support class and field learning. Educators face three main challenges in teaching evidence-based practices: keeping current with emerging evidence-based practices, defining effective ways to teach these practices, and keeping current with the changes that emerging practices have on credentialing requirements and counselor scope of practice. Providers, educators and policy makers believed they could expand their collaboration to enhance student-learning experiences in addiction education programs. The article discusses concerns and solutions that impact the preparation of addiction professionals in a rapidly changing field.

Teaching Addiction Counseling: A Comparison of Social Interdependence Methods and Traditional Lecture-Based Instruction

ABSTRACT As more diverse students enter the field of addiction counseling, educators and researchers are challenged to explore more inclusive teaching methods for better academic outcomes. In this study, outcomes from an experimental group using cooperative learning methods for a course in addiction counseling were compared to outcomes from the same course taught with traditional lecture. Measures of learning perception, cooperation, and factual learning did not reveal significant differences. While cooperative learning presents an opportunity for innovation, teacher skill and acumen may weigh more heavily as predictors of effective learning outcomes.

CE FEATURE: Auricular Transcutaneous Electrical Neuro-Stimulation, Addiction Education, Behavioral Training, Coaching Support and the Nicotine Addiction Treatment Process

This qualitative, retrospective instrumental case study explored the effects of auricular transcutaneous electrical neuro-stimulation (ATENS) [auriculotherapy] in combination with addiction education, behavioral training and coaching support to gain greater understanding of this intervention with six motivated smokers in the addiction treatment process. Purposeful sampling was used in case selection. In-depth interviews were conducted to collect the data. Each of the participants had used auriculotherapy to become smoke free and had remained smoke free for at least a year at the time of the interviews. Two theoretical models of addiction are discussed to explain addiction etiology and susceptibility. Although the study was conducted with a small group and the findings are limited to this sample, they are consistent with other studies found in the literature.The findings suggest that current interventions advocated for nicotine addicted smokers may not be sufficient to support smoker's long term efforts. A...

Medical Students' Experiences with Addicted Patients

ABSTRACT Project CREATE was an initiative to strengthen undergraduate medical education in addictions. As part of a needs assessment, forty-six medical students at Ontario's five medical schools completed a bi-weekly, interactive web-based survey about addiction-related learning events. In all, 704 unique events were recorded, for an average of 16.7 entries per student. The most commonly discussed topic was alcohol withdrawal and the complications of alcohol use. The most common learning venues were lectures and clinical encounters in the emergency department or hospital. The proportion of advice-related topics (e.g., advice to drinkers and smokers) to advice plus non-advice related topics (e.g., medical complications) was greater for outpatient and community settings than for acute care and didactic settings (ratio 1.29, chi sq 15.85, p < 0.01). Students reacted strongly to the psychosocial impact of addictions on patients, yet they viewed addiction as a personal choice, not an illness. Conclusion: Medical students are not being trained to diagnose addiction or provide advice and counseling. Medical schools need to provide students with positive clinical experiences supervised by physicians experienced in addictions.

Substance Abuse Counselor Certification in California: How is Nicotine Addiction Addressed?

Persons entering substance abuse treatment smoke at rates three to four times that of the general population, but programs providing substance abuse treatment rarely address comorbid nicotine addiction. With California's recent adoption of a regulation requiring alcohol and other drug (AOD) counselors to be certified, this study explored the degree to which nicotine addiction education was required or recommended to obtain certification by examining pertinent documentation and Web sites. Findings reveal two main points. First, the text of the California AOD Counselor Certification regulation and supporting documents make no mention of cigarettes, nicotine, smoking, or tobacco, and thus do not mandate or recommend they be addressed in the counselor certification process. Second, although nicotine or tobacco were not mentioned in regulatory or supporting documents, four of the 10 certifying organizations mentioned nicotine at least once in handbooks, program books, continuing education topics, or other materials available online. One certifying organization offered specialization in smoking and nicotine addiction as separate tracks within its certification training program. While systematic inclusion of smoking and nicotine addiction in counselor training offers one strategy to address smoking in substance abuse treatment settings, these topics are not addressed in regulations or supporting documents governing the certification of California AOD counselors.

Knowledge, Attitudes and Practices of Pharmacists Concerning Prescription Drug Abuse

This study assessed the knowledge, attitudes, and professional practices of pharmacists regarding addiction and patient use of controlled medications. This research project explored the relationship between pharmacy education, perceived and actual knowledge, and professional interactions as it pertains to problems surrounding dependency and addiction. A questionnaire of 25 items was administered at three separate continuing education programs in Florida in 2005. A total of 484 surveys were completed. Pharmacists (67.5%) reported participating in two hours or less of addiction/substance abuse education in pharmacy school. Of particular concern was that 29.2% reported having received no addiction education. Pharmacists who had greater amounts of addictionspecific education had a higher likelihood of correctly answering questions relating to the science of addiction and substance abuse counseling. In addition, pharmacists who reported more education counseled patients more frequently and felt more confident about counseling. A majority of respondents (53.7%) reported that they had never referred a patient to drug treatment in their career. These findings suggest that the neurobiological basis for addictive diseases, standards of care, and pain management guidelines were not widely understood by the sample. More research should be undertaken to determine the educational needs of practicing pharmacists to enable them to assume a leadership role in detecting, preventing, and treating prescription drug abuse.

Implementing Motivational Interviewing

Abstract Addiction treatment agencies face challenges in adopting and sustaining Motivational Interviewing (MI) use. Addiction Educators can assist agencies in changing practices by preparing new practitioners to have some beginning skills in adoption and sustaining strategies. Investigators assessed three types of agency training and six administrative activities to support adoption and sustaining MI. Investigators observed agency progress and recorded agency successes and challenges. Generally, education workshops alone did not result in long-term adoption and sustainability of MI. Agencies found external expert consultation, enhanced supervisor skills in coaching/mentoring MI use, case review of MI use and study groups effective in supporting MI use. The paper provides recommendations that addiction educators can integrate into their curriculum to build support for agencies in adopting and sustaining MI. The recommendations may also help agencies in their adoption of MI. Educators may find these same s...

A Million Little Lessons: The Evaluation and Use of Mass Media in Counselor Addiction Education

ABSTRACT Mental health counselors, school counselors, and rehabilitation counselors, much like other professional counselors, encounter clients whose lives are somehow affected by substance use and addictions. Although counselors regularly encounter substance-dependent clients, spouses, children, and/or employers affected by substance abuse, training in substance abuse and related issues is often not included in counselor training programs. This paper offers caution and considerations to be addressed when developing the objectives and techniques of a pedagogy that uses films, biographies, memoirs, and other forms of contemporary mass media as an adjunct in addiction training in counselor education.

Emergent Discourses in Addictions Education and Training in Southern Australia and Northern Aotearoa/New Zealand

ABSTRACTIn a global project of self-determination and cultural revitalization, indigenous peoples are demanding recognition of distinct values, traditions and experiences in the design and delivery of health and social programs. Within the addictions field in southern Australia and northern Aotearoa/New Zealand, alternative approaches to education and training initiatives, informed by and inclusive of indigenous paradigms, are emerging in response to hegemonies of power, knowledge and practice. Questioning received understandings about the etiology and resolution of addictive behaviours, emergent discourses draw attention to the roles of colonialism, neo-colonialism, and cultural oppression in addiction and recovery. Moreover, although supported by social and virtual networks, emergent discourses arc complicatcd-at times, fractured-by vigorous debate surrounding critical issues and complex identity positions. [Article copies available for a fee from The Haworth Document Delivery Service: 1-800-HAWORTH. E-mail address: <docdelivery@haworthpress.com> Website: <http://www.HaworthPress.com> © 2004 by The Haworth Press. Inc. All rights reserved.]

Disability Policy Matters in Addiction Education

While most addiction education studies programs address treatment, little attention is given to disability policy matters. This article outlines suggestions for the inclusion of such material at th...