Curricular Threading

Sponsored by the Annenberg Physician Training Program: Abstinence-Based Recovery from Addictive Disease (APTP)
All physicians and every other member of the healthcare team must work together to meet the needs of patients experiencing substance use disorders. *
Physicians need repeated exposure to high-quality content related to substance use and mental health so that they understand how significantly it affects their patients and are motivated to help them.
Physicians also experience addictions, with consequences for patients. We need to build on the Healthy Doc=Healthy Patient link, ensuring that all physicians and every member of the healthcare team achieve and maintain optimal health, so that they will take better care of their patients. **
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One-tenth of American adults suffer from substance use disorders at some point in their lives, yet only one-quarter of such people receive any form of treatment.3 Since these disorders have multiple clinical consequences, every physician should understand how substance use disorders present and how to address them in their own clinical settings. Embedding information related to substance use disorders throughout the medical curriculum helps ensure that all physicians receive appropriate training.

 

Patients with substance use disorders are often stigmatized when seeking healthcare services. Providers who are competent and confident in their understanding of substance use disorders and their treatment are more likely to provide appropriate counseling and care to patients.4 We have demonstrated that physicians and other primary care providers exposed to our substance use disorder content experience an increase in their addiction medicine treatment competence and a reduction in their stigmatizing feelings toward patients with substance use disorders.5 When physicians and their teams understand that they can effectively intervene, they are more likely to provide good care.6

 

Physicians’ personal substance use habits have been consistently shown to affect their ability to assess, prevent, treat, and refer patients with substance use disorders. Ensuring that the population of physicians is as healthy as possible, including around substance use habits, makes it more likely that patients get the help they need. Exposing students, trainees, and physicians to information related to addictive disease can reduce their personal use of these substances,7 and increase their substance-related counseling of patients, belief in the relevance of substance use counseling, and confidence in performing that counseling.8

 

Online learning related to substance use disorders and addiction medicine has been proven effective. Furthermore, medical schools and schools of public health have adopted the materials for their in-person and hybrid programs, creating an even broader reach for these materials both online and offline. 

 

The Annenberg Physician Training Program: Abstinence Based Treatment for Addictive Disease has sponsored a curricular threading initiative in health science courses so that physicians and their teams will be prepared to competently and compassionately treat patients with substance use disorders, using an integrated learning model and with a public health lens. The curricular threading components are meant to enhance knowledge, attitudes, behaviors, and skills related to the treatment of substance use disorders for all providers in training and in practice while enhancing the healthy habits of physicians and their teams helping to ensure that all physicians are ready and willing to prevent and treat addictive disease in their patient populations and in the wider community.

 

See some examples of curricular threading below:

 

Endnotes
  1. Oberg, E.B., Frank, E. (2009) Physicians’ health practices strongly influence patient health practices. Royal College of Physicians of Edinburgh. https://www.rcpe.ac.uk/journal/physicians-health-practices-strongly-influence-patient-health-practices
  2. Frank, E., Dresner, Y., Shani, M., Vinker, S. (2013) The association between physicians’ and patients’ preventive health practices. Canadian Medical Association Journal. https://www.cmaj.ca/content/cmaj/185/8/649.full.pdf
  3. 10 percent of US adults have drug use disorder at some point in their lives. (2015) US Department of Health and Human Services. https://www.nih.gov/news-events/news-releases/10-percent-us-adults-have-drug-use-disorder-some-point-their-lives
  4. Frank, E., Elon, L., Naimi, T., Brewer, R. (2008) Alcohol consumption and alcohol counselling behaviour among US medical students: cohort study. British Medical Journal. https://pubmed.ncbi.nlm.nih.gov/18996938/
  5. Clair, V., Rossa-Roccor, V., Mokaya, A.G., Mutiso, V., Musau, A., Tele, A., Ndetei, D.M., Frank, E. (2019) Peer- and Mentor-Enhanced Web-Based Training on Substance Use Disorders: A Promising Approach in Low-Resource Settings. Psychiatric Services. https://pubmed.ncbi.nlm.nih.gov/31551043/
  6. Weaver, M. et al. (1999) Role of the Primary Care Physician in Problems of Substance Abuse. JAMA Internal Medicine. https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/485027
  7. Frank, E., Elon, L., Spencer, E. (2009) Personal and clinical tobacco-related practices and attitudes of U.S. medical students. Preventive Medicine. https://www.sciencedirect.com/science/article/abs/pii/S0091743509003235?via%3Dihub
  8. Frank, E. et al. (2008) Alcohol consumption and alcohol counseling behaviors among a cohort of U.S. medical students. British Medical Journal.

 

  1. Oberg, E.B., Frank, E. (2009) Physicians’ health practices strongly influence patient health practices. Royal College of Physicians of Edinburgh. Link Here 
  2. Frank, E., Dresner, Y., Shani, M., Vinker, S. (2013) The association between physicians’ and patients’ preventive health practices. Canadian Medical Association Journal. Link Here  
  3. 10 percent of US adults have drug use disorder at some point in their lives. (2015) US Department of Health and Human Services. Link Here  
  4. Frank, E., Elon, L., Naimi, T., Brewer, R. (2008) Alcohol consumption and alcohol counselling behaviour among US medical students: cohort study. British Medical Journal. Link Here   
  5. Clair, V., Rossa-Roccor, V., Mokaya, A.G., Mutiso, V., Musau, A., Tele, A., Ndetei, D.M., Frank, E. (2019) Peer- and Mentor-Enhanced Web-Based Training on Substance Use Disorders: A Promising Approach in Low-Resource Settings. Psychiatric Services. Link Here  
  6. Weaver, M. et al. (1999) Role of the Primary Care Physician in Problems of Substance Abuse. JAMA Internal Medicine. Link Here   
  7. Frank, E., Elon, L., Spencer, E. (2009) Personal and clinical tobacco-related practices and attitudes of U.S. medical students. Preventive Medicine. Link Here  
  8. Frank, E. et al. (2008) Alcohol consumption and alcohol counseling behaviors among a cohort of U.S. medical students. British Medical Journal.