Despite the critical need for addiction medicine training in family care, several challenges exist, including a Lack of faculty expertise; a lack of clinical programs focusing on the prevention and treatment of unhealthy substance use; and inadequate training in family-oriented care. This article discusses these challenges and provides suggestions for the implementation of a robust assessment of training in family care.
Using a systemic approach to substance abuse training would increase family physician’s ability to provide basic substance abuse services in primary care settings. The goal is to improve treatment outcomes for children and families. In this article, we propose a model Family Medicine residency curriculum to achieve this goal.
A comprehensive curriculum should incorporate a variety of didactic and interactive learning techniques. The curriculum would document clinical competency by direct observation and periodic reinforcement of substance abuse concepts. It would also incorporate family systems thinking.
In addition, the curriculum should be designed in web-based modules. It could be completed by residents who were unable to attend conferences. This would also enhance continuity in the curriculum.
The curriculum should also be combined with other interventions. Some of these include Cross-System Care Coordination (CSCC), a program that is designed to improve care for families with low functioning and multiple needs.
Identifying and treating the problem entails a multidisciplinary approach. This includes physician education on substance use disorders, prescription drug monitoring programs, and behavioral therapy. Increasing access to naloxone can help prevent opioid overdoses.
There is also an increase in the number of people using fentanyl, a synthetic opioid. While the opioid crisis has claimed the lives of thousands of people, it has also inspired physicians to take a more active role in managing the condition.
The American Society of Addiction Medicine (ASAM) has come up with a list of criteria for evaluating a clinical program that specializes in the prevention and treatment of unhealthy substance use in family care. The criteria, known as the ASAM gold standard, is designed to help practitioners determine the appropriate intensity of services needed for the treatment of a patient’s substance use disorder.
Despite the advances in science and research, there is still a large gap in the education of physicians regarding addiction. Although there are effective therapies for substance use disorders, physicians are often not equipped to effectively implement them. As a result, the impact of physicians and their treatment practices has diminished. This is a significant public health concern.
Fortunately, several training initiatives have emerged internationally. These initiatives are designed to provide training in various areas of addiction medicine. These training initiatives often involve the integration of evidence-based practices, which have been shown to increase the motivation of specialized treatment programs. These treatments are also associated with significant improvements in health outcomes for individuals with SUD. These treatments are often delivered in general medical settings.
Electives in addiction medicine training in family care should include training in cultural competency. This will improve residents’ understanding of cultural practices and help them to become more sensitive to patients’ cultural needs. This is particularly important for physicians, who may feel inadequately prepared to deal with addiction.
The study assessed current addiction medicine curricula in US family medicine residency programs. It also evaluated the barriers to curriculum development. The authors identified existing training guidelines from the Accreditation Council for Graduate Medical Education and the Family Medicine Residency Review Committee. They developed an eight-module curriculum based on substance abuse competencies defined by Project MAINSTREAM. A curriculum is a viable option for a typical three-year family medicine residency program.
The course was a positive experience for students and faculty. Students found it to be an educational opportunity, and they were encouraged to pursue further training. However, some students suggested that the course should be expanded. Some suggested that more guest speakers would be beneficial. Other students felt that the atmosphere was more open and encouraged discussions.
Educating residents on unhealthy substance use is not an easy task. Residency programs have developed formal curricula to help residents learn about healthy versus unhealthy substances and other related topics. However, the integration of such a curriculum into a busy residency program remains challenging.
A study published in the National Center for Health Statistics (NCHS) Data Brief reveals a correlation between addiction training and residency setting. The study found that residency programs with DEA-X licenses are more likely to provide an addiction medicine curriculum than programs that do not have such a license. However, this was not a statistically significant correlation. The second of two CERA omnibus surveys included questions about the subject.
The ACGME, the Accreditation Council for Graduate Medical Education, requires residency training programs to demonstrate that they are providing practice-based learning opportunities. It also requires training programs to demonstrate data-driven changes in curricula to improve the quality of resident physician education.