Skip to main content
SpringerLink
Log in

Training Medical Students, Residents, and Fellows in Opioid Use Disorder Treatment

  • Chapter
  • First Online:
Treating Opioid Use Disorder in General Medical Settings

Abstract

Opioid use disorder (OUD) results in substantial morbidity and mortality. Despite the existence of evidence-based treatments, individuals with OUD often lack access to trained healthcare providers. Developing an effective workforce to address the large treatment gap perpetuating opioid-related morbidity and mortality requires enhanced OUD training across the continuum of medical education. As more OUD content is being introduced in undergraduate and graduate medical education, applying a framework to guide core content, trainee assessment, and role modeling can help standardize and coordinate educational interventions across training levels. Key recommendations to integrate OUD content into existing curricula include identifying educational gaps and institutional strengths, incorporating early clinical experiences with patients receiving OUD treatment, providing specific instruction in medications for OUD as first-line treatment options, promoting interprofessionalism, applying competency-based assessments, and addressing stigma in all training materials.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 64.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. ACGME Common Program Requirement IV.C.2. 2020. Retrieved from https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRResidency2020.pdf

  2. Alford DP, Bridden C, Jackson AH, Saitz R, Amodeo M, Barnes HN, Samet JH. Promoting substance use education among generalist physicians: an evaluation of the Chief Resident Immersion Training (CRIT) program. J Gen Intern Med. 2009;24(1):40–7. https://doi.org/10.1007/s11606-008-0819-2.

    Article  PubMed  Google Scholar 

  3. Alford DP, Carney BL, Jackson AH, Brett B, Bridden C, Winter M, Samet JH. Promoting addiction medicine teaching through functional mentoring by co-training generalist chief residents with faculty mentors. Subst Abus. 2018;39(3):377–83. https://doi.org/10.1080/08897077.2018.1439799.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Antman KH, Berman HA, Flotte TR, Flier J, Dimitri DM, Bharel M. Developing core competencies for the prevention and management of prescription drug misuse: a medical education collaboration in Massachusetts. Acad Med. 2016;91(10):1348–51. https://doi.org/10.1097/acm.0000000000001347.

    Article  PubMed  Google Scholar 

  5. Ashburn MA, Levine RL. Pennsylvania state core competencies for education on opioids and addiction. Pain Med. 2017;18(10):1890–4. https://doi.org/10.1093/pm/pnw348.

    Article  PubMed  Google Scholar 

  6. Babor TF, Higgins-Biddle JC, Higgins PS, Gassman RA, Gould BE. Training medical providers to conduct alcohol screening and brief interventions. Subst Abus. 2004;25(1):17–26. https://doi.org/10.1300/J465v25n01_04.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Barron R, Frank E, Gitlow S. Evaluation of an experiential curriculum for addiction education among medical students. J Addict Med. 2012;6(2):131–6. https://doi.org/10.1097/ADM.0b013e3182548abd.

    Article  PubMed  Google Scholar 

  8. Berland N, Fox A, Tofighi B, Hanley K. Opioid overdose prevention training with naloxone, an adjunct to basic life support training for first-year medical students. Subst Abus. 2017;38(2):123–8. https://doi.org/10.1080/08897077.2016.1275925.

    Article  PubMed  Google Scholar 

  9. Boyce P, Spratt C, Davies M, McEvoy P. Using entrustable professional activities to guide curriculum development in psychiatry training. BMC Med Educ. 2011;11:96. https://doi.org/10.1186/1472-6920-11-96.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Bruneau J, Ahamad K, Goyer M, Poulin G, Selby P, Fischer B, et al. Management of opioid use disorders: a national clinical practice guideline. CMAJ. 2018;190(9):E247–e257. https://doi.org/10.1503/cmaj.170958.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Butkus R, Rapp K, Cooney TG, Engel LS. Envisioning a better U.S. health care system for all: reducing barriers to care and addressing social determinants of health. Ann Intern Med. 2020;172(2 Suppl):S50–s59. https://doi.org/10.7326/m19-2410.

    Article  PubMed  Google Scholar 

  12. Crotty K, Freedman KI, Kampman KM. Executive summary of the focused update of the ASAM national practice guideline for the treatment of opioid use disorder. J Addict Med. 2020;14(2):99–112. https://doi.org/10.1097/adm.0000000000000635.

    Article  PubMed  Google Scholar 

  13. Edens EL, Drew S, Heimer R, Jordan A, Krause R, Powell L, et al. Addiction treatment: clinical skills for healthcare providers [MOOC]. Coursera 2019

    Google Scholar 

  14. Englander H, Weimer M, Solotaroff R, Nicolaidis C, Chan B, Velez C, et al. Planning and designing the improving addiction care team (IMPACT) for hospitalized adults with substance use disorder. J Hosp Med. 2017;12(5):339–42. https://doi.org/10.12788/jhm.2736.

    Article  PubMed  Google Scholar 

  15. Feeley RJ, Moore DT, Wilkins K, Fuehrlein B. A focused addiction curriculum and its Impact on student knowledge, attitudes, and confidence in the treatment of patients with substance use. Acad Psychiatry. 2018;42(2):304–8. https://doi.org/10.1007/s40596-017-0771-8.

    Article  PubMed  Google Scholar 

  16. Gano L, Renshaw SE, Hernandez RH, Cronholm PF. Opioid overdose prevention in family medicine clerkships: a CERA study. Fam Med. 2018;50(9):698–701. https://doi.org/10.22454/FamMed.2018.757385.

    Article  PubMed  Google Scholar 

  17. Graddy R, Accurso AJ, Nandiwada DR, Shalaby M, Holt SR. Models of resident physician training in opioid use disorders. Curr Addict Rep. 2019;6:355–64. https://doi.org/10.1007/s40429-019-00271-1.

    Article  Google Scholar 

  18. Hart D, Franzen D, Beeson M, Bhat R, Kulkarni M, Thibodeau L, et al. Integration of entrustable professional activities with the milestones for emergency medicine residents. West J Emerg Med. 2019;20(1):35–42. https://doi.org/10.5811/westjem.2018.11.38912.

    Article  PubMed  Google Scholar 

  19. Howley L, Whelan A, Rasouli T. Addressing the opioid epidemic: U.S. medical school curricular approaches. AAMC Analysis in Brief, 18, 2018.

    Google Scholar 

  20. Khidir H, Weiner SG. A call for better opioid prescribing training and education. West J Emerg Med. 2016;17(6):686–9. https://doi.org/10.5811/westjem.2016.8.31204.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Kunins HV, Sohler NL, Giovanniello A, Thompson D, Cunningham CO. A buprenorphine education and training program for primary care residents: implementation and evaluation. Subst Abus. 2013;34(3):242–7. https://doi.org/10.1080/08897077.2012.752777.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Larochelle MR, Bernson D, Land T, Stopka TJ, Wang N, Xuan Z, et al. Medication for opioid use disorder after nonfatal opioid overdose and association with mortality: a cohort study. Ann Intern Med. 2018;169(3):137–45. https://doi.org/10.7326/m17-3107.

    Article  PubMed  PubMed Central  Google Scholar 

  23. McGinty EE, Stone EM, Kennedy-Hendricks A, Bachhuber MA, Barry CL. Medication for opioid use disorder: a national survey of primary care physicians. Ann Intern Med. 2020;173(2):160–2. https://doi.org/10.7326/m19-3975.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Miller NS. Florida medical schools developing common curriculum for pain and opioid Rx. Orlando Sentinel. 2017. Retrieved from https://www.orlandosentinel.com/health/os-florida-medical-schools-pain-management-group-20170907-story.html

  25. Miller NS, Sheppard LM, Colenda CC, Magen J. Why physicians are unprepared to treat patients who have alcohol- and drug-related disorders. Acad Med. 2001;76(5):410–8. https://doi.org/10.1097/00001888-200105000-00007.

    Article  CAS  PubMed  Google Scholar 

  26. Morley-Forster PK, Pergolizzi JV, Taylor R Jr, Axford-Gatley RA, Sellers EM. Mitigating the risk of opioid abuse through a balanced undergraduate pain medicine curriculum. J Pain Res. 2013;6:791–801. https://doi.org/10.2147/jpr.S47192.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Mullan F. Social mission in health professions education: beyond flexner. JAMA. 2017;318(2):122–3. https://doi.org/10.1001/jama.2017.7286.

    Article  PubMed  Google Scholar 

  28. Muvvala SB, Schwartz ML, Petrakis I, O’Connor PG, Tetrault JM. Stitching a solution to the addiction epidemic: a longitudinal addiction curricular thread across four years of medical training. Subst Abus. 2020;41(4):475–9. https://doi.org/10.1080/08897077.2019.1709606.

    Article  PubMed  Google Scholar 

  29. Nunes EV, Kunz K, Galanter M, O’Connor PG. Addiction psychiatry and addiction medicine: the evolution of addiction physician specialists. Am J Addict. 2020;29(5):390–400. https://doi.org/10.1111/ajad.13068.

    Article  PubMed  Google Scholar 

  30. Oldfield BJ, Tetrault JM, Wilkins KM, Edelman EJ, Capurso NA. Opioid overdose prevention education for medical students: adopting harm reduction into mandatory clerkship curricula. Subst Abus. 2019;41(1):29–34. https://doi.org/10.1080/08897077.2019.1621241.

    Article  PubMed  Google Scholar 

  31. PCSS. Provider Clinical Support System (PCSS).

    Google Scholar 

  32. Rasyidi E, Wilkins JN, Danovitch I. Training the next generation of providers in addiction medicine. Psychiatr Clin North Am. 2012;35(2):461–80. https://doi.org/10.1016/j.psc.2012.04.001.

    Article  PubMed  Google Scholar 

  33. SAMHSA. Key substance use and mental health indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration 2020.

    Google Scholar 

  34. Sharfstein JM, Olsen Y. Making amends for the opioid epidemic. JAMA. 2019;321(15):1446–7. https://doi.org/10.1001/jama.2019.3505.

    Article  PubMed  Google Scholar 

  35. Stein MR, Arnsten JH, Parish SJ, Kunins HV. Evaluation of a substance use disorder curriculum for internal medicine residents. Subst Abus. 2011;32(4):220–4. https://doi.org/10.1080/08897077.2011.598408.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Suhail-Sindhu S, Patel P, Sugarman J, Hansen H. Program for Residency Education, Community Engagement, and Peer Support Training (PRECEPT): connecting psychiatrists to community resources in Harlem, NYC. In: Hansen H, Metzl JM, editors. Structural competency in mental health and medicine: a case-based approach to treating the social determinants of health. Cham: Springer International Publishing; 2019. p. 137–48.

    Chapter  Google Scholar 

  37. Suzuki J, Ellison TV, Connery HS, Surber C, Renner JA. Training in buprenorphine and office-based opioid treatment: a survey of psychiatry residency training programs. Acad Psychiatry. 2016;40(3):498–502. https://doi.org/10.1007/s40596-015-0313-1.

    Article  PubMed  Google Scholar 

  38. Taylor JL, Rapoport AB, Rowley CF, Mukamal KJ, Stead W. An opioid overdose curriculum for medical residents: Impact on naloxone prescribing, knowledge, and attitudes. Subst Abus. 2018;39(3):371–6. https://doi.org/10.1080/08897077.2018.1439800.

    Article  PubMed  Google Scholar 

  39. Tesema L, Marshall J, Hathaway R, Pham C, Clarke C, Bergeron G, et al. Training in office-based opioid treatment with buprenorphine in US residency programs: a national survey of residency program directors. Subst Abus. 2018;39(4):434–40. https://doi.org/10.1080/08897077.2018.1449047.

    Article  PubMed  Google Scholar 

  40. Holt SR, Segar N, Cavallo DA, Tetrault JM. The addiction recovery clinic: a novel, primary-care-based approach to teaching addiction medicine. Acad Med. 2017;92(5):680–3. PMID: 28441678.

    Google Scholar 

  41. Tetrault JM, Petrakis IL. Partnering with psychiatry to close the education gap: an approach to the addiction epidemic. J Gen Intern Med. 2017;32(12):1387–9. https://doi.org/10.1007/s11606-017-4140-9.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Tong S, Sabo R, Aycock R, Prasad R, Etz R, Kuzel A, Krist A. Assessment of addiction medicine training in family medicine residency programs: a CERA study. Fam Med. 2017;49(7):537–43.

    PubMed  PubMed Central  Google Scholar 

  43. Wakeman SE, Larochelle MR, Ameli O, Chaisson CE, McPheeters JT, Crown WH, et al. Comparative effectiveness of different treatment pathways for opioid use disorder. JAMA Netw Open. 2020;3(2):e1920622. https://doi.org/10.1001/jamanetworkopen.2019.20622.

    Article  PubMed  Google Scholar 

  44. Wallace PM, Warrier S, Kahn MJ, Welsh C, Fischer M. Developing an opioid curriculum for medical students: a consensus report from a national symposium. Subst Abus. 2019;41(4):425–31. https://doi.org/10.1080/08897077.2019.1635971.

    Article  PubMed  Google Scholar 

  45. Weimer MB, Tetrault JM, Fiellin DA. Patients with opioid use disorder deserve trained providers. Ann Intern Med. 2019;171(12):931–2. https://doi.org/10.7326/m19-2303.

    Article  PubMed  Google Scholar 

  46. Zerbo E, Traba C, Matthew P, Chen S, Holland BK, Levounis P, et al. DATA 2000 waiver training for medical students: lessons learned from a medical school experience. Subst Abus. 2020;41(4):463–7. https://doi.org/10.1080/08897077.2019.1692323.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Program in Addiction Medicine and Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA

    Kenneth L. Morford & Jeanette M. Tetrault

  2. Department of Psychiatry, VA Connecticut Healthcare System, West Haven, CT, USA

    Caroline G. Falker

Authors
  1. Kenneth L. Morford
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Caroline G. Falker
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jeanette M. Tetrault
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jeanette M. Tetrault .

Editor information

Editors and Affiliations

  1. Department of Medicine, Massachusetts General Hospital, Charlestown, MA, USA

    Sarah E. Wakeman

  2. Brown University, The Miriam and Rhode Island Hospitals, Providence, RI, USA

    Josiah D. Rich

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Morford, K.L., Falker, C.G., Tetrault, J.M. (2021). Training Medical Students, Residents, and Fellows in Opioid Use Disorder Treatment. In: Wakeman, S.E., Rich, J.D. (eds) Treating Opioid Use Disorder in General Medical Settings. Springer, Cham. https://doi.org/10.1007/978-3-030-80818-1_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-80818-1_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-80817-4

  • Online ISBN: 978-3-030-80818-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation