Addiction Training for Health Care Professionals

    The following summarizes our position on addiction training for health care professionals.

    In order to effectively address our nation’s addiction crisis, addiction must be fully integrated within the mainstream health care system. To achieve this, all health professionals must be trained in the basics of addiction. Partnership to End Addiction supports efforts to increase addiction education among health care professionals, including mandated provider training.

    For over 100 years, the medical community has been effectively removed from addiction treatment. The separation of addiction care from mainstream medicine is evident in the minimal education and training that health care providers receive in relation to addiction. Medical schools and other health professional training programs barely address addiction.[1] As a result, many health care providers do not feel confident in their abilities to treat a patient with substance use disorder (SUD)[2] and tend to share many of the same stereotypes and misconceptions about such individuals as those held by the general public.[3] These biases significantly affect the type and quality of care that a patient with addiction receives.[4] The lack of medical professionals trained in addiction treatment makes it exceedingly difficult for patients and their families to find quality, effective, lifesaving care.

    To ensure that people with addiction receive the treatment they need, health care professionals must be trained to treat SUD as they do any other complex disease and should no longer be allowed to dismiss addiction care as being outside of their profession’s purview. This change will not happen overnight. Many seasoned medical professionals who have not been involved in addiction treatment will likely have entrenched views about addiction and their responsibility to treat it. The greatest shift in care will most likely occur once emerging and future health professionals receive the proper education and training to address addiction as the treatable disease that it is. As the opioid epidemic has worsened in recent years, professional health care education and training programs have begun to incorporate some addiction training into their curricula.[5] Yet, such changes have not been widely adopted, signaling the need for mandated training requirements.

    To truly transform how addiction is addressed in the United States, professional health care training programs must provide comprehensive and ongoing training about addiction prevention and treatment, just as they train health professionals to prevent and treat other complex chronic diseases that affect a significant proportion of the patient population. All medical and other health professional training programs, including residency training programs, that train providers to prescribe medication, should educate and train providers on the core competencies for identifying, treating and managing substance use and addiction. Such core competencies should also be required components of health processional licensing exams, board certification exams and continuing education requirements, including maintenance of certification programs.[6] Policy makers should provide additional resources and incentives to increase training. Where necessary, policy makers may also consider mandating training.

    Given addiction’s prevalence, training requirements should apply to all health care professionals, but especially for those who prescribe controlled substances with potential for addiction. Under current law, training requirements are only imposed on health care providers who wish to prescribe buprenorphine, a medication used to treat opioid addiction. This requirement has not advanced the goal of increasing provider training, but rather created a barrier to providing addiction treatment (see position statement on Buprenorphine Prescribing Waiver).

    Addiction is a disease but, as a country, we still have a long way to go to treat it as one. We cannot effectively end our nation’s addiction crisis without equipping our health care system to prevent, identify, treat and manage addiction like diabetes, heart disease, or any other chronic condition. While provider training, alone, will not achieve full integration of addiction treatment with the mainstream health care system, it is essential and will save lives.

    Published

    April 2017

    [1] CASAColumbia. Addiction medicine: closing the gap between science and practice. New York: Author; 2012.

    [2] 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.

    [3] Lloyd C. The stigmatization of problem drug users: a narrative literature review. Drugs: Educ Prev Policy. 2013;20(2):85–95.

    [4] McLellan AT, Lewis DC, O’Brien CP, Kleber HD. Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation. J Am Med Assoc. 2000;284(13):1689–95.

    Pauly BB, McCall J, Browne AJ, Parker J, Mollison A. Toward cultural safety: nurse and patient perceptions of illicit substance use in a hospitalized setting. Adv Nurs Sci. 2015;38(2):121–35.

    [5] Commonwealth of Massachusetts. 2015. Baker-Polito administration announces groundbreaking medical school program to curb opioid crisis. Available at: https://core.ac.uk/download/pdf/146529648.pdf.

    Commonwealth of Massachusetts. 2016. Baker-Polito administration, advanced practice nurses, physician assistants and community health centers expand on core competencies to combat opioid epidemic. Available at: https://www.mass.gov/news/baker-polito-administration-advanced-practice-nursesphysician-assistants-and-community-health

    McCance-Katz EF, George P, Scott NA, Dollase R, Tunkel AR, McDonald J. Access to treatment for opioid use disorders: medical student preparation. Am J Addict. 2017;26(4):316–8.

    [6] CASAColumbia. Addiction medicine: closing the gap between science and practice. New York: Author; 2012.


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