From Education to Practice: Addressing Opioid Misuse through Health Care Provider Training: A Special Issue of Substance Abuse Journal

Abstract

Opioid misuse may be ignored by providers who are unwilling or not confident in engaging the complex nature of substance use disorders among their patient populations. Addiction is a complex disease, and although providers often are comfortable in identifying, assessing, and treating the complex diseases of their patients, basic knowledge and skills of identification, assessment, and treatment expertise involving opioids for pain, addressing opioid misuse, and treatment of opioid use disorder are lacking. Initiatives to improve knowledge of opioid use, misuse, and opioid use disorder among health care providers are emerging. In this issue of the Substance Abuse journal, we examine the science and evidence base of educational interventions and public initiatives addressing opioid use and addiction. These initiatives include naloxone rescue awareness and programs, community-based training initiatives, and system or public health approaches to improve student, trainee, and clinician education/training revolving around opioid misuse and opioid use disorder. We call on stakeholders to fund more research to investigate and implement the proven means to educate undergraduate students, graduate trainees, and clinicians regarding pain and addiction. We also recognize the 2016 peer reviewers of our journal who have performed meritorious, volunteer service to advance the science of addiction.

Heterogeneity in Prescription Opioid Pain Reliever Misuse Across Age Groups: 2015–2017 National Survey on Drug Use and Health

“…The observed lower rates of OUD treatment among individuals misusing opioids obtained from a medical or social source compared with an illicit/other source may reflect less severity, as well as potential under-recognition of misuse and opioidrelated problems among these individuals. 40,41 The low rate of OUD treatment among adolescents is consistent with other studies documenting challenges in teens with opioid-related problems getting treatment, [42][43][44] highlighting the need for ongoing efforts to increase available treatment options for younger individuals. Furthermore, OUD treatment rates were also low among older adults.…”

“…As opioid misuse and opioid-related problems may go unrecognized in many clinical settings, there is ongoing need for clinician training regarding identifying individuals with opioid-related problems. 40,41 While not every individual misusing opioids requires treatment, our findings that only 6% of individuals misusing opi-oids received treatment likely reflect unmet need. The observed lower rates of OUD treatment among individuals misusing opioids obtained from a medical or social source compared with an illicit/other source may reflect less severity, as well as potential under-recognition of misuse and opioidrelated problems among these individuals.…”

“…(aOR = 0.66, 95% CI = [0.49-0.88]), whereas older individuals were significantly more likely to report a medical source (age[35][36][37][38][39][40][41][42][43][44][45][46][47][48][49], aOR = 1.72, 95% CI = [1.40-1.20]; age 50-64, aOR = 2.41, 95% CI = [1.71-3.27]; age 65+, aOR = 3.96, 95% CI = [2.20-7.10]). Relative to individuals aged 18-34, older individuals were significantly less likely to report a social source (relative to a non-social source) (age 35-49, aOR = 0.76, 95% CI = [0.62-0.91]; age 50-64, aOR = 0.63, 95% CI = [0.47-0.86]; age 65+, aOR = 0.39, 95% CI = [0.21-0.74]).…”

The prescription opioid crisis: role of the anaesthesiologist in reducing opioid use and misuse

“…Prescriber awareness of the risks and benefits of opioid analgesia has been proposed to lead directly to reductions in harmful prescribing. 112 Despite broad public attention to the opioid epidemic, many practicing physicians received little or no training during medical school or residency on these topics. 113 There is an opportunity and a responsibility for the institution to assume this role.…”

Addressing the growing opioid and heroin abuse epidemic: a call for medical school curricula

“…Many physicians lack knowledge regarding the identification, assessment, and treatment of opioid addiction [21,22]. Increased awareness and education among physicians will enable them to identify patients at risk for substance abuse and overdose and manage patient care more effectively.…”