Training Health Professionals in Substance Abuse: A Review

Abstract

Alcohol- and drug-related problems are a major component of the work of health professionals. Most professionals are inadequately trained to handle the problems they will confront in this field. The need for training in aspects of substance abuse is widely accepted. This paper is a review of reports of such training programs in English-speaking countries. The programs have been reviewed in four categories: (1) courses for practitioners and teachers of health professionals, (2) courses for medical students, (3) courses for nurses and nursing students, and (4) courses for other health professionals. Many programs have achieved their objectives, but documentation for many of them is insufficient to provide guidance for future program development. In general, knowledge gain is easily demonstrated, but changes in attitudes and skills require special conditions in training.

Achieving effective supervision

“…We have already mentioned the unique set of dynamics associated with recovering and non-recovering workers, which requires specific attention in relationship to determining appropriate supervisory relationships and processes [3]. A second major challenge is the fact that most professional courses do not adequately cover the knowledge and skills required for practice in alcohol and other drugs [45]. Finally, there is the challenge produced by the nature of drug and alcohol problems, which are particularly prone to repeated relapse, self-harm and complex problems across multiple domains.…”

A longitudinal evaluation of medical student knowledge, skills and attitudes to alcohol and drugs

“…Reasons for the lack of action among medical practitioners include doctors’ negative attitudes towards substance users [6,42,43], a general knowledge and skills deficit in this area [44–46], belief that treatment efficacy is poor despite clear evidence to the contrary [47,48], discomfort in discussing such topics [44], limited perceived responsibility for addiction problems [28,49] and time and economic constraints [50]. Unfortunately, many of these barriers listed above develop from the very outset of a physician’s career—during their undergraduate medical education.…”

Two birds with one stone: experiences of combining clinical and research training in addiction medicine

“…It is possible that doctors, who participate in specialised training, already have some experience with addiction research and appreciation for the field [45]. Although literature confirmed that attitude and competency gain takes longer to demonstrate, our participants reported positive learning outcomes, such as increased knowledge following the training [13]; however, it is unclear whether combined clinical and research training made them better doctors and whether patient outcomes improved [37, 39]. Future evaluations of clinician-scientist programmes should employ robust study designs and strategies, with a focus on outcome analyses [2, 11, 28].…”