Medical Student Training on Buprenorphine and Opioid Dependence

DESCRIPTION (provided by applicant): We propose to develop a suite of Internet based modules to provide education and skills training to medical students on the topic of buprenorphine treatment and opioid addiction. Opioid dependence is a growing problem in the United States involving both use of legal medications for non-medical uses and illegal drug use. Over 2.4 million Americans are using prescription opioids for non-medical uses, and 400,000 Americans used heroin last year. Although only part of the problem, heroin use is associated with significant medical issues such HIV, and Hepatitis B and C. Currently, these topics are not part of the standard medical school curriculum. However, opioid dependence and treatment with buprenorphine are topics well suited to teaching medical students since explanation of these topics leads to discussion of the role of practicing physicians in substance abuse treatment, raises complicated multi-disciplinary treatment issues, involves understanding complex biological and social basis of addictions, and leads to the discussion of how new treatments are developed and moved into practice. We will complete creation of a suite of six lessons for medical students. Each lesson will utilize a clinical case scenario approach, which will include straightforward clinical scenarios involving patients with issues related to opioid dependence. The modules will include the following information: 1) the scope of the problem with opioid dependence and other substance abuse, 2) the role of the practicing physician in substance abuse treatment, 3) pharmacology of opioids, 4) detection, diagnosis and assessment of opioid dependence, 5) psychiatric and other common comorbidities with substance abuse, and 6) how novel treatments are developed and implemented in practice ('bench to bedside' issues). We will evaluate the suite of modules' effect on attitudes toward substance abuse patients, clinical practice, self-efficacy, and knowledge. A randomized study will compare subjects using the buprenorphine modules to subjects using modules on a topic that does not contain substance abuse information. Clinical practice changes will be measured using interviews with simulated patients who are trained to bring up issues related to opioid use or treatment. After the value of the courses has been scientifically demonstrated, we will work with medical schools throughout the United States that are interested in adding the modules to their curriculum. If successful, the training will expand the capabilities of medical students and prepare them for the challenges they will face as practicing physicians.