Ram Anita, Chisolm Margaret S
Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Acad Psychiatry. 2016 Jun;40(3):454-60. doi: 10.1007/s40596-015-0314-0. Epub 2015 Mar 7.
This commentary highlights the growing demand for substance abuse prevention and treatment, summarizes the literature regarding the current insufficiencies in substance abuse training in medical schools, and suggests strategies to address this gap in physician education. The authors describe how the combination of mandated coverage for substance abuse services and expanding treatment needs means that more physicians, regardless of their patient populations, will be faced with addressing the problem of substance use. The authors review the literature on substance abuse training in medical schools, which indicates insufficient exposure to this topic. The authors describe how current substance abuse training at medical schools is focused on transmitting scientific knowledge with relatively little education or training in attitudes and skills central to effective prevention and treatment. Given the gap between clinical need and physician education, the authors suggest several strategies for medical schools to increase training in substance abuse knowledge, attitudes, and skills, which will enhance the practice of evidence-based care. The authors posit that medical curricular reform, combined with initiatives to change clinical culture around substance abuse, will translate into improved rates of screening, shorter overall length of treatment, effective referrals for continued treatment, and increased access to care for individuals who use substances and so reduce the morbidity and mortality associated with substance use.
本评论强调了对药物滥用预防和治疗的需求不断增长，总结了关于医学院校目前药物滥用培训不足之处的文献，并提出了解决医师教育这一差距的策略。作者描述了药物滥用服务强制覆盖与不断扩大的治疗需求相结合意味着，更多的医生，无论其患者群体如何，都将面临解决药物使用问题的情况。作者回顾了医学院校药物滥用培训的文献，这表明对该主题的接触不足。作者描述了医学院校目前的药物滥用培训如何侧重于传授科学知识，而在有效预防和治疗的核心态度和技能方面的教育或培训相对较少。鉴于临床需求与医师教育之间的差距，作者为医学院校提出了几种增加药物滥用知识、态度和技能培训的策略，这将提高循证医疗的实践水平。作者认为，医学课程改革，再加上改变围绕药物滥用的临床文化的举措，将转化为更高的筛查率、更短的总体治疗时长、有效的持续治疗转诊，以及增加对使用药物者的护理可及性，从而降低与药物使用相关的发病率和死亡率。
