Terra Sigillata

I missed this note on Friday at the Wall Street Journal Health Blog but the National Institute on Drug Abuse (NIDA) has made available some great new curricular resources through their Centers of Excellence for Physician Information Program (NIDA CoEs) (press release)

“Physicians can be the first line of defense against substance abuse and addiction, but they need the resources and the training,” said NIDA Director Dr. Nora D. Volkow. “Our long term goal is for doctors to incorporate screening for drug use into routine practice like they currently screen for other diseases; to help patients that are abusing to stop; and to refer more serious cases to specialized treatment.”

Three themes have emerged in this first wave of CoE offerings: the importance of communication in the doctor-patient relationship, particularly around sensitive issues; the recognition that substance abuse may play an integral role in many disorders physicians treat, even when not the presenting condition; and the crucial part physicians can play in both identifying substance abuse in their patients and reducing their risk of developing a substance use disorder.


The overall CoE program is here and the listing of universities that developed each module here. I note this because it appears that the development of each resource was the result of a NIDA R25 education grant. If you want to just go for the jugular, the list of modules by topic is here.

I’m not through all of the materials but I’ve got to say that I’ve always been a fan of the problem-based learning approach as opposed to yet another PowerPoint presentation. The case on drug abuse in the physician developed by the University of North Dakota (PDF) is excellent and addresses a critical issue in practitioners impairment, taking the unfortunately common case of an anesthesiologist.

The second half of this document presents an overview of the student-centered, problem-based learning approach as written by Robert E. Waterman and Stewart P. Mennin at the University of New Mexico School of Medicine.

I’m all for any education that treats substance abuse disorders as a true disease and, as in other NIDA education modules, balances effective pain management while minimizing risk of opioid dependence. Many drugs of abuse come from my field of natural products pharmacology and I have personal experience with how physicians sometimes treat the substance abuser and their family with a lack of compassion.

We as scientists are not immune either and our own tribe has suffered tragic losses due to substance dependence. Despite the fact that we most recently lost and incredibly talented young scientist, I am amazed at some of the heartless, judgmental comments that come out of the mouths (and keyboards) of even people who study drug abuse for a living. Therefore, education on substance abuse as a disease behavior with a significant genetic predisposition is essential in science and medical curricula.

The NIDA curricular resources fill an unmet need in medical education. These curricular resources can be applied not just in primary medical education but in residency training and continuing medical education as well.

Nice to see some grant money well-spent.

Comments

  1. #1 Andre Agassi
    November 10, 2009

    I think that is important for everyone, It is an annual, of up to 1 meter of height, little graft plant, with the oblong leaves, sinuosodentadas in the edges, with the petals of several colors, targets, pink, red and violets, this indicates findrxonline in article, with a dark spot in the base. The fruit is a capsule of good size. It is spread by the south of Europe, North Africa, central and South Asia and America. It exists in the Iberian Peninsula, in addition to the narcotic, another plant with similar effects, the Chelidonium majus, well-known with the names of golondrinera grass or the wanderers, verruguera grass and celidueƱa. Latex removes rarely from the incisions of the immature fruits and of other parts of the plant. This latex coagulates in contact with the air. The opium is a mixture of ranges, different resins, sugars and other substances, between which 20 have pharmacological activity, almost all alkaloids like: morphine, codeine, thebaine, narcobathtub, narceƭna and papaverina; most important of all of them it is the morphine, contained in the opium in variable proportion (3-22 %) and to which it confers his main qualities.

  2. #2 Florida
    November 10, 2009

    These points to an interesting article in findrxonline where they talk about this subject it is necessary to inform the community.
    It is ultimately the patient’s responsibility to use narcotics responsibly.
    A few years ago, narcotics were only prescribed after surgery, severe trauma, or for terminal cancer because of a concern over the possibility of addiction. Recently, they have been cautiously prescribed to treat moderate to severe non-malignant chronic pain in conjunction with other modalities such as physical therapy, cortisone and trigger point injections, muscle stretching, meditation, or aqua therapy. Unfortunately, the upsurge of narcotics as medical treatment also increased associated cases of abuse and addiction.
    Derived from either opium (made from poppy plants) or similar synthetic compounds, narcotics not only block pain signals and reduce pain, but they affect other neurotransmitters, which can cause addiction. When taken for short periods, only minor side effects such as nausea, constipation, sedation and unclear thinking are noted.