HealthCare educational differences in pain management, adverse childhood experiences and their relationship to substance use disorder education

The Ohio Attorney General selected experts from a number of academic fields to the Scientific Committee on Opioid Prevention and Education (SCOPE) to help the State of Ohio in tackling the opioid crisis in the United States. The focus of SCOPE is the application of scientific principles in the development of prevention and educational strategies for reducing substance use disorder (SUD). SUD education for healthcare workers was one of SCOPE's main areas of interest. The objective of the present was to identify the content and extent to which future healthcare professionals are trained in pain management, SUD, and adverse childhood experiences (ACEs).

Medicine, pharmacy, advanced practice registered nurse (APRN), physician assistant, dentistry, and optometry were among the 49 healthcare professional schools in Ohio that received a survey in December 2019. Initial patient screening, training in SUD, training in treatment for patients at high risk for SUD, and education in evaluating patients for ACEs were all covered in the survey. The data was analyzed using descriptive statistics.

The survey was completed by thirty-one of the forty-nine schools. The majority of disciplines said their core curriculum included some type of basic instruction in SUD concepts. The training on ethical issues surrounding SUD were not as widely covered (range 0-62.5%). Pharmacologic treatment curriculum integration was "moderate" to "great" in medicine, APRN, physician assistant, and pharmacy schools. Other pain-relieving techniques were "somewhat" to "moderately" incorporated. There were differences in teaching on the danger of pharmaceutical abuse based on various health factors. Motivational interviewing training was included in at least 67.7% of medical, APRN, physician assistant, and pharmacy schools. The percentage of schools that included ACEs instruction in their curriculum ranged from 0% to 66.7 percent.

The findings of the study pointed to the necessity for standardized training requirements in the basics of pain management, substance abuse, and ACEs. We recommend that an SUD curriculum contain the following aspects in addition to these essential concepts:

1. When evaluating pain and SUD patients, use motivational interviewing strategies.
2. While caring for patients in pain, assess societal determinants of health.
3. Evaluate the ethical implications of treating SUD patients.
4. Evaluate patients who require ACEs-based pain management.

As an outcome of these results, SCOPE is working on a statewide interprofessional educational symposium that will focus on these areas of recognized need.