An Interprofessional approach for healthcare students to address and understand the opioid epidemic

Background/rationale (300 words) A 2017 report from the CDC indicates over 70,000 people lost their life due to drug overdose1. Multiple factors work together to create this epidemic. Sadly, it has become known that the medical care system maintains some responsibility for the current situation. Indeed, leading up to the opiate epidemic, some well-intentioned changes occurred in the health care system that contributed to an increase in opioid addiction. Specifically, in 2001 pain was first conceptualized as the 5th vital sign2. Concurrently, there was proliferation of the notion prescription opiate medications were safe with a low potential for abuse and addiction3. Correspondingly, there was increased reliance on medication rather than other approaches to address and manage patient pain4. Presumably most medical professionals are now aware that prescription opioids are highly addictive and efforts have been taken to reduce reliance on prescription opiates to treat pain. Medical professionals are encouraged to consider: What is my profession’s role, and my individual role in addressing the opioid epidemic? Do I feel competent to appropriately intervene with a client who may be struggling with addiction? Do I know the components of harm reduction? Am I aware of harm reduction resources? Do I know how to quickly connect someone struggling with addiction with needed treatment? Reviews of the health records of fatal opioid overdose suggest these individuals tend to interact with at least one health professional in the year preceding their death. As such, all health professionals are called on to be prepared to address an important risk factors for the initiation, continuation and relapse in addiction—pain management. Additionally, health professionals should be prepared to refer any patient to harm reduction and treatment resources. Finally, health professionals should have a solid understanding of the roles and responsibilities of other healthcare professionals in addressing the opiate addiction. Purpose/Goal (100 words) The purpose is to empower all health professionals to understand their role in addressing the opiate epidemic and feel competent in working with patients struggling with addiction or those at risk of addiction or relapse. We aimed to assess the value of a specific interprofessional workshop curriculum in achieving statistically significant improvement in students self-described confidence identifying their values and beliefs as they relate to substance abuse, responding appropriately when interacting with someone with a substance abuse disorder, quickly finding local harm reduction resources, and quickly finding local, available substance abuse treatment resources for a person struggling with addiction. Describe method/methodology (200 words) N=347 students representing seven health professions were invited to participate in a pretest survey examining their confidence “identifying my own values and beliefs as they relate to substance abuse,” “responding appropriately when interacting with someone with a substance abuse disorder,” “quickly finding local harm reduction resources for a patient struggling with alcohol or drug addiction,” and “quickly finding local, available substance abuse treatment resources for a pregnant woman struggling with addiction.” All students were then invited to attend a 2 hour interprofessional workshop which included a panel discussion by a local police officer who leads a police assisted addiction recovery program, a community activist in long term recovery from opioid addiction and an occupational therapist who specializes in pain management. Professors from each of the disciplines made a two minute presentation on their profession’s role in addressing patient pain and the opiate epidemic. Student participants were divided into interprofessional teams and were provided a case study and a series of discussion questions. During the case study students were introduced to and used a new tool drughelp.care that can be used to find harm reduction resources and a treatment that matches an individual’s characteristics. Participants completed a post-test survey. Significance/importance to the field (300 words) Multiple systems were involved in creating the opioid epidemic and dedicated involvement of multiple systems is required to resolve the crisis. The educational event that will be described in this presentation is appropriate for students in medicine, pharmacy, nursing, occupational therapy, physical therapy, speech therapy, social work and substance abuse counseling. It is also can be used to provide continuing education to seasoned professionals in each of these fields. Each of the four outcome variables measured are salient in reducing opioid addiction and overdose death. First, facilitating examination of a professional’s values and beliefs is important because it is through this process professionals can identify sources of bias and identify areas where stigma might inadvertently impeded patient care. Second, some health professionals might not feel fully competent and confident responding appropriately when interacting with someone with a substance abuse disorder. Therefore, it is essential that all health professionals know and understand their role and responsibility when it comes to pain management and helping to prevent addiction or relapse. Third, harm reduction refers to a series of services and resources that can help to save the life of someone who is struggling with active addiction or relapse. If every health professional was aware of local harm reduction resources and routinely connected those in need with these resources, overdose deaths would decline. Finally, oftentimes their is a small window of time when a person struggling with addiction is amenable to treatment. For this reason, being able to quickly finding local, available substance abuse treatment resources for a person struggling with addiction is essential and life saving. Taken together, this educational session and corresponding assessment of the outcomes are of importance. Results and/or outcomes (300 words) We aimed to assess the value of a specific interprofessional workshop curriculum in achieving statistically significant improvement in students self-described confidence regarding four substance abuse related areas. Data were analyzed to calculate the pre-test and post-test measures of student’s confidence in four areas (values and beliefs, responding appropriately, finding harm reduction resources, and quickly finding treatment resources) using a paired sample t-test. Dependent variables were measured on a five point scale (1=strongly disagree, 5=strongly agree). Of the N=347 students who attended the interprofessional educational event, N=220 students completed both the pretest survey and the post-test survey. There was a statistically significant difference in pre-test (M=4.22, SD=.726) and post-test (M=4.44, SD=.558) scores for students who attended the interprofessional workshop regarding their self-described confidence identifying their values and beliefs as they relate to substance abuse t(219)=-3.991, p=.000. There was a statistically significant difference in pre-test (M=3.60, SD=.867) and post-test (M=4.10, SD=.695) scores for students who attended the interprofessional workshop regarding their confidence in responding appropriately when interacting with someone with a substance abuse disorder and t(219)=-8.759, p=.000. There was a statistically significant difference in pre-test (M=3.32, SD=.955) and post-test (M=4.28, SD=.567) scores for students who attended the interprofessional workshop regarding their self-described confidence quickly finding local harm reduction resources, t(219)=14.205, p=.000. There was a statistically significant difference in pre-test (M=3.10, SD=1.031) and post-test (M=4.23, SD=.624) scores for students who attended the interprofessional workshop regarding their self-described confidence quickly finding local, available substance abuse treatment resources for a person struggling with addiction, t(219)=14.991, p=.000. Conclusion (300 words) In an effort to address the opioid crisis, we aimed to assess the value of a specific interprofessional workshop curriculum in improving student’s readiness to intervene with patients struggling with opioid addiction. Our findings suggest this educational curricula is valuable in achieving its stated goals. Specifically, we find statistically significant improvement in students self-described confidence identifying their values and beliefs as they relate to substance abuse, responding appropriately when interacting with someone with a substance abuse disorder, quickly finding local harm reduction resources, and quickly finding local, available substance abuse treatment resources for a person struggling with addiction. One notable limitation to this study includes reliance on self-reported level of confidence. Future research should aim to measure knowledge at pre-test and post-test in addition to student’s confidence. Findings from this study are useful to health education systems across the country. This model interprofessional education program can be emulated and used to develop competency in students and seasoned professionals in the healthcare workforce.