Educating Together, Improving
Together: Harmonizing
Interprofessional Approaches
to Address the Opioid Epidemic
Kathy Chappell, Eric Holmboe, Lauren Poulin, Steve Singer,
Elizabeth Finkelman, and Aisha Salman, Editors
WASHINGTON, DC
NAM.EDU
NATIONAL ACADEMY OF MEDICINE • 500 Fifth Street, NW • WASHINGTON, DC 20001
NOTICE: This publication has undergone peer review according to procedures established by the National Academy of Medicine (NAM). Publication by the NAM signifies that it is the product of a carefully considered process and is a contribution worthy of public attention, but does not constitute endorsement of conclusions and recommendations by the NAM. The views presented in this publication are those of individual contributors and do not represent formal consensus positions of the authors’ organizations; the NAM; or the National Academies of Sciences, Engineering, and Medicine.
Digital Object Identifier: https://doi.org/10.17226/27108
Library of Congress Control Number: 2022933212
Copyright 2021 by the National Academy of Sciences. All rights reserved.
Printed in the United States of America.
Suggested citation: Chappell, K., E. Holmboe, L. Poulin, S. Singer, E. Finkelman, and A. Salman, Editors. 2021. Educating Together, Improving Together: Harmonizing Interprofessional Approaches to Address the Opioid Epidemic. NAM Special Publication. Washington, DC: National Academy of Medicine.
“Knowing is not enough; we must apply.
Willing is not enough; we must do.”
—GOETHE
ABOUT THE NATIONAL ACADEMY OF MEDICINE
The National Academy of Medicine is one of three Academies constituting the National Academies of Sciences, Engineering, and Medicine (the National Academies). The National Academies provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions. The National Academies also encourage education and research, recognize outstanding contributions to knowledge, and increase public understanding in matters of science, engineering, and medicine.
The National Academy of Sciences was established in 1863 by an Act of Congress, signed by President Lincoln, as a private, nongovernmental institution to advise the nation on issues related to science and technology. Members are elected by their peers for outstanding contributions to research. Dr. Marcia McNutt is president.
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The National Academy of Medicine (formerly the Institute of Medicine) was established in 1970 under the charter of the National Academy of Sciences to advise the nation on issues of health, health care, and biomedical science and technology. Members are elected by their peers for distinguished contributions to medicine and health. Dr. Victor J. Dzau is president.
Learn more about the National Academy of Medicine at NAM.edu.
ACTION COLLABORATIVE ON COUNTERING THE U.S. OPIOID EPIDEMIC HEALTH PROFESSIONAL EDUCATION AND TRAINING WORKGROUP
KATHY CHAPPELL (Co-Lead), American Nurses Credentialing Center
ERIC HOLMBOE (Co-Lead), Accreditation Council for Graduate Medical Education
STEVE SINGER (Co-Lead), Accreditation Council for Continuing Medical Education
DAVID BENTON, National Council of State Boards of Nursing
TIMOTHY BRENNAN, The Addiction Medicine Foundation
ROBERT CAIN, American Association of Colleges of Osteopathic Medicine
THERESA CAMPO, American Association of Nurse Practitioners
LEMREY “AL” CARTER, National Association of Boards of Pharmacy
JIANGUO CHENG, American Academy of Pain Medicine
DAVOREN CHICK, American College of Physicians
CHARLENE DEWEY, Vanderbilt University Medical Center
OMAR ESCONTRIAS, American Dental Education Association
RICK GARCIA, American Association of Colleges of Nursing
JAMES GIFFORD, Federation of State Medical Boards
LISA HOWLEY, Association of American Medical Colleges
MARGARET JARVIS, Geisinger Health System
BEVERLEY JOHNSON, Institute for Patient- and Family-Centered Care
RONEET LEV, Independent Emergency Physicians Consortium
LUCINDA MAINE, American Association of Colleges of Pharmacy
RAY MITCHELL, Georgetown University and Liaison Committee on Medical Education
DANIEL PACE, American Academy of Physician Assistants
MARGOT SAVOY, American Academy of Family Physicians
JOY RUCKER, Texas Harm Reduction Alliance (former)
DANIEL SLEDGE, Williamson County Mobile Outreach Team
NAM Staff
Development of this publication was facilitated by contributions of the following NAM staff:
ELIZABETH FINKELMAN, Senior Program Officer
AISHA SALMAN, Program Officer
NOAH DUFF, Associate Program Officer
EMMA FREILING, Research Assistant
JENNA OGILVIE, Deputy Director of Communications
MADELEINE DEYE, Senior Editorial Assistant
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REVIEWERS
This special publication was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with review procedures established by the National Academy of Medicine.
We wish to thank the following individuals for their contributions:
ELIZABETH BENTLEY, Kaiser Permanente
RONALD M. CERVERO, Uniformed Services University of the Health Sciences
DARLA SPENCE COFFEY, Council on Social Work Education
HOLLY HAGLE, University of Missouri-Kansas City
TERRI JORGENSON, U.S. Department of Veterans Affairs
KELSEY KRUSHINSKI, Baptist Memorial Hospital Memphis
MICHELE MATTHEWS, Massachusetts College of Pharmacy and Health Sciences
SUZANNE NESBIT, Johns Hopkins University
The reviewers listed above provided many constructive comments and suggestions, but they were not asked to endorse the content of the publication and did not see the final draft before it was published. Review of this publication was overseen by AISHA SALMAN, Program Officer, and ELIZABETH FINKELMAN, Senior Program Officer. Responsibility for the final content of this publication rests entirely with the editors and the NAM.
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CONTENTS
4 Educational Requirements Survey (Study 2)
Collective Insights from the Literature Review
Variation in Regulatory Requirements to Address Pain Management and Substance Use Disorder
C Coding Matrix for Articles on Practice Gaps
E Organizations Providing Links to Requirements
F State CME Requirements for Prescribers
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BOXES AND TABLES
BOXES
1 A Call for Learning Leadership
TABLES
1 Literature Review Research Article Composition
2 Health Care Professionals by Type Represented in the Literature Review
3 Specialties Represented in Literature Review
4 Practice Environments Represented in Literature Review
5 Domains of Practice in Literature Review
6 Data Sources Used to Identify or Describe PPGs in the Literature
7 Patient Populations Referred to in Literature Review Articles
8 PPGs by Type or Stage in the Care Process Included in the Literature Review
9 Professional Practice Gap by Category in Literature Review
10 Summary of PPG Themes by Category
11 Policy Themes Identified in the Literature Review
12 Respondents by Type of Organization
13 Health Care Professional Type by Jurisdiction
17 Count of Policies by Category
18 Focus and Type of Policy by Organization Category
19 Professional Practice Gaps Identified from Peer-Reviewed Literature
21 Taking Action on the Key Priorities—Who Can Affect Change and How?
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ACRONYMS AND ABBREVIATIONS
ABMS | American Board of Medical Specialties |
ACCME | Accreditation Council for Continuing Medical Education |
APRN | advance practice registered nurse |
BIPOC | Black, Indigenous, and people of color |
BTP | breakthrough pain |
CDC | U.S. Centers for Disease Control and Prevention |
CE | continuing education |
CLO | Chief Learning Officer |
CME | continuing medical education |
CMS | Centers for Medicare & Medicaid Services |
COVID-19 | coronavirus disease 2019 |
CPD | continuing professional development |
DC | District of Columbia |
DDS | doctor of dental surgery |
DMD | doctor of medicine in dentistry |
DO | doctor of osteopathic medicine |
DSCSA | Drug Supply Chain Security Act |
EHR | electronic health records |
FDA | Food and Drug Administration |
FHIR | Fast Healthcare Interoperability Resources |
FSMB | Federation of State Medical Boards |
HHS | U.S. Department of Health and Human Services |
IPCE | interprofessional continuing education |
MAT | medication-assisted treatment |
MD | medical doctor |
MOUD | medication for opioid use disorder |
NAM | National Academy of Medicine |
NCCPA | National Commission on Certification of Physician Assistants |
NIH | National Institutes of Health |
NQF | National Quality Forum |
ORC | Opioid Regulatory Collaborative |
OUD | opioid use disorder |
PA | physician assistant |
PDMP | prescription drug monitoring program |
PPGs | professional practice gaps |
Project ECHO | Project Extension for Community Healthcare Outcomes |
REMS | risk evaluation and mitigation strategies |
RN | registered nurse |
SAMHSA | Substance Abuse and Mental Health Services Administration |
SBIRT | screening, brief-intervention and referral to treatment |
SUD(s) | substance use disorder(s) |