The Development of Medications for the Treatment of Opiate and Cocaine Addictions Issues for the Government and Private Sector (1995) / Chapter Skim
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6 Training and Education
6 Training and Education
Pages 134-153
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From page 134... ...
The infrastructure for research and development of a new medication has many components: strong federal leadership and private sector commitment, federal and industry support of research, basic scientists dedicated to elucidating the mechanisms of disease, clinical investigators designing and conducting clinical research and identifying potential leads for new treatments, clinicians specifically trained in the diagnosis and treatment of the disease, health care professionals knowledgeable about recent research findings, adequate reimbursement for treatment, and an educated public that supports effective treatments. In the area of anti-addiction medications development, however, many of those components are scarce or nonexistent.
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From page 135... ...
While the biomedical sciences in general are having difficulty in attracting and funding young researchers, especially clinical investigators (IOM, 1988, 1990; NRC, 1994) , the numbers being attracted to the field of drug addiction research are particularly sparse.
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From page 136... ...
Drug abuse treatment is intrinsically interdisciplinary and involves a variety of health care professionals, including counselors, social workers, therapists, psychologists, nurses, and physicians. The committee supports increased training opportunities for all health care professionals involved in drug abuse treatment, but the focus here is on increasing the numbers of clinical investigators and clinicians working in drug addiction research and treatment.
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From page 137... ...
NIDA funding of research career development awards has increased annually from $507,000 in fiscal year (FY) 1991 (funding five awards)
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From page 138... ...
· Health Resources and Services Administration (HRSA) Bureau of Health Professions has established the Physician Consortium on Substance Abuse Education, which brings together representatives from academia, government agencies, medical professional organizations, and accrediting agencies to focus on drug abuse education for all levels of medical training.
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From page 139... ...
Health education schools of many disciplines also offer training. Foundations Many foundations provide support for drug abuse curriculum development and sponsor educational activities on drug abuse which have included conferences of medical educators, scholarship programs for medical student training on substance abuse, and continuing medical education programs.
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Typically, the fellowship programs are affiliated with psychiatry departments, either solely (85 percent) or jointly with other departments including internal medicine and family practice; few of the programs were affiliated solely with family practice programs or departments.
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. Many of these core specialty boards offer certification examinations in subspecialty areas, such as geriatric medicine or addiction psychiatry.
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Applicants for the LRP program must have qualified educational debt in excess of 20 percent of their annual NIH basic pay or stipend and must be employed under a mechanism that allows for their NIH employment to last a minimum of 2 years (Health Policy and Biomedical Research News of the Week, 1994~. To achieve greater national impact, loan repayment for work in the drug addiction field could be extended beyond NIH employees to encompass NIDA trainees and others working in the field.
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From page 143... ...
INCREASING KNOWLEDGE AND SKILLS AMONG PRIMARY CARE PHYSICIANS Just as critical as infusing the addiction field with researchers and medical specialists is expanding primary care physicians' knowledge and skills in the diagnosis and treatment of drug abuse. Given the consequences of managed care, health care reform efforts, and the potential for new medications to treat drug addiction, primary care physicians must be able to diagnose drug addiction, and they must be familiar with its treatment modalities.
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From page 144... ...
In 1989, under the auspices of the HRSA Bureau of Health Professions, the Physician Consortium on Substance Abuse Education was formed and subsequently drafted recommendations for improving drug abuse education at all levels of medical education (U.S.
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From page 145... ...
Foundation targeted residency education on drug abuse as the topic for its October 1994 conference. Leadership of the primary care certifying boards and of the residency review committees in internal medicine, family practice, pediatrics, and OBGYN along with business purchasers of health care, state legislative leaders, and drug abuse experts met and reached consensus on the urgency and necessity for primary care residency review committees to require drug abuse education for all residents under their supervision.
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From page 146... ...
Continuing medical education (CME) can fill the gap, and several organizations, including the American Society of Addiction Medicine and the American Society for Medical Education an Research in Substance Abuse conduct workshops and conferences that prepare faculty for teaching continuing medical education courses.
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From page 147... ...
CSAP's Faculty Development Program which trains medical school faculty members to serve as role models, educators, and mentors in the field of drug abuse research and treatment, is a good model. COMPREHENSIVE DRUG ABUSE CENTERS 147 The goal of a solid infrastructure needed to support anti-addiction medications development and comprised of specialists and primary care physicians who are knowledgeable in the diagnosis and treatment of drug abuse, can be realized in part through the implementation of comprehensive, multidisciplinary drug abuse centers recommended by the committee (Chapter 2~.
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From page 148... ...
funding. The core treatment unit of the comprehensive center would provide state-of-the-art patient care, serving as a valuable community treatment resource treatment costs could be supported in part by community or state block grant funding administered by the Center for Substance Abuse Treatment (CSAT)
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From page 149... ...
All ATCs are multidisciplinary and provide training opportunities for addiction counselors and other professionals, including social workers, marriage and family therapists, psychologists, psychiatrists, and primary care physicians and nurses. ATC funds are used to develop clinical training programs, support faculty, and conduct training needs assessments.
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From page 150... ...
The FY 1995 Department of Health and Human Services appropriations bill calls on NIDA to "support up to five multidisciplinary comprehensive substance abuse centers that will undertake research, service, arid training activities to demonstrate the effectiveness of such coordinated activities focused on women, children, alla minorities" (U.S. Congress, Senate, 19941.
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From page 151... ...
Few clinicians and clinical researchers have been interested in pursuing careers in drug abuse research and treatment, arid current efforts, through fellowships, traineeships, research development awards, and certification, have not attracted sufficient interest in the drug addiction field. This shortage of medical specialists has had a negative effect on the pharmaceutical industry.
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From page 152... ...
1988. Substance abuse units taught by four specialties in medical schools and residency programs.
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From page 153... ...
1991. Policy Report ofthe Physician Consortium on Substance Abuse Education.
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