A Multi-Modal Curriculum Teaching Opioid Use Disorder Management in Young Adult Populations

Abstract

BACKGROUND The use of both prescription and illicit opioids among adolescents and young adults (AYA) is increasing. Barriers to effective treatment of opioid use disorders among AYA range from patients leaving against medical advice to decreased knowledge and experience of providers caring for those with opioid dependence. No formal curricula for residents on AYA opioid use disorder and management have been implemented despite rapidly increasing use in this population. OBJECTIVE To develop a brief curriculum for trainees who encounter AYA that will increase knowledge and skills to treat opioid use in the AYA population.  Methods: Twenty-six pediatric and family medicine interns participated in this pilot study. The multimodal curriculum included standardized patient encounters, case-based learning sessions, didactics, and high-fidelity simulations. The curriculum encompasses five individual sessions, each with a different theme: motivational interviewing, naloxone administration, opioid withdrawal medications, complex overdoses, and infectious complications of intravenous drug use. A pre-survey was administered prior to the curriculum and a post-survey was administered at the conclusion to assess its effectiveness in improving knowledge for this specific population and increasing comfort levels providing medical interventions in AYA patients with opioid use disorders. RESULTS Trainee comfort levels increased significantly in all four domains as measured by the average Likert scale, including interviewing AYA about opioid use (2.5 (standard deviation (SD) 1.2) to 4 (SD 0.9), p<0.0001)), prescribing medication for opioid use disorder (1.3 (SD 0.5) to 2.8 (SD 1.3), p<0.0001)), treating acute opioid overdose (1.5 (SD 0.8) to 3.7 (SD 0.9), p<0.0001)), and treating infectious complications of intravenous drug use (1.7 (SD 0.8) to 3 (SD 1.1), p <0.0001)). The Chi-square test showed similarly significant increases in comfort levels. CONCLUSIONS Early trainees who provide care to young adults benefit from opioid education specific to this population. Participants described increased knowledge and comfort in interviewing and treating this vulnerable patient group.