Education and Training in the Drug and Alcohol Field,with Special Reference to Programs at Macquarie University

Abstract: A distinction is made between education and training. Education means that knowledge or information is gained. Training involves the acquisition of specific, usually practically oriented skills. Training and education often go hand in hand, but while it is possible to educate without training, training without prior education is difficult and never optimal. At Macquarie University, education and training aspects of drug and alcohol issues have been separated into distinct programmes, and individual courses within these are tailored to somewhat different target groups.     

Institutional Denial or Minimization: Substance Abuse Training in Social Work Education

ABSTRACT

Substance abuse in the United States has reached catastrophic proportions. 23.6 million people needed treatment for an illicit drug or alcohol use problem (1 U.S. Department of Health and Human Services. 2004. Substance Abuse: A National Challenge Prevention, Treatment, and Research at HHS Available at: http://www.hhs.gov/news/factsheet/subabuse.html Accessed January 10, 2007 [Google Scholar]). According to the National Association of Social Workers, 60% of all mental health services are carried out by social workers (3 SAMSHA. October 2006. October, Washington, DC: United States Department of Labor; Bureau of Labor Statistics (BLS). Available at: http://data.bls.gov/oep/servlet/oep.noeted.servlet.ActionServlet Accessed December 10, 2008 [Google Scholar]). Therefore, social workers are in a critical and unique position to address substance abuse. This study examined the education and training new social workers receive at 216 graduate programs accredited or in-candidacy for accreditation by the Council of Social Work Education. An overwhelming number did not have substance abuse courses as a requirement for all students, and a significant number did not have one course dedicated to substance abuse. These astounding deficiencies can only be described as an institutional denial or minimization.     

Motivational Enhancement Therapy to Increase Resident Physician Engagement in Substance Abuse Education

ABSTRACT

Rates of screening, brief intervention, and referral to treatment (SBIRT) for alcohol and drug use by physicians remain low, despite evidence of efficacy. Motivational enhancement therapy (MET) may be a promising means to help physicians resolve ambivalence about intervening with alcohol and drug users and take advantage of educational opportunities. In the present study, 9 internal medicine residents received brief MET prior to standard education in SBIRT. Residents' self-reported SBIRT attitudes and behaviors were measured before the intervention and at a 5-week follow-up point. Changes in SBIRT attitudes and behaviors all occurred in the expected direction, although, due to the small sample size, none reached statistical significance. Results suggest that MET may enhance educational opportunities and lead to changes in SBIRT behavior.     

Professional Training

Abstract: The discernment and treatment of alcohol and other drug related problems, while continuing to involve those working in specialised agencies, will, if only because of the prevalence of such problems, need to engage the attention of professionals working in a variety of settings. For such professions to respond with competence and confidence to these problems will require that their training accord much more attention to these matters. Examples are given of initiatives being taken in Western Australia to ensure the “institutionalisation” of training in the addictions in a variety of professional and vocational groupings.     

Creating Meaning and Value in Substance Abuse Education

Medical faculty committed to teaching about substance abuse face the challenges of teaching about a stigmatized disease. They often work with little support and few colleagues. These clinician educators must find tools to help sustain them in this work. Knowledge of emerging data on effective diagnosis and treatment of substance abuse in the primary care setting and excellent clinical skills in managing patients with substance abuse are key. More important is the ability to find sustenance and inspiration in working with the addicted patients who have been our teachers.     

Integration and Evaluation of Substance Abuse Research Education Training (SARET) into a Master of Social Work program

ABSTRACT

Background: The Substance Abuse Research and Education Training (SARET) program is funded by the National Institutes of Drug Abuse in 2006 as a novel approach to spark interest in substance abuse research among medical, dental, nursing, and social work graduate students through a Web-based curriculum and research mentorships. This report presents the initial integration of the intervention in a Master of Social Work (MSW) program, the components of the program, and the mixed-methods evaluation of its effect on students' attitudes towards substance abuse research and treatment. Methods: SARET comprises 2 main components: stipend-supported research mentorships and a Web-based module series, consisting of 6 interactive, multimedia modules addressing core SA research topics, delivered via course curricula and in the research mentorships. An initial evaluation was designed to assess SARET's acceptability and short-term impact on participants' interest in SA research. The components of this Web-based curriculum evaluation include focus group feedback on the relevance of the modules to SW students, number of courses into which the modules were integrated with number of module completions, changes in interest in SA research associated with module completion. Results: The full series of Web-based modules has been integrated across several courses in the social work curriculum, and social work students have become integral participants in the summer mentored research experience. One hundred eighteen students completed at least 1 module and 42 students completed all 6 modules. Neurobiology, Screening, and Epidemiology were the most widely viewed modules. Students reported positive impact on their vision of SA-related clinical care, more positive attitudes about conducting research, and in some cases, change in career. Conclusions: The SARET program's modules and summer mentored research increased clinical and research interest related to SUDs, as well as interprofessional attitudes among social work students. Participants have shown some early research success. Longer-term follow-up will enable us to continue to assess the effectiveness of the program.     

Perinatal Substance Abuse Education: A Review of Existing Curricula

The magnitude of the substance abuse problem in this country requires that health care professionals be appropriately and adequately trained to recognize and care for substance abusing patients, yet didactic and clinical curricular content on the topic remains limited for most of them. Efforts have been made over the past 25 years to develop faculty who have expertise in alcohol, tobacco, and other drug abuse and who can provide leadership in curricular development. Through these efforts, pockets of faculty expertise developed in nursing, medicine, social work, and psychology programs around the country. In addition, a number of printed substance abuse curricula were developed. The purpose of this article is to address issues regarding the substance abuse information needed by health professionals and to review the available educationial curricula, especially as they relate to perinatal substance abuse. Discussion of methods to update information as substance abuse knowledge expands is also included.     

Effective Treatment for Substance Abuse:

No abstract available for this article.     

A Review of Systems for Continued Education and Training in the Substance Abuse Field

ABSTRACT

Continued education of professionals is a major factor for service improvement and evidence-based good practice. This project explores the strategies used for this purpose across countries (CET = continued education and training in the substance abuse field). A structured questionnaire was circulated internationally by an expert committee of the Swiss Federal Office of Public Health. Reports from 11 countries were collected in 2005. The following review is based on these reports and structured according to the questionnaire (questions in italics). The authors of the reports are listed in the acknowledgements. The countries are Australia, Austria, Finland, France, Germany, Greece, Italy, The Netherlands, Scotland, Switzerland, and the United States. As a result of this project, an international think tank on continued education and training was established and is briefly described.     

Psychometric properties of the Substance Abuse Subtle Screening Inventory-3

The psychometric properties of the Substance Abuse Subtle Screening Inventory-3 (SASSI-3) were analyzed using a sample of 254 college students. Internal consistency coefficients were calculated for the total scale and its subscales, with the face-valid subscales yielding the highest coefficients. The ability of the SASSI-3 to identify students with a current alcohol dependence disorder (as measured by the Composite International Diagnostic Interview – Substance Abuse Module, DSM-IV) was also evaluated. The total scale was found to offer only a very limited degree of clinical utility (sensitivity = .65). The scale's sensitivity was significantly enhanced when the cutting score for one of its subscales (the Face-Valid Alcohol [FVA] subscale) was optimized in the present sample (new sensitivity LEVEL = .89), but even with that change, the performance of the overall scale was matched by that of the FVA subscale alone. These results raise questions about the usefulness of the subtle items of the SASSI-3 in identifying alcohol dependence in a college population.     

The Effects on Facilitators of a Substance Abuse Education Program

This retrospective–anecdotal study was conducted to determine if involvement in a learner-centered continuing education program in substance abuse prevention would influence the careers and work-related activities of thefacilitators. A questionnaire was sent to 33 individuals who served as facilitators of a large substance abuse prevention education project. Of the 31 who responded, 21 (67.7%) indicated that serving as a facilitator resulted in either major changes or some changes to their careers, and 25 (80.6%) felt that they were much more likely or more likely to incorporate substance abuse prevention activities into their work. Teaching in substance abuse education programs may cause changes in the career paths and work-related activities of the facilitators. Investigators may need to incorporate evaluations of the effects of a particular program on the intended learners as well as the facilitators.     

Integrating Substance Abuse Content into Social Work Courses: Effects of Intensive Faculty Training

An evaluation was conducted in a graduate school of social work to assess the integration of substance abuse content into basic and advanced courses by instructors with and without specialized substance abuse training. Students in these courses completed questionnaires that asked about the amount, type, and usefulness of substance abuse content presented during the semester. Instructors with and without specialized substance abuse training completed questionnaires that examined their perceptions of the amount, type, and usefulness of the substance abuse content they had taught. Results showed that (1) faculty with specialized substance abuse training were more likely than faculty without such training to integrate substance abuse content; (2) courses taught by trained faculty received higher ratings from students on the quality of the content; (3) both groups of faculty (trained and untrained) perceived that more substance abuse content had been taught than their students perceived; and (4) neither faculty nor students perceived that too much substance abuse content had been taught. This approach could be useful to social work programs and other disciplines interested in measuring the effects of changes in course content.     

Adolescent Substance Abuse:

Adolescent substance abuse remains a significant problem confronting the nation. This paper addressed the state of practice with regard to adolescent substance abuse prevention intervention. Data on the extent, nature, and consequences of adolescent substance use are presented and problems with the definition of substance abuse in this population are considered. Primary and secondary prevention programs are discussed, including programs targeting high risk youth, school and peer group, families, and communities. Tertiary prevention intervention efforts are outlines and the need for further treatment research highlighted. In addition, the importance of intervention across multiple populations and systems is emphasized.     

A Pilot Project: Continuing Education for Pharmacists on Substance Abuse Prevention

The American Association of Colleges of Pharmacy advocates that pharmacists can have a significant impact on substance abuse prevention provided they receive adequate training. Continuing education programs are needed to enable practicing pharmacists to augment their limited education. This paper examines the process the Society of Teachers of Family Medicine (STFM) used to develop a pilot continuing education program for pharmacists. With limited literature and a small number of pharmacy teaching about substance abuse, input on topics and training methods was obtained from a convenience sample of practicing pharmacists to enhance the information from the pharmacist faculty regarded as content experts. Results of this pilot study revealed lack of agreement between faculty and practicing pharmacists regarding the prioritizing of content and educational methods. Consequently, input must be obtained from targeted audiences instead of relying solely on the advice of identified academic content experts when designing continuing educational programs. Other professions should consider this process when designing continuing education programs. Pharmacists are poised to play an important role in the prevention of substance abuse problems, but they need continuing education about substance abuse.     

Assessing Correlates of the Growth and Extent of Methamphetamine Abuse and Dependence in California

Using aggregate-level data, this study performed cross-sectional analyses on all 1,628 populated California zip code areas and longitudinal analyses on 581 consistently defined zip codes over six years (1995–2000), relating place and population characteristics of these areas to rates of hospital discharges for amphetamine dependence/abuse using linear spatial models. Analyzing the data in two ways, spatial time series cross-sections and spatial difference models, amphetamine dependence/abuse were greatest in rural areas with more young low-income whites, larger numbers of retail and alcohol outlets, and smaller numbers of restaurants. Growth rates of these problems were greater in areas with higher income and larger non-White and Hispanic populations. This suggests that there was some change in the penetration of the methamphetamine epidemic into different population groups during this time. Study implications and limitations are discussed.     

Didactic and Experiential Education in Substance Abuse Programs

Medical model and social model programs both include client education as part of their service mandate, although the two models may define and accomplish the task of education differently. The role of education in substance abuse recovery has not been clear in either the treatment or recovery models. This paper therefore begins with a debate of the value of “educating” substance abuse clients, using several possible definitions of education and drawing upon a variety of theories from health education and community psychology. We divide these types of education into two broad definitional categories: knowledge acquisition and life skills development. Using data collected during a process evaluation at one medical and two social model programs, we provide examples of how knowledge acquisition and life skills development are accomplished at these sites. Analysis of the observational data pointed to two approaches to education, one didactic, the other experiential. All three sites used a didactic approach to knowledge about addiction. Only the social model sites used an experiential approach to convey knowledge and skills about recovery, and the development of life skills.     

Social Competence of Adolescents in Residential Substance Abuse Treatment

ABSTRACT

While substance use disorder (SUD) is a multifaceted problem stemming from both genetic and non-genetic factors, one of the factors that might influence substance use in adolescents is their ability to interact effectively and build healthy relationships with others. Social competence is both a protective factor against SUD and, in its deficiency, a risk factor for SUD. To explore the link between social competence and SUD, the current study aimed to measure the social competence of residents of a youth treatment center and to compare the results to those of a normed sample. Addiction counselors completed the Home and Community Social Behavior Scales (HCSBS) on 54 youths in residential addiction treatment. Results showed that males were significantly more likely than females to be in the “at risk” category for social competence and, in particular, for peer relations. Implications for treatment are discussed.     

A Longitudinal Comparison of Two Versions of an Interactive Multimedia Substance Abuse Education Program

Using a grant from the National Institute on Drug Abuse, The Missouri Institute of Mental Health produced a series of media tools designed to teach fourth-, fifth-, and sixth-grade children from African–American churches about the science of drug addiction. Beginning with a core curriculum, we created two separate interventions. In the SpaceScouts version of the program, the content is embedded within a narrative storyline delivered via an interactive DVD. In the LockerTalk version of the program, content is delivered in a more didactic form via an interactive CD-ROM. Youths from a dozen churches were randomly assigned to one of these two conditions or to a wait-list control. We conducted pretest, posttest, and four- and eight-month follow-up evaluations. We ran an additional sample of youths through our programs during a summer camp. Analyses of our programs revealed that students who received our interventions demonstrated some modest gains in knowledge. Specifically, students who viewed SpaceScouts demonstrated improvements from baseline on one of the three sub-modules at post-test. Students who viewed LockerTalk, however, showed greater overall mastery of the content as compared to the students who viewed SpaceScouts or were in the wait-list control condition.     

Drug-Abusing Homeless Clients in California's Substance Abuse Treatment System

Abstract

As many as one-half to three-fourths of homeless persons have diagnoses of alcohol or other drug dependence. Rates of alcohol and other drug use disorders, and the social costs associated with untreated substance disorder, are higher among homeless than nonhomeless persons. Despite the high level of need for treatment, relatively few substance-abusing homeless individuals receive treatment for their drug problems, suggesting difficulties in accessing treatment. This study addresses access by focusing on the select group of homeless drug users who have overcome barriers to enter the substance abuse treatment system in California and by examining differences between these homeless treatment clients and nonhomeless drug-using clients. Major findings from bivariate and logistic regression analyses performed on 187 homeless and 1,820 nonhomeless treatment clients are that homeless clients were more likely than nonhomeless clients to have a primary drug problem of cocaine/crack and to be injecting methamphetamine and other amphetamines, and that they were no less likely to complete their treatment program. An implication of this study is that homeless persons with primary drug problems appear to have no less commitment to achieving treatment goals than their nonhomeless counterparts.

     

Interdisciplinary Service-Learning Substance Abuse Projects

Abstract

The purpose of this paper is to describe the development and implementation of community-based, service-learning field projects by 30 health professional faculty fellows of Project MAINSTREAM, a faculty development program on substance abuse. The fellows worked together for two years in 10 Interdisciplinary Faculty Learning Groups (IFLGs), which consisted of three academics of different disciplines. The ten projects are viewed within the context of service-learning and are based on a balance between the provision of services to the community and furthering the learning objectives of Project MAINSTREAM.