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Alcohol and Drug Abuse in Medical Education. INSTITUTION State Univ Doman RESUME ED 192 216 CG 014 672 AUTHOR Galanter, Marc. Ed. TITLE Alcohol and Drug Abuse in Medical Education. INSTITUTION State univ. of New York, Brooklyn., Downstate Medical Center.: Yeshiva univ.. Bronx, N.Y. Albert Einstein Coll. of Medicine. PONS AGENCY National Inst. on Drug Abuse (DBZW/PHS), Rockville, Md. REPORT NO ADM-79 -891 PUP EATS SO GRANT TO1-DA-00083: T01-CA-00197 NOTE 128p. AVAILABLE Pint superintendent of Documents, O.S. Government Printing Office, Washington, DC 20402 EDES PRICE mF01/FC06 Plus Postage. DESCRIPTORS *Alcohol Education: *Drug Abuse: *Drug Education: Higher Education: *Medical Education: medical School Faculty; Medical Services; *Physician Patient Relationship: Physicians: *social Responsibility: State cf the Art Reviews ABSTRACT This book presents the state of the art of American medical education in alcohol and drug abuse,and is the culmination of a four-year collaborative effort among the medicalschool faculty, of the Career Teacher Program in Alcohol and DrugAbuse. The first part contains reports, curricula, andsurvey data prepared for the medical education community, focusingon drug abuse and alcoholism teaching in medical/osteopathic schools, icourse on alcoholism for physicians, the Career Teacher Program andResource Handbook, and the role of substance abuse attitudes in_treatment.The second part is-- the proceedings of the NationalConference on Medical Education and Drug Abuse, November 1977. The conference sessionsaddress issues such as: (1) the physician's role in substance abuse treatment;(2) physicians' use of drugs and alcohol:(3) drug abuse questions on the National Board Examinations: and (4)an overview of the Career Teacher Program activities. (Author/HLM) * *s * * * * * * * * * * * * * * ** ***************** * * * * ** * * * * * * * * * * * * * * * * * * * * * * * *0 Reproductions supplied by EDRS are the best thatcan be made from the original document. ***************************************************************1 . -gl National Institute on Drug Abuse National Institute on Alcohol Abuse and Alcoholism Alcohol and Drug Abuse in Medical Education US OilIAMTMErav OF HEAtroc ADUCATION A WELFARE NATIONAL INSTITUTE OF AM AT ION THIS 00CUMINT HAS BEEN Reeao Outt0 IXACttY AS elECEIvED FROM THE IIIRS411400 CiaGANItAssolv °atom,- A flA16 IT POINTS vIEW OR opiAloAL STATED 00 NOT NECEssAaeLv SENT 00itittas NATIONAL INSTITUTE OF SOUCAT411A1 POSstIoN cla POLICY U.S. DEPARTMENT OF HEALTH, EDUCATION, AND WELFARE Public Health Service Alcohol, Drug Abuse, and Mental Health Administration 42 t, 2 Association for Medical Education and Research in Substance Abuse EXECUTIVE COMMITTEE MARC GALANYER, M.D. JOSEPH WESTERMEYER. M.D., Ph.D. President Secretary-Treasurer JOHN E, FRYER, M.D. ROBERT MILLMAN. M.D. Vice President JOHN N. CHAPPEL. M.D. SIDNEY H. SCHNOLL, M.D., Ph.D. JOHN SEVERINGHAUS. M.D. Career Teachers in Alcohol and Drug Abuse GEARY ALFORD, Ph.D. RONALD S. KRUG, Ph.D. RUDY ARREDONDO. Ed.D. LEON KU HS, M.D. ROLAND M. ATKINSON, M.D. JOSEPH LEVIN, Ed.D. JOSEPH M. BENFORADO, M.D. JEROME LEVY, Ph.D. KENNETH BLUM, Ph.D. KARIN MACK. M.D. LOUIS pozzErn, M.D. MARVIN MATTHEWS. M.D. ALAN BROWN, M.D. ROBERT MILLMAN, M.D. JOHN N. CHAPPEL M.D. JOHN MORGAN, M.D. THOMAS J, CROWLEY, M.D. JAMES O'BRIEN, Ph.D., M.D. DONALD I. DAVIS, M.D. PAUL PASCAROSA, M.D. DAVID EILAND, M.D. ROBERT), RHODES, Ph.D. WILLIAM E. FLYNN, M.D. JACK M, ROGERS, M.D. JOHN E. FRYER, M.D. HENRYIIROSETt, M.D. MARC GALANTIR, M.D. KENNETH S. RUSSELL, Ed.D. JULES GOLDEN, M.D. JOHN SEVERINGHAUS, M.D. JOHN S. GRIFFIN, Jr.. M.D. SIDNEY H. SCHNOLL M.D. ALYCE C. GULLATTEE M.D. CLAUDIO TORO, M, D, JAMES HALIKAS, M.D. GEORGE S. TYNER. M.D. ANDREW K. S. HO, Ph.D. LUCAS S. VAN ORDEN, M.D., Ph.D. GEORGE JACKSON, M.D. JOSEPH WESTERMEYER, M.D., Ph.D. KIM A. KEELEY, M.D. CHARLES L. WHITFIELD, M.D. KENNETH WILLIAMS. M.D. Career Teacher Centers STATE UNIVERSITY OF NEW YORK BAYLOR COLLEGE OF MEDICINE Downstate Medical Center BENJAMIN KISS1N, M, D, 0 JOSEPH SCHOOLAR. M.D., P".D. Director Director JOEL SOLOMON, M.D. ALEX POKORNY, M.D. Program Coordinator Program Codirector CHARLES BUCHWALD. Ph.D. Program Administrator 3 Alcohol and Drug Abuse in Medical Education Marc Galante,. M.D. Editor Department of Psychiatry Albert Einstein College of Medicine The Medical Career Tischer Program of The National institute on Drug Abuse end The National Institute on Alcohol Abuse end Alcoholism and The Association for Medical Education and Research in Substance Abuse National Institute on Drug Abuse National institute on Alcohol Abuse and Alcoholism 5600 Fishers Lane Rockville, Maryland 20857 The U.S. Oovernment does not endorse, favor,or disparage any specific product or commodity. Trade or proprietarynames appearing in this publication are used only because theyare considered essential in the con- text of the studies reported herein. This publication was written under grants 1101 DA00083 to the State University of New York, Downstate Medical Center, Brooklyn,N.Y., and 1101 DA 00197 to the Albert Einstein College of Medicine, Yeshiva Uniyersky, Bronx, N.Y. 5 DREW Publication No. (ADM) 79-891 Printed 1980 Per Isla by tha leperlataadene of Doemasata, 13.8, Clevanteene PrintingMoe Waa Marton. D.C. 80108 Editorial Board Charles Buchwald, Ph.D. Downstate Medical Center State University of New York John N. Chappel, M.D. University of Nevada Thomas J. Crowley, M.D. University of Colorado Donald I. Davis, M.D. George Washington University John B. Griffin, Jr., M.D. Emory University George Jackson, M.D. Mount Sinai School of Medicine Alex Pokorny, M.D. Baylor College of Medicine Sidney H. Schnoll, M.D., Ph.D. Eagleville Hospital John Severinghaus, M.D. Columbia University Joel Solomon, M.D. Downstate Medical Center State University ofNewYork iii6 Foreword A systematic and intensive study of medical education in alcohol and drug abuse is relatively new. As national awareness of the medical problems resulting from alcoholism and drug abuse has grown during thiPut decade, medical educators, practicing physicians, treatment pro- gram staffs, clients in treatment, and others have drawn attention to the need for training physicians to recognize, diagnose, treat, and properly manage patients with substance abuse problems. With the establishment of the National Institute on Alcohol Abuse and Alcoholism and the National Institute on Drug Abuse, a career teacher program was developed. The purposes of the program have been to educate medical school faculty for a teaching career in drug abuse and alcoholism and to develop medical school curriculums in the field. A significant indication of the growing interest in medical education in substance abuse has been the formation, by career teachers and colleagues from their medical schools, of the Association for Medical Education and Research In Substance Abuse (AMERS A). This volume is the first of a series of publications in which career teachers and members of AMERS A will collaborate. It is offered to the medical educator in the hope that it will be a valuable resource In considering some of the issues involved in preparing physicians to treat drug or alcohol patients and their families. James F. Callahan Jeanne Trimble Deputy Chief Assistant Chief Manpower and Training Branch Paining Branch Division of Resource Development Division of Resource Development National Institute on Drug Abuse National Institute on Alcohol Abuse and Alcoholism y L. 7 v . CONTENTS FOREWORD v INTRODUCTION: A PERSPECTIVE ON ALCOHOL AND DRUG ABUSE IN MEDICAL EDUCATION Mare Ga/anter 1 THE STATE OF THE ART 1. DRUG ABUSE AND ALCOHOLISM TEACHING IN U.S. MEDICAL AND OSTEOPATHIC SCHOOLS. 1975-77 Alex Pokorny, Patsy Putnam, and John E. Fryer 7 2. MEDICAL EDUCATION IN ALCOHOL AND DRUG ABUSE: THE CAREER TEACHER PROGRAM Mare Ga/anter 20 CURRICULUM MATERIAL 3. PHYSICIAN EDUCATION IN SUBSTANCE ABUSE: CURRICULUM OBJECTIVES Donald ! Davis 27 4, A COURSE ON ALCOHOLISM FOR PRIMARY CARE PHYSICIANS George Jackson 34 S. THE CAREER TEACHER RESOURCE HANDBOOK Charles Buchwald 40 EVALUATION TECHNIQUES 6. SUBSTANCE ABUSE ATTITUDES: THEIR ROLE AND ASSESSMENT IN MEDICAL EDUCATION AND TREATMENT John N. Chappel and Ronald S. Krug 49 7,EVALUATION OF KNOWLEDGE IN SUBSTANCE ABUSE Alex Pokorny, Ronald S. Krug, David Smith, John B. Griffin, and Kenneth S. Russell 58 J u. mu8 PROCEEDINGS OF THE NATIONAL CONFERENCE ON MEDICAL EDUCATION IN ALCOHOL AND DRUG ABUSE Jointly sponsored by the Association for Medical Education and Research in Substance Abuse and the Career Teacher Program in Alcohol and Drug Abuse (A DAMHA) November 5-6. 1977. Washington. D.C. OPENING REMARKS Marc Galante 75 KEYNOTE ADDRESS Ernest Noble 77 DEBATING THE ISSUES I: THE ROLE OF THE PHYSICIAN IN SUBSTANCE ABUSE TREATMENT Frank Seixas. Moderator 83 SHOULD ALL PHYSICIANS BE 'TRAINED TO TREAT ALCOHOL AND DRUG ABUSE? InFavor: Benjamin gissin 85 Against: E.Mansell Paulson 88 DEBATING THE ISSUES 2: PHYSICIANS' USE OF ALCOHOL AND DRUGS: IMPLICATIONS FOR MEDICAL EDUCATION Sidney Cohen.Moderator 93 HAS MEDICAL EDUCATION FOCUSED TOO MUCH ON THE ADVERSE CONSEQUENCES OF THE NONMEDICAL. USE OF PSYCHOACTIVE AGENTS? In Favor:Norman Zinberg 95 Against:LeClair Bissell 97 AMERICAN MEDICAL EDUCATION IN ALCOHOL AND DRUG ABUSE: THE STATE OF THE ART REPORT ON A NATIONAL SURVEY Results of the Survey Alex Pokorny 105 Report on the SheVisits John E. Fryer . 109 THE NATIONAL BOARD EXAMINATIONS SUBSTANCE ABUSE QUESTIONS ON THE NATIONAL BOARDS Introduction John B. Griffin 113 Report on Substance Abuse Questions on the National Boards David Smith 114 9 viii EDUCATIONAL ACTIVITIES OF THE CAREER TEACHERS Joseph Schoo lar, Moderator 119 A DEAN'S PERSPECTIVE George S. Tyner 121 DATA ON STUDENT ATTITUDES John N. Choppel 123 CURRENT FINDINGS ON STUDENT ATTITUDES Ronald S. Krug 123 OLD DOGS AND NEW TRICKS John E. Fryer 125 BIOBEHAVIORAL STUDIES IN SUBSTANCE ABUSE Thomas J. Crowley 128 AA AND THE PHYSICIAN Kenneth Williams 130 .!Ix 10 Introduction: A Perspective on Alcohol and Drug Abuse in Medical Education Marc Galanter, M.D.
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