Strategic Plan for Interdisciplinary Faculty Development: Arming the Nation’s Health Professional Workforce for a New Approach to Substance Use Disorders Edited by MARY R. HAACK, PHD, RN, FAAN HOOVER ADGER, JR., MD, MPH Association for Medical Education and Research in Substance Abuse (AMERSA) 125 Whipple Street, 3rd Floor Providence, Rhode Island 02908 For more information: AMERSA Telephone: 401-349-0000 Fax: 877-418-8769 Web Sites: www.amersa.org and www.projectmainstream.net This publication has been produced by the Association for Medical Education and Research in Substance Abuse under a Cooperative Agreement (HRSA-#U78HP00001) with the Bureau of Health Professions, Health Resources and Services Administration (HRSA), in collaboration with the Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration (SAMHSA). The conclusions and opinions expressed herein are those of the authors and do not necessarily represent the views and policies of HRSA or of SAMHSA. September 2002 TABLE OF CONTENTS Table of Contents............................................................................................................................................................iii Contributors ....................................................................................................................................................................v Acknowledgments .........................................................................................................................................................vii Letter from the President of the Association for Medical Education and Research in Substance Abuse............................. viii Letter from the Project Director ..................................................................................................................................... ix Foreword........................................................................................................................................................................ x Executive Summary ........................................................................................................................................................ 1 Mary R. Haack, PhD, RN, FAAN, and Hoover Adger, Jr., MD, MPH Part I: Evidence Supporting the Strategic Plan Chapter 1. Prevention of Alcohol and Drug Abuse: What Works? .................................................................................. 25 Karol L. Kumpfer, PhD Chapter 2. Screening, Assessment, and Intervention for Substance Use Disorders in General Health Care Settings ............................................................................................................................. 47 Michael F. Fleming, MD, MPH Chapter 3. Is Addiction an Illness? Can It Be Treated? ................................................................................................... 67 A. Thomas McLellan, PhD Chapter 4. Medicaid Reimbursement of Primary Care Providers for Treatment of Substance Use Disorders ..................... 95 Mary R. Haack, PhD, RN, FAAN, and Farrokh Alemi, PhD Chapter 5. Substance Abuse in Older Adults: Review and Recommendations for Education and Practice in Medical Settings ........................................................................................................................... 105 Kristen Lawton Barry, PhD, Frederic C. Blow, PhD, and David W. Oslin, MD Chapter 6. Substance Use Disorders in Children and Adolescents and the Impact on Children in Families Affected by Substance Use .................................................................................................................. 133 Hoover Adger, Jr., MD, MPH, and Michelle K. Leff, MD Chapter 7. Recognizing and Treating Dual Diagnosis in General Health Care Settings: Core Competencies and How to Achieve Them.................................................................................................... 143 Kathleen T. Brady, MD, PhD Chapter 8. Impairment Issues for Health Care Professionals: Review and Recommendations ........................................ 155 Martha E. Brown, MD, Alison M. Trinkoff, RN, ScD, FAAN, Arden G. Christen, DDS, MSD, MA, and Ernest J. Dole, PharmD, FASHP, BCPS, CDE Part II: Discipline-Specific Recommendations for Faculty Development Chapter 1. The Role of Allied Health Professionals in Substance Abuse Education ........................................................ 169 John A. Bonaguro, PhD, PT, Ernie Nalette, EdD, PT, and Mary Lee Seibert, EdD Chapter 2. Dental Education in the Prevention and Treatment of Substance Use Disorders........................................... 185 Arden G. Christen, DDS, MSD, MA, and Joan A. Christen, BGS, MS Chapter 3. The Physician’s Role in Caring for Patients with Substance Use Disorders: Implications for Medical Education and Training .................................................................................................. 207 David A. Fiellin, MD, Richard Butler, DO, Gail D’Onofrio, MD, Richard L. Brown, MD, MPH, and Patrick G. O’Connor, MD iii Chapter 4. The Role of Midwives in Caring for Women with Substance Use Disorders: Implications for Training .......... 223 Pat Paluzzi, CNM, DrPH, Nicole Deggins, CNM, MSN, Ellen Hutchins, MSW, ScD, and Patricia Burkhardt, CNM, DrPH Chapter 5. Substance Abuse Education for Nurse Practitioners in Primary Care ........................................................... 235 Elias Vasquez, PhD, NNP, FAAN, and Marie Eileen Onieal, MMHS, RN, CPNP Chapter 6. Nursing Education in the Prevention and Treatment of Substance Use Disorders ......................................... 247 Madeline A. Naegle, RN, PhD, FAAN Chapter 7. Recommendations for Implementing Effective Substance Abuse Education in Pharmacy Practice................. 263 Ernest J. Dole, PharmD, PhC, FASHP, BCPS, CDE, and Anthony Tommasello, PhD Chapter 8. Improving Physician Assistant Education and Practice in Substance Use Disorders and Policy Recommendations on Substance Abuse Education for Physician Assistants .................................................. 273 Catherine R. Judd, MS, PA-C, Roderick Hooker, PhD, PA, and Perri Morgan, MS, PA-C Chapter 9. Educating Psychologists about Substance Abuse ......................................................................................... 289 William R. Miller, PhD Chapter 10. Incorporating Substance Abuse Prevention into Public Health Curricula ................................................... 305 Christopher L. Ringwalt, DrPH, MSW Chapter 11. Educating Social Workers to Work with Individuals Affected by Substance Use Disorders .......................... 319 Shulamith Lala Ashenberg Straussner, DSW, CAS, CEAP, and Evan Senreich, CSW, ACSW, CASAC Appendixes Appendix A: Acronyms ............................................................................................................................................... 341 Appendix B: Glossary .................................................................................................................................................. 345 iv CONTRIBUTORS Hoover Adger, Jr., MD, MPH Arden G. Christen, DDS, MSD, MA Associate Professor Department of Oral Biology School of Medicine School of Dentistry Johns Hopkins University Indiana University Baltimore, MD Indianapolis, IN Farrokh Alemi, PhD Joan Christen, BGS, MS School of Nursing and Health Services Department of Oral Biology Management School of Dentistry George Mason University Indiana University Fairfax, VA Indianapolis, IN Kristen Lawton Barry, PhD Nicole M. Deggins, CNM, MSN, MPH Department of Psychiatry University of Mississippi Medical Center University of Michigan Lexington, MS Ann Arbor, MI Ernest J. Dole, PharmD, PHC, FASHP, Frederic C. Blow, PhD BCPS, CDE Department of Psychiatry Lovelace Health Systems University of Michigan College of Pharmacy Ann Arbor, MI University of New Mexico Health and Sciences Center John Bonaguro, PhD Albuquerque, NM School of Health Sciences and Human Performance David A. Fiellin, MD Ithaca College Department of Internal Medicine Ithaca, NY Yale University School of Medicine New Haven, CT Kathleen Brady, MD, PhD Department of Psychiatry Michael Fleming, MD, MPH Medical University of South Carolina Family Medicine Research Program Charleston, SC University of Wisconsin Madison, WI Martha Brown, MD USF Psychiatry Center Mary R. Haack, PhD, RN, FAAN University of South Florida Department of Behavioral and Community Tampa, FL 33613 Health Nursing School of Nursing Richard L. Brown, MD, MPH University of Maryland Department of Family Medicine Baltimore, MD University of Wisconsin Madison, WI Roderick Hooker, PhD, PA Department of Physician Assistant Studies Patricia Burkhardt, CNM, DrPH University of Texas Southwestern Division of Nursing Medical Center New York University Dallas, TX New York, NY Ellen Hutchins, ScD, MSW Richard Butler, DO Women’s Health Branch Michigan State University College of Division of Perinatal Systems and Women’s Osteopathic Medicine Health Madison Heights, MI Maternal and Child Health Bureau Health Resources and Services Administration Rockville, MD v Catherine Judd, PA-C, MS David Oslin, MD Department of Physician Assistant Studies Department of Psychiatry University of Texas Allied Health Sciences University of Pennsylvania School Philadelphia, PA Desoto, TX Gail D’Onofrio, MD Karol Kumpfer, PhD Section of Emergency Medicine Department of Health Education Yale University University of Utah New Haven, CT Salt Lake City, UT Pat