Characterizing the Impact of Clinical Exposure to Patients with Opioid Use Disorder on Medical Students’ Perceptions of Stigma and Patient Care

Liu, Ewen; Moumen, Mohammed; Goforth, Jon; Keating, Michelle; Hsu, Fang‐Chi; Douglas, Heather; Oliver, J. H.; Strowd, Roy E.

doi:10.1080/10401334.2022.2038175

Cited by 2 publications

(4 citation statements)

References 17 publications

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“…111,112 Instead, the best care for these patients may be achieved with empathy and understanding, and such care may be encouraged through early influential encounters with OUD patients during medical training. 113 An emphasis on the overall psychosocial well-being of the patient, rather than the simple absence of symptoms, promotes comprehensive treatment of OUD.…”

Section: Next Stepsmentioning

confidence: 99%

At a Crossroads: Opioid Use Disorder, the X-Waiver, and the Road Ahead

Dhillon,

Feulner,

Beitollahi

et al. 2024

TOJ

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Background: Buprenorphine/naloxone (Suboxone) is widely considered the first-line treatment for opioid use disorder (OUD), which causes significant morbidity and mortality in the United States, but prior to 2023, practitioners interested in prescribing buprenorphine/naloxone for OUD needed a special Drug Enforcement Administration certification (the X-Waiver) that imposed a patient cap and other limitations. The Consolidated Appropriations Act of 2023 considerably decreased the restrictions on prescribing practitioners. Buprenorphine/naloxone can now be prescribed like any other prescription opioid, excluding methadone. The historic context for the opioid crisis, OUD, the X-Waiver, and additional initiatives that may be needed beyond legislative change to effectively address OUD are the subjects of this review. Methods: To develop this review of the opioid crisis, OUD, and OUD treatment, we conducted a literature search of the PubMed database and constructed a timeline of the opioid crisis and changes in OUD treatment, specifically the X-Waiver, to characterize the historic context of OUD and the X-Waiver against the background of the opioid crisis. Results:The opioid crisis has had pervasive public health and economic impacts in the United States. Major changes to the treatment of OUD have occurred as a result of the Drug Addiction Treatment Act of 2000 that imposed the X-Waiver and the Consolidated Appropriations Act of 2023 that repealed the X-Waiver. Conclusion:The repeal of the X-Waiver is predicted to increase the accessibility of buprenorphine/naloxone in the United States. However, additional work beyond legislative change, including institutional support and reduction of stigma and disparities, is needed to substantially improve outcomes for OUD patients.

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Section: Next Stepsmentioning

confidence: 99%

At a Crossroads: Opioid Use Disorder, the X-Waiver, and the Road Ahead

Dhillon,

Feulner,

Beitollahi

et al. 2024

TOJ

View full text Add to dashboard Cite

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“…Similarly, individuals with substance use disorders (SUDs) experience considerable amounts of stigma and campaigns to increase empathy have been an important strategy in helping to address this epidemic. [12][13][14] Recognizing these concerns, we sought to provide programming to help build empathy in future medical care trainees and reduce stigma toward patients living with HIV/HCV and many of the other comorbidities that these individuals often experience SUDs, mental illness, trauma, and other challenges. In October, 2013 Johns Hopkins Center for AIDS Research launched the Generation Tomorrow (GT) program to increase HIV and HCV awareness/detection in Baltimore and engage the next generation of health professionals (students) and community members (peers) in HIV and HCV outreach services.…”

Section: Introductionmentioning

confidence: 99%

“…Indeed, empathy is an essential consideration for medical care, particularly for communities that face disproportionate levels of stigma and discrimination. Individuals living with HIV and hepatitis C (HCV), which exemplify preventable and treatable diseases that disproportionately affect racial and ethnic minority groups, 12 are an important example. Recent evidence suggests that nonjudgmental, empathetic care may increase treatment adherence for patients living with HIV and HCV.…”

Section: Introductionmentioning

confidence: 99%

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Addressing Stigma by Increasing Empathy Toward Vulnerable Populations in Preprofessional Trainees: Impacts of the Generation Tomorrow Summer Health Disparities Scholars Program

Antoine,

Manogue,

Blue

et al. 2023

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background: Creating empathetic health care professionals is critical to addressing the health equity challenges of today, particularly because it relates to vulnerable populations. Methods: To assess the impact of the Johns Hopkins Center for AIDS Research Generation Tomorrow Summer Health Disparities Scholars (GTSHDS) program on students' empathy toward individuals living with substance use disorder and differential impact on empathy related to the COVID-19 pandemic, the Attitudes towards Mental Illness Questionnaire (AMIQ), an assessment of stigmatizing attitudes, was administered. Preprogram and postprogram participation AMIQ survey data were compared using paired t tests to explore changes within the program year. Unpaired t tests were used to characterize differences between the mean scores across the 2 student cohorts. Results: Both GTSHDS cohorts displayed postprogram increase in empathy. Mean 2019 cohort AMIQ scores shifting from −1.4 (SD 2.01) to −0.8 (SD 2.35) (P = 0.54), and the 2022 cohort shifting from −3.67 (SD 2.01) to −3 (SD 1.61) (P = 0.79). On average, individual scores improved by 2.2 (SD 1.65) points in the 2019 cohort and 2.4 (SD 1.86) points in the 2022 cohort (P = 0.83). Although these were not statistically significant, they suggested a trend toward more empathy. Conclusions: Preliminary data suggest that programs such as GTSHDS that expose students to various aspects of health care principles can prepare future health care professionals in a manner that may reduce health care disparities. Future research with larger population sizes is needed to understand the impacts of the curriculum on empathy and related concepts to achieving health equity.

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Characterizing the Impact of Clinical Exposure to Patients with Opioid Use Disorder on Medical Students’ Perceptions of Stigma and Patient Care

Cited by 2 publications

References 17 publications

At a Crossroads: Opioid Use Disorder, the X-Waiver, and the Road Ahead

At a Crossroads: Opioid Use Disorder, the X-Waiver, and the Road Ahead

Addressing Stigma by Increasing Empathy Toward Vulnerable Populations in Preprofessional Trainees: Impacts of the Generation Tomorrow Summer Health Disparities Scholars Program

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