Ending the War on People with Substance Use Disorders in Health Care

Dineen, Kelly K.; Pendo, Elizabeth

doi:10.1080/15265161.2021.1891353

Cited by 5 publications

(3 citation statements)

References 10 publications

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“…In reviewing the HRES framework, foundational content topics we encourage programs to dedicate curricular time to include harm reduction theory & NHRC principles, historical context on the War on Drugs and United States’ drug policy [ 80 , 81 ], knowledge of the evidence-based efficacy of harm reduction (e.g., does not increase use or drug-related crime, promotes community safety, increases treatment engagement) [ 82 , 83 ], and the Hawk et al values that support integration of harm reduction into trainees’ bedside manner and care-plans [ 14 ]. These foundations will emphasize the importance of implementing known clinical strategies as tools of harm reduction such as providing HIV & HCV testing/immunizations/treatment [ 84 – 86 ], PrEP & PEP [ 87 ], and low-threshold MOUD [ 88 ], using a trauma-informed approach to care [ 89 ], and addressing the social and structural determinants of health that impact our patients on an individual level (e.g., Housing First models) [ 90 , 91 ].…”

Section: Discussionmentioning

confidence: 99%

Harm reduction in undergraduate and graduate medical education: a systematic scoping review

Smith,

Shah,

Adamczyk

et al. 2023

BMC Med Educ

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Background Substance use increasingly contributes to early morbidity and mortality, which necessitates greater preparation of the healthcare workforce to mitigate its harm. The purpose of this systematic scoping review is to: 1) review published curricula on harm reduction for substance use implemented by undergraduate (UME) and graduate medical education (GME) in the United States and Canada, 2) develop a framework to describe a comprehensive approach to harm reduction medical education, and 3) propose additional content topics for future consideration. Methods PubMed, Scopus, ERIC: Education Resources Information Center (Ovid), and MedEdPORTAL were searched. Studies included any English language curricula about harm reduction within UME or GME in the United States or Canada from 1993 until Nov 22, 2021. Two authors independently reviewed and screened records for data extraction. Data were analyzed on trainee population, curricula objectives, format, content, and evaluation. Results Twenty-three articles describing 19 distinct educational programs across the United States were included in the final sample, most of which created their own curricula (n = 17). Data on educational content were categorized by content and approach. Most programs (85%) focused on introductory substance use knowledge and skills without an understanding of harm reduction principles. Based on our synthesis of the educational content in these curricula, we iteratively developed a Harm Reduction Educational Spectrum (HRES) framework to describe curricula and identified 17 discrete content topics grouped into 6 themes based on their reliance on harm reduction principles. Conclusions Harm reduction is under-represented in published medical curricula. Because the drug supply market changes rapidly, the content of medical curricula may be quickly outmoded thus curricula that include foundational knowledge of harm reduction principles may be more enduring. Students should be grounded in harm reduction principles to develop the advanced skills necessary to reduce the physical harm associated with drugs while still simultaneously recognizing the possibility of patients’ ongoing substance use. We present the Harm Reduction Educational Spectrum as a new framework to guide future healthcare workforce development and to ultimately provide the highest-quality care for patients who use drugs.

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Section: Discussionmentioning

confidence: 99%

Harm reduction in undergraduate and graduate medical education: a systematic scoping review

Smith,

Shah,

Adamczyk

et al. 2023

BMC Med Educ

View full text Add to dashboard Cite

show abstract

“…We do not make such a case in the associated article. Yet, as Dineen and Pendo (2021) demonstrate in their commentary on the mistreatment of people with substance use disorders in health care, there is evidence to support such a case.…”

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confidence: 99%

“…With a view to equitably improving health outcomes for all individuals and communities regardless of race, del Pozo et al suggest that police discretion should be guided by a "public health ethic." In turn, Dineen and Pendo (2021) acknowledge that pernicious exceptionalism toward the regulation of medical treatment for addiction-together with practices and policies shaped by racist narratives and the construction of drug use as deviant-contribute to the substandard and discriminatory care of people with substance use disorders. Such exceptionalism also contributes to long-term vulnerabilities in relation to employment, housing, and service access.…”

mentioning

confidence: 99%