The Interface between Substance Abuse and Chronic Pain Management in Primary Care: A Curriculum for Medical Residents

Objectives: To develop and assess a housestaff curriculum on opioid and other substance abuse among patients with chronic noncancer pain (CNCP). Methods: The two-hour, case-based curriculum delivered to small groups of medical housestaff sought to improve assessment and management of opioid-treated CNCP patients, including those with a substance use disorder. A two-page pre-post survey was administered to assess self-efficacy change on a scale from 1 (strongly disagree) to 5 (strongly agree). Results: Of 47/50 (94%) respondents, self-efficacy significantly improved across all items (mean pre vs. post ratings, P less than 0.001). Housestaff were more prepared to manage patients on chronic opioid medication (2.8 vs. 3.8), including those with substance use disorders (2.3 vs. 3.4). They felt more prepared to identify opioid dependence (2.8 vs. 3.9) and overall rated the curriculum favorably (4.2). Conclusions: The brief curriculum was well received and appears effective. Further study is needed to determine practice impact. (Contains 4 tables and 8 online resources.)