Announcing AADPRT’s Presidential Taskforce on Addictions Training “To better meet the nation’s mental healthcare needs, the mission of the American Association of Directors of Psychiatric Residency Training [AADPRT] is to promote excellence in the education and training of future psychiatrists.” The United States is in a public health crisis due to addictios: The media reports rising rates of overdose deaths across the country and mortality in middle-aged white males has increased. Marijuana is being legalized in many states despite its potential impact on the developing adolescent brain and role as a gateway drug (https://www.aacap.org/aacap/Policy_Statements/2014/aacap_marijuana_legalization_policy.aspx).
The “dark net,” bitcoin and other technological innovations facilitate drug purchasing online by any-age user [http://www.newsbtc.com/2016/06/25/drug-sales-bitcoin-usage-dark-net-increase/]. Despite efficacious available treatments, about 90% of Americans with treatable Substance Use Disorders are not in treatment (SAMSHA 2011 https://www.samhsa.gov/data/sites/default/files/NSDUHNationalFindingsResults2010-web/2k10ResultsRev/NSDUHresultsRev2010.pdf).
While they have a critical role to play, subspecialists in addiction psychiatry are too few in number to cope with this crisis alone. Similarly, primary care physicians and addiction medicine specialists are crucial on the front lines to address the problem; however, for complex patients with psychiatric comorbidities, psychiatric care is needed both in an integrated/collaborative care model and in specialty care. Since 2001 ACGME has required general psychiatry residents to complete one month FTE of addictions training or addictions psychiatry; child psychiatry fellows have no specific requirement. Surveys of training programs indicate significant variability in the setting and timing of current addictions training [Shorter and Dermatis, 2012]. While experts suggest exposure to longitudinal treatment and witnessing recovery are ideal, many programs rely on acute settings. A recent survey found residents’ attitudes towards Substance Use Disorders actually worsened over the course of their training [Avery et al., 2016].
ENTER AADPRT’s new Addictions Training Taskforce. Initiated in March 2017, this taskforce will build on extraordinary efforts already underway by our colleagues in allied organizations: the American Psychiatric Association (with its Addiction Council and Council on Medical Education and Life-long Learning); the American Academy of Addiction Psychiatry; and the American Academy of Child and Adolescent Psychiatry (Substance Abuse and Addiction Committee). Expert members of these groups are developing guidelines and resources for addictions training, and helping us understand what knowledge, skills and attitudes psychiatry trainees need to acquire during training. What will the role of the AADPRT Taskforce be?
· To learn what training programs are currently doing in addictions training, and what they need in order to implement expert recommendations what optimal training should look like
· To develop a strategic plan for improving addictions training moving forward
· To provide a clearing-house for existing educational resources and a platform for disseminating them
· To develop educational modules that turn content into dynamic, interactive adult-learning sessions
· To offer “train the trainer” sessions at our Annual Meeting
· To suggest a developmental approach across training to the acquisition of milestones-based competencies that apply to addictions assessment and treatment
Ann Schwartz, MD, from Emory is chairing the task force, which has broad representation by size and type of program and geographic location. As AADPRT’s President, I welcome your ideas and suggestions for this effort to help improve addictions training in psychiatry and contribute to solving this crisis together.
sdejong@cha.harvard.edu REFERENCES
Avery J, Han BH Zerbo E et al. Psychiatry residents’ attitudes towards individuals with substance use disorders and schizophrenia. Am J Addict 2016; 25.
SAMSHA. Substance Abuse and Mental Health Services Administration, Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, SDUH Series H-41, HHS Publication No. (SMA) 11-4658.
Shorter D and Dematis H. Addiction training in general psychiatry training: A national survey. Subst Abus. 2012; 33:392-394.
AAP Bulletin – Summer 17, Page 3 of 7
