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Substance Use Disorders in Primary Care

Competencies
  • General




    General
    • Course Registration Questionnaire
    • Pre-Test Quiz
    • Peer Corner Forum
  • How to create an account and enroll in the course?

     

     

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      Welcome to Substance Use Disorders in Primary Care (SUDPC). The SUDPC course provides an introduction to the prevention, screening, and treatment (medication, risk of interactions with substances, psychological therapies) of substance use disorders related to alcohol, tobacco, and other drug use. The course also provides an introduction to the health consequences associated with substance use disorders and the links between substance use disorders and mental health disorders. Students will gain practical knowledge on how to communicate with patients, conduct a medical consultation to assess substance use disorders, monitor treatment effects, and decide when to refer their patients to specialized settings. The course uses various formats of learning resources (e.g., academic publications, health agencies recommendations, medical associations recommendations, and government guidelines), and its activities allow students to practice techniques with their local peers in hopes of reducing the prevalence and burden of substance use disorders.

      This SUDPC course is sponsored by the Africa Mental Health Foundation,  and the University of Florida. Like all NextGenU.org courses, it is competency-based, using competencies adapted from the WHO Mental Health Gap Action Programme (mhGAP) and learning resources from accredited, world-class organizations such as the National Institute on Drug Abuse, Substance Abuse and Mental Health Services Administration, and the World Health Organization.

      The course was initially co-developed by Veronic Clair, MD, MSc, CCFP, FRCPC; Sukhdeep Jassar, MPH; and Abednego Musau, MBChB. The course was redesigned and updated by Pablo Baldiviezo, MD, DiplEd; Carolina Bustillos, MD, DiplEd; Genikka Camille Gabral, B.ED, MSc; Magali Collonnaz, MD, MPH, MSc; Felix Emeka Anyiam, MPH, MScPH, DataSc.; Yhan O'Neil Williams, BSc, Ph.D.; Hugo Rojas, MD, MSc, DiplEd;

      For publications on NextGenU.org’s courses’ efficacy, see NextGenU.org’s publication page. Subscribe to our newsletter to be notified of future updates, new courses, and to be part of our community.

       There are six (6) modules to complete, which provide an introduction to: 

      1. Introduction to Substance Use Disorder Services in Primary Care
      2. Addressing Stigma and Protecting Human Rights
      3. Substance Use Disorders and Primary Health Care
      4. Using the ASSIST Package for the Assessment and Brief Intervention for Substance Use
      5. Monitoring, Follow-Up, Comorbidities, and General Well-Being
      6. Communication with People Seeking Care, Their Caregivers and Family

      The completion time for this course is estimated at 148 hours, comprising 28 hours of learning resources, 56 hours of studying and assimilating content, and 64 hours of participating in learning activities and quizzes, to assist the learners in the synthesis of learning materials. This course is equivalent to 3 credit hours.

      The course requires completion of Discussion Forums and Peer Activities. At the end of each module, there is a practice quiz of ten (10) multiple-choice questions. After you’ve completed each module, quiz, and learning activity, at the end of the course, you’ll have access to a final exam consisting of fifty (50) multiple-choice questions and a chance to evaluate this course. Participants have up to three opportunities to take the final exam and achieve the required score of >=70%.

      Once you’ve passed the last test, you will be able to download a certificate of completion from NextGenU.org and our course’s co-sponsoring organizations. We keep your personal information confidential, never sell any of your information, and only use anonymized data for research purposes. Also, we are happy to report your testing information and share your work with anyone (your school, employer, etc.) at your request. 

      Engaging with this Course:

      You may browse this course for free to learn for your personal enrichment; there are no requirements. To register for this course, it is a requirement that learners have a college-level/bachelor's degree.

      To obtain a certificate, a learner must first register for the course and then successfully complete:
      • Pre-test,
      • All the reading requirements,
      • All quizzes and pass with a 70% with unlimited attempts,
      • All peer activities,
      • All discussion forums,
      • The final exam with a minimum of 70% and a maximum of 3 attempts, and
      • The self and course evaluation forms.

      To obtain credit:
      • Complete all requirements listed above for the certificate, and
      • Your learning institution or workplace should approve the partner-university-sponsored NextGenU.org course for educational credit, as they would for their learner taking a course anywhere.

      NextGenU.org is happy to provide your institution with:
      • A link to and description of the course training, so they can see all its components, including the co-sponsoring universities and other professional organization co-sponsors,
      • Your grade on the final exam,
      • Your work products (e.g., case study activities) and any other required or optional shared materials that you produce and authorize to share with them,
      • Your evaluations -- course, self-assessments, and
      • A copy of your certificate of completion, with the co-sponsoring universities and other organizations listed.

      To obtain a degree, NextGenU.org co-sponsors degree programs with institutional partners. To obtain a full degree co-sponsored with NextGenU.org, registrants must be enrolled in a degree program as a student of a NextGenU.org institutional partner. If you think your institution might be interested in offering a degree with NextGenU.org, contact us.

      We hope you will find this a rewarding learning experience, and we count on your assessment and feedback to help us improve this training for future students.

      Here are the next steps to take the course and earn a certificate.
      • Complete the registration form.
      • Take the pre-test.
      • Begin the course with Module 1: Introduction to Substance Use Disorder Services in Primary Care. In each lesson, read the description, complete all required readings and any required activity, and take the corresponding quizzes.

      This course meets nationally approved standards of education developed for the addiction/substance use disorders counseling profession. This course's participants are assured that the continuing education (CE) credits provided will be accepted toward national credentialing by the NAADAC Certification Commission for Addiction Professionals (NCC AP), as well as by many of the individual state licensing/certification bodies in the addiction and other helping professions.


      *The previous version of this course is not available for new registrations. Only students that were registered before can complete it.

      • Module 1: Introduction to Substance Use Disorder Services in Primary Care

        Competency covered in this module: 

        • Understand and be receptive to including mental health and substance use disorder services in primary care.
        • Module1: Lesson 1: General Information

          Learning Objective:
          Upon completion of this lesson, you will be able to:
          • Discuss how primary health care can be involved in lessening the burden of mental illness, including substance use disorders.
          • Define the concept of "task-shifting."
          • Describe the WHO mhGAP principles of care and priority conditions.
          • Summarize the science behind substance abuse and its possible effects on health and social functioning.
          Approximate time required for the readings for this lesson (at 144 words/minute): 10 hours and 19 minutes.

          Click here to start this lesson

          4 URLs, 1 Forum
          • Required Learning Resources and Activities
          • Mental Health in Primary Care: Illusion or Inclusion? URL

            Read the following sections: Executive summary (Page 1), The issue (Pages 4-5), Opportunities and challenges (Page 7), and Actions (Pages 2 and 9-10). (22 minutes)

            WHO - 2018

          • Task Sharing Approaches to Improve Mental Health Care in Rural and Other Low Resource Settings: A Systematic Review URL

            Read from the beginning of the article to the heading "Methods" (Pages 1-3). (5 minutes)

            Journal of rural health - 2019

          • mhGAP Intervention Guide. URL

            Read the preface (pg. iii), the introduction (pgs. 1-4), the module "Essential Care & Practice," (pgs. 5-14), and the "Overview of Priority MNS Conditions" (pgs 16-18) to understand the World Health Organization's recommendations on addressing mental, neurological and substance use disorders in primary care. (35 minutes)

            WHO - 2015

          • Drugs, Brains and Behavior: The Science of Addiction URL

            Read the manual titled "Drugs, Brains, and Behavior" from page 1 to the end of page 25, as this will be your foundation for understanding the science behind addiction and health. (41 minutes)

            NHI - 2020

          • Discussion Forum 1: General Principles of Care (300 minutes)

            In this activity, you will reflect on your workplace and explain how WHO mhGAP general principles of care and priority conditions can be integrated into your work’s specific settings.

            Step 1. Review

            Review the learning resources for this lesson, especially the mhGAP general principles.

            Step 2. Study

            Study the given scenario below:

            Scenario

            In a month, you will attend a meeting with regional health authorities to discuss the management of patients suffering from mental health in the region. The organizers have invited you to the meeting as a representative of primary care workers and tasked you with writing a report to document your workplace's monthly successes, challenges, conflicts, safety commendations, and best practices. You have also been asked to observe whether the mhGAP general principles of care have been integrated into the workplace as daily clinical practices and to discuss if the 7 priority conditions have been frequently observed in your daily clinical practice.

            Step 3. Respond

            Write a 200-600 word workplace observation report that details the following:

            • Period of observation
            • Relevant elements in a working environment or workplace
              (Examples: physical features, organizational culture, psychological and social support, safety, workload management, among others)

              • Description
              • Observational challenges/needs/conflicts
              • Successes/ Achievements
            • Discussion of Insights
              • Integration of the mhGAP general principles of care
                • How are these incorporated into the workplace?
                • How does the inclusion of these principles contribute to the successes or failures within the workplace?
              • Importance of the seven mental health priority conditions
                • Are all (or some of) the priority conditions frequent in your daily practice?
                • Why is each of the 7 priority conditions frequent among your patients? If some priority conditions are not frequent among your patients, despite being listed by the WHO, could you explain why?
              • Commendations and Recommendation

            Step 4: Share

            To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

            Step 5: Interact

            To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

          • Quiz: Module 1
            Restricted Not available unless:
            • The activity Course Registration is marked complete
            • The activity Pre-Test is marked complete

            To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to view the case studies and respond to the questions.

        • Module 2: Addressing Stigma and Protecting Human Rights

          Competency covered in this module: 

          • Being aware of and being able to address stigma promoting and protecting the human rights of those you serve.
          • Module 2: Lesson 1: Policies and Legislation

            Learning Objectives:
            Upon completion of this lesson, you will be able to:
            • Describe stigma and its potential impact, as well as the practical strategies to address it.
            • Describe how physician/clinician attitudes toward patients with substance use disorders can impact recognition, diagnosis, and treatment of patients.
            • Illustrate care that is free from discrimination on the basis of race, color, sex, language, religion, political or other opinions, nationality, ethnicity, indigenous or social origin, property, birth, age, or other status.
            • Discuss how to provide care in a way that respects the dignity of the person and is culturally sensitive and appropriate.
            • Discuss how to minimize stigma, marginalization, and discrimination, and promote the social inclusion of people with mental, neurological, and substance use disorders by fostering strong links with employment, educational, social (including housing), and other relevant sectors.
            Approximate time required for the readings for this lesson (at 144 words/minute): 10 hours and 57 minutes.

            Click here to start this lesson

            5 URLs, 1 Forum
            • Required Learning Resources and Activities
            • Mental Illness-related Stigma in Healthcare URL

              Read the entire paper. (18 minutes)

              Healthcare Management Forum - 2017

            • Patient Communication In Substance Abuse Disorders URL

              Read the entire paper. (10 minutes)

              StatPearls - 2021

            • Human Rights and Health URL

              Read the entire webpage. (14 minutes)

              WHO - 2017

            • mhGAP Intervention Guide. URL

              Under "Essential Care & Practice," read the sections "Use effective communication skills" and "Promote respect and dignity" in Module 1: Essentiel care and practice (pgs. 6-7). (4 minutes)

              WHO - 2015

            • Reducing the stigma of mental health disorders with a focus on low- and middle-income countries URL

              Read the entire paper. (33 minutes)

              Asian Journal of Psychiatry - 2021

            • Discussion Forum 2: A Petition Towards Equality and Inclusion (420 minutes)

              In this activity, you will write and create a petition letter promoting care that is free from discrimination, as well as equality and inclusion of people with mental, neurological, and substance use disorders.

              Step 1. Analyze

              Reflect on instances where stigma, marginalization, and discrimination are observed in the healthcare setting. To be more specific, analyze and list the following:

              • A documented account of discrimination in the healthcare setting in a region/location on any of the following bases:

                • Race, color, sex, language
                • Religion, political opinion, nationality, ethnicity, property, birth, age, social origin
              • A documented account of discrimination in the same region/location due to any of the following

                • Mental and neurological disorders
                • Substance use disorders
              • A personal account of discrimination experienced in the same region/location, if any

              Step 2. Write

              After analyzing and drafting, write a 200-600 word petition addressing two-three accounts of discrimination. To be specific, the petition letter must include the following details:

              58

              Step 3: Share

              To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

              Step 4: Interact

              To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

          • Module 2: Lesson 2: International and National Standards

            Learning Objectives:
            Upon completion of this lesson, you will be able to:
            • Explain international and national standards, legislation, and policies on mental health and human rights.
            • Demonstrate how to pay greater attention to the patient's right to privacy and confidentiality.
            • Demonstrate how a patient (or their designated decision-maker) is aware of the proposed therapy and has given their free and informed permission.
            Approximate time required for the readings for this lesson (at 144 words/minute): 11 hours and 13 minutes.

            Click here to start this lesson

            4 URLs, 1 Forum, 1 Quiz
            • Required Learning Resources and Activities
            • Mental Health and Human Rights in the 21st Century URL

              Read the entire article. This article will give you an overview of international considerations for mental health human rights, legislations, standards, and policies. (7 minutes)

              World Psychiatry - 2019

            • Principles for the Protection of Patient Privacy URL

              Read the entire article. (14 minutes)

              Canadian Medical Association - 2017

            • Consent: A Guide for Canadian Physicians URL

              Read the document to learn about consent. (60 minutes)

              The Canadian Medical Protective Association-Empowering better healthcare - 2021

            • Discussion Forum 3: On Patient Privacy and Informed Consent (420 minutes)

              In this activity, you will write dialogue about a case scenario on patients' right to privacy, confidentiality, and informed consent.

              Step 1. Analyze

              Study and analyze the given scenario below:

              Scenario

              A 21-year-old man presents to the outpatient detoxification and rehabilitation facility for opioid, nicotine, and alcohol detoxification. For this month, this patient has been using 30 bags of heroin intravenously, four 48-ounce cans of beer per week, and has smoked three packs of cigarettes per day. According to the patient, he only decided to seek medical attention because his girlfriend has reported him to the necessary authorities - which led to monitoring by a probation officer once a week. The patient requested for his case to remain confidential and private, but as his physician, you are worried about his state and are considering communicating with the family to arrange a probation treatment program instead of risking jail.

              Step 2. Write

              After studying the scenario, write a 200-500 word dialogue between the physician and the patient that will demonstrate the following:

              • How to respond to this situation taking into consideration the principles for the protection of patient privacy and confidentiality
              • How the patient (or their designated decision-maker) is aware of the proposed therapy 
              • When consent is needed or provided
              • What can be done in this scenario if the patient still does not give consent to share his medical information

              Note: Indicate clearly which parts of the dialogue are said by the physician and which parts are said by the patient. 

              Step 3: Share

              To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

              Step 4: Interact

              To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

            • Quiz: Module 2

              To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to view the case studies and respond to the questions.

            • Recommended Additional Readings
            • What “Informed Consent” Really Means URL

              Read the entire webpage. (10 minutes)

              Association of American Colleges - 2019

          • Module 3: Substance Use Disorders and Primary Health Care

            Competency covered in this module: 

            • Understand the various best practices for the medical management of tobacco, alcohol, and other substance use disorders in primary care.
            • Module 3: Lesson 1: Tobacco Specific Information and Approaches

              Learning Objectives:
              Upon completion of this lesson, you will be able to:
              • Discuss the effectiveness of tobacco cessation interventions.
              • Recognize quick, in-practice resources to support tobacco cessation interventions.
              • Describe the personal health disease risks (cardiovascular, respiratory, and cancer) associated with tobacco use.
              • Describe the general benefits of quitting smoking.
              • Discuss the symptoms of tobacco withdrawal and the methods of dealing with those symptoms.
              • Summarize the health consequences of involuntary (secondhand) exposure to tobacco smoke.
              • Describe the link between tobacco and Chronic Obstructive Pulmonary Disorder (COPD) and be familiar with best practices for the management of COPD.
              Approximate time required for the readings for this lesson (at 144 words/minute): 6 hours and 3 minutes.

              Click here to start this lesson

              9 URLs
              • Required Learning Resources and Activities
              • Quitting Tobacco URL

                In this resource titled "Quitting Tobacco," read the information in the table to learn about the effectiveness of smoking cessation interventions. (1 minute)

                WHO - 2020

              • When Primary Care Providers and Smokers Meet: A Systematic Review and Metasynthesis URL

                Read from the beginning of the article to the heading "Methods." (24 minutes)

                Nature - 2021

              • Clinical Cessation Tools URL

                Read the webpage and the first two PDF documents: "You Can Help Your Patients Quit Tobacco Use" and "A Practical Guide to Help Your Patients Quit Using Tobacco." (13 minutes)

                CDC - 2021

              • Health Effects of Cigarette Smoking URL

                Read the entire webpage titled "Health Effects of Cigarette Smoking" to learn more about the personal health risks of tobacco use. (6 minutes)

                CDC - 2021

              • Benefits of Quitting URL

                Watch the video and read the entire webpage. (8 minutes)

                CDC - 2020

              • Handling Nicotine Withdrawal and Triggers When You Decide To Quit Tobacco URL

                Read the entire webpage. (28 minutes)

                NIH - 2022

              • Health Effects of Secondhand Smoke URL

                Read this resource to learn more about the effects of secondhand smoke on the health of children. (5 minutes)

                CDC - 2020

              • Chronic Obstructive Pulmonary Disease (COPD): Diagnosis and Management URL

                This resource titled "Chronic Obstructive Pulmonary Disease (COPD)" provides you with another set of best practices in relation to COPD diagnosis and management. (36 minutes)

                BCGuidelines - 2017

              • Recommended Additional Readings
              • Tobacco Cessation Tools & Resources URL

                This webpage lists various smoking cessation tools and resources. In the section "Physician Resources and Tools," read the first document, "Tobacco and Nicotine Cessation Toolkit," and watch the video "Video: Mental Health Conditions and Cigarettes."
                Although not required, you can read any other resource from this webpage. (27 minutes)

                The American Academy of Family Physicians Foundation - 2020

            • Module 3: Lesson 2: General Approaches to Address Alcohol and Other Substance Use Disorders in Primary Care

              Learning Objectives:
              Upon completion of this lesson, you will be able to:
              • Describe the general approaches to address alcohol, tobacco, and other substance use in primary care.
              • Recognize the symptoms of acute intoxication for a substance and treat or refer accordingly.
              • Demonstrate how to take a thorough medical history, including the history of the presenting complaint(s), past history, and family history (as relevant), and know the red flags for substance use disorders.
              • Summarize the evidence-based model of brief intervention in primary care for other psychoactive substances.
              Approximate time required for the readings for this lesson (at 144 words/minute): 16 hours.

              Click here to start this lesson

              10 URLs, 1 Forum
              • Required Learning Resources and Activities
              • Primary Healthcare Approach to Substance Abuse Management URL

                Read the entire article. (13 minutes)

                South African Family Practice - 2021

              • Identification of and Treatment for Unhealthy Alcohol Use in Primary Care Settings URL

                Read the entire article. (8 minutes)

                American Academy of Family Physicians - 2019

              • mhGAP Intervention Guide for Mental, Neurological and Substance Use Disorders in Non-specialized Health settings: mental health Gap Action Programme (mhGAP) Version 2.0 URL

                In the "mhGAP Intervention Guide," review the section entitled "Disorders due to substance use" on pages 105 to 130. (51 minutes)

                WHO - 2015

              • TIP 45 Detoxification and Substance Abuse Treatment URL

                Read Chapter 2 "Settings, Levels of Care, and Patient Placement" (pages 11 to 21). (35 minutes)

                Substance Abuse and Mental Health Services Administration - 2018

              • Diagnosis and Treatment of Drug Abuse in Family Practice - American Family Physician Monograph URL

                Read the entire article plus the section "Drug Use Questionnaire." (10 minutes)

                National Institute of Drug abuse - 2018

              • Elements of the Psychiatric Assessment URL

                Read the entire article. (5 minutes)

                University of Nevada, Reno School of Medicine - 2016

              • Gathering Information About Substance Use URL

                Read the entire webpage. (5 minutes)

                Substance Abuse and Mental Health Services Administration - 2021

              • Red and Yellow Flag Behaviors for Substance Use Disorders URL

                Download the PDF and read the entire document. (1 minute)

                UMass Chan Medical School - 2019

              • The Asam Criteria Assessment Interview Guide URL

                Read the entire document. (35 minutes)

                American Society of Addiction Medicine - 2020

              • Brief Interventions for Alcohol and Other Drug Use URL

                Read the entire article. (17 minutes)

                Australian Prescriber - 2018

              • Peer Activity 1: Gathering Information about Substance Use (420 minutes) Forum

                In this activity, you will simulate a fictional consultation between a physician and a patient suffering from substance use disorders. 

                Step 1. Study

                Analyze and study the given scenario:

                You are the company doctor for the workplace, and for this week, a 30-year-old female employee is referred to you for consultation due to suspected substance use disorder. The immediate supervisor of the employee has presented an anecdotal report of her daily observations. From the anecdotal evidence, it appears that the employee’s colleagues have noticed erratic behavior, excessive mood swings, and loss of appetite almost every day without any notable reasons. One distinct description they have noticed is that the female employee has dilated pupils.

                Step 2. Draft

                Draft a screening form that will be used during the fictional consultation, and that will assess the following details:

                • Medical history of the patient
                  • Patient demographics 
                  • History of presenting complaints (i.e., use of the most frequent substances: tobacco, alcohol, cannabis, illicit drugs, misuse of prescription drugs…)
                  • Relevant past medical history
                  • Family history
                  • Allergies
                  • Social History
                • Physical symptoms suggesting substance use disorders
                • Red flags for substance use disorders

                Step 3. Simulate

                Administer the drafted screening form by simulating the fictional scenario to a friend (with consent) who will act as the patient or, in the absence of another person, simulate the fictional scenario by acting as the physician and, at the same time, the patient. Make a 3-5 minute audio recording of your simulation. Also, include in your simulation if the case addressed in the history presented red flags for substance use disorder. 

                Step 4. Share

                To share your audio recording, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                Step 5. Interact

                Evaluate and categorize the work from one of your peers based on items A - E of the rubric below. Provide a rationale for the grade you have provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as an example:

                Item A is  .…. because….  My suggestions for improvement are….
                Item B is  .…. because….  My suggestions for improvement are….
                Item C is  .…. because….  My suggestions for improvement are….
                Item D is  .…. because….  My suggestions for improvement are….
                Item E is  .…. because….  My suggestions for improvement are….

            • Module 3: Lesson 3: Alcohol Use Disorder Specific Information

              Learning Objectives:
              Upon completion of this lesson, you will be able to:
              • Describe the specific effects of alcohol on the overall health.
              • Describe the specific effects of alcohol on the liver.
              • Demonstrate how to assess the person for alcohol withdrawal symptoms and treat or refer accordingly.
              Approximate time required for the readings for this lesson (at 144 words/minute): 12 hours and 1 minute.

              Click here to start this lesson

              8 URLs, 1 Forum, 1 Quiz
              • Required Learning Resources and Activities
              • Alcohol-Related Health Conditions URL

                Read the entire webpage. (3 minutes)

                Health Promotion Agency - 2020

              • What Are the Effects of Alcohol? URL

                Read the entire webpage. (6 minutes)

                Australian Government Department of Health - 2021

              • Alcohol-Related Liver Disease URL

                Read the entire webpage and the video titled: "Video: liver disease." (10 minutes)

                NHS - 2021

              • Alcohol-Associated Liver Disease: A Review on its Pathophysiology, Diagnosis and Drug Therapy URL

                Read the "Introduction" and "Alcohol consumption and ALD" sections. (8 minutes)

                Elsevier B.V. - 2021

              • Clinical Practice Guideline on Alcohol Withdrawal Management URL

                Read the summary of recommendations (pp. 4-15), stop at the Introduction. (55 minutes)

                The American Society of Addiction Medicine - 2020

              • Clinical Institute Withdrawal Assessment of Alcohol Scale - Revised (CIWA-Ar) URL

                Download the document and read the entire scale. (5 minutes)

                Insight - 2019

              • Evaluation of the Course and Treatment of Alcohol Withdrawal Syndrome with the Clinical Institute Withdrawal Assessment for Alcohol – Revised: A Systematic Review-Based Meta-analysis URL

                Read the abstract and the introduction (pages 1 and 2). (10 minutes)

                Drug and Alcohol Dependence - 2021

              • Discussion Forum 4: Assessing Severity of Alcohol Withdrawal Symptoms (420 minutes)

                In this activity, you will assess the severity of the alcohol withdrawal symptoms presented by three different patients and suggest which patients need treatment or referral.

                Step 1. Review

                Review the learning resources for this lesson.

                Step 2. Study

                Study and analyze the three patient cases of alcohol withdrawal below:

                18

                Step 3. Assess

                Assess which among Patients A, B, and C need/s immediate medical attention and treatment and which need/s referral using a formulated criteria based on the standard criteria of the Clinical Institute Withdrawal Assessment of Alcohol Scale.

                Step 4. Respond

                Write a 200-500 word assessment summary of your findings for Patients A, B, and C with the following inclusions:

                • Rank Patients A, B, and C based on the severity of alcohol withdrawal symptoms
                • Propose referral or treatment for each patient, specify which patient/s, if any, need/s immediate medical attention
                • Justify the ranking, referral, and treatment proposals
                • Include other recommendations for assessment and treatment options

                Step 5: Share

                To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                Step 6: Interact

                To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

              • Quiz: Module 3

                To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to view the case studies and respond to the questions.

              • Recommended Additional Readings
              • Alcohol Use Disorder and Depressive Disorders URL

                Read the entire article. (26 minutes)

                Alcohol Research - 2019

            • Module 4: Using the ASSIST Package for the Assessment and Brief Intervention for Substance Use

              Competency covered in this module: 

              • Understand how to effectively screen for substance use disorders using the ASSIST package.
              • Be able to deliver an effective brief intervention to address substance abuse.
              • Module 4: Lesson 1: Ability to Screen Effectively and Quickly for Substance Use Disorders

                Learning Objective:
                Upon completion of this lesson, you will be able to:
                • Demonstrate the skills necessary to screen for substance disorders using the ASSIST Screening Tool.
                • Recognize the skills required for addiction prevention counseling.
                • Demonstrate the skills that help set respectful limits on patient requests for prescription medication.
                • Demonstrate how to clearly and supportively recommend treatment to patients with substance use disorders.
                • Demonstrate the skills for evaluating a patient’s stage of change, readiness to accept the diagnosis, and readiness to undertake behavior change.
                Approximate time required for the readings for this lesson (at 144 words/minute): 13 hours and 49 minutes.

                Click here to start this lesson

                7 URLs, 1 Forum, 1 Quiz
                • Required Learning Resources and Activities
                • How to Use the ASSIST-Lite Screening Tool to Identify Alcohol and Drug Use and Tobacco Smoking URL

                  Read-only the section "How to use the ASSIST-Lite tool: a step-by-step guide." (25 minutes)

                  Public health England - 2021

                • Addiction Counseling Competencies: The Addiction Counseling Competencies The Knowledge, Skills, and Attitudes of Professional Practice URL

                  Read section 2 "The Eight Practice Dimensions of Addiction Counselling" on pages 35 to 48. (20 minutes)

                  Substance Abuse and Mental Health Services Administration - 2019

                • Prescribing Drugs of Dependence in General Practice, Part C1 URL

                  Read the section "Key principles for appropriate opioid prescribing in general practice" on page 1, the section "Clinical governance - 2.1 Patient focus" on pages 13 to 15, and the section "2.4 Accountable prescribing of opioids in general practice" on pages 21 to 23. (18 minutes)

                  The Royal Australian College of General Practitioners - 2019

                • Treatment Approaches for Drug Addiction URL

                  Read the entire webpage. (15 minutes)

                  US Department of Health and Human Services - 2019

                • Brief Intervention in Substance Use Disorders URL

                  Read the entire article. (29 minutes)

                  US National Library of Medicine - 2018

                • University of Rhode Island Change Assessment URL

                  Read the entire webpage on the URICA tool, which can be used to assess the stage of change. (6 minutes)

                  University of Rhide ISland

                • Peer Activity 2: Familiarizing with ASSIST Screening Tool and Treatment Approaches for Substance Use Disorders (480 minutes) Forum

                  In this activity, you will role-play (audio only) a practice interview using the ASSIST Screening Tool between a physician and a patient suffering from substance use disorders and discuss treatment approaches suitable for the patient.

                  Step 1. Review

                  Review how to use the ASSIST Screening Tool from the learning resources of this lesson.

                  Step 2. Prepare

                  Prepare the following prior to the role-play:

                  • The ASSIST-Lite form for general healthcare services (You can download the tool here: https://www.gov.uk/government/publications/assist-lite-screening-tool-how-to-use)
                  • The patient actor (ask a friend or a person to play as the patient suffering from a substance use problem)
                  • The environment where the role-play interview will be simulated
                    • This can be an audio recorded face-to-face interview or an audio-recorded virtual interview via Zoom/Skype/Microsoft Teams, etc.

                  Note: This should be a fictional interview. To respect privacy and confidentiality principles, do not record an interview with one of your actual patients.

                  Step 3. Record

                  Record a 3-5 minute audio demonstrating the role-playing of how to administer the ASSIST Screening Tool to the patient actor, your interpretation of the scores obtained by the patient actor, and your proposed actions/treatments. Make sure that the following will also be demonstrated in the video recording:

                  • Skills needed/required to screen for substance disorders using the ASSIST Screening Tool
                  • Correct administration of ASSIST Screening Tool
                  • Correct interpretation of the ASSIST Screening Tool scores
                  • Skills needed/required to set respectful limits on prescribing medication and drugs of dependence to the patient
                  • Skills needed/required to have clear and supportive recommendations on treatment options applicable to patients with substance use disorders

                  Step 4. Share

                  To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                  Step 5. Interact

                  Evaluate and categorize the work from one of your peers based on items A - E of the rubric below. Provide a rationale for the grade you have provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as an example:

                  Item A is  .…. because….  My suggestions for improvement are….
                  Item B is  .…. because….  My suggestions for improvement are….
                  Item C is  .…. because….  My suggestions for improvement are….
                  Item D is  .…. because….  My suggestions for improvement are….
                  Item E is  .…. because….  My suggestions for improvement are….

                • Quiz: Module 4

                  To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to view the case studies and respond to the questions.

                • Recommended Additional Readings
                • Enhancing Motivation for Change in Substance Use Disorder Treatment URL

                  Read Chapter 1 "A New Look at Motivation" from pages 1 to 16, and Chapter 2 "Motivational Counseling and Brief Intervention" from page 17 to page 25. Although not required, you can read the remaining content of chapter 2 from page 26 to page 33. (79 minutes)

                  Substance Abuse and Mental Health Services Administration - 2019

              • Module 5: Monitoring, Follow-Up, Comorbidities, and General Well-Being

                Competency covered in this module: 

                • Be able to provide general care, monitoring, and follow-up, taking into consideration general health status, common comorbidities, and issues faced by those with substance use disorders.
                • Understand comorbidities associated with alcohol abuse, including HIV, depression, psychosis, and reproduction implications such as fetal alcohol spectrum disorders.
                • Address special reproductive health issues for women using substances or receiving pharmacological treatments for comorbidities.
                • Understand the importance of promoting healthy lifestyles and the general well-being of those with substance use disorders and/or mental health conditions.
                • Module 5: Lesson 1: Mental Health Comorbidities

                  Learning Objectives:
                  Upon completion of this lesson, you will be able to:
                  • Distinguish the link between various mental health conditions and substance use disorders.
                  • Recognize evidence of SEVERE self-injury such as signs of poisoning or intoxication or signs/symptoms requiring urgent medical treatment such as bleeding from a self-inflicted wound, loss of consciousness, or extreme lethargy.
                  • Explain how to maintain regular contact and follow-up with patients as needed.
                  • Explain how to identify and manage depression in all who have a tobacco, alcohol, or other substance use disorder.
                  • Explain how and when to ask patients for self-harm or suicidal thoughts and how to offer psychosocial support.
                  • Discuss how to offer psychosocial support to patients with self-harm and suicidal thoughts.
                  Approximate time required for the readings for this lesson (at 144 words/minute): 12 hours and 24 minutes.

                  Click here to start this lesson

                  9 URLs, 1 Forum
                  • Required Learning Resources and Activities
                  • Why is There Comorbidity Between Substance use Disorders and Mental Illnesses? URL

                    Read the entire article. (15 minutes)

                    National Institute on Drug Abuse - 2020

                  • mhGAP Intervention Guide: For Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings v2.0 URL

                    Read the sections on self-harm and suicide (pgs. 131-140). (13 minutes)

                    WHO - 2015

                  • Patient Communication in Substance Abuse Disorders URL

                    Read the entire article. (10 minutes)

                    National Center for Biotechnology Information, US National Library of Medicine - 2021

                  • mhGAP Intervention Guide: For Mental, Neurological and Substance Use Disorders in Non-specialized Health Settings Version 2.0 URL

                    Read the section on depression (pgs. 19-32). (18 minutes)

                    WHO - 2015

                  • Managing Depression in Primary Care URL

                    Read the entire article. (22 minutes)

                    Singapore Medical Journal - 2017

                  • Depression in Primary Care: Assessing Suicide Risk URL

                    Read the entire article. (16 minutes)

                    Singapore Medical Journal - 2017

                  • Self-harm and Suicide in Adults URL

                    Read Section 6 (pgs. 46-50). (14 minutes)

                    Royal College of Psychiatrists - 2020

                  • Discussion Forum 5: Proposing and Adopting Psychosocial Support for Patients with Self-Harm and Suicidal Thoughts (420 minutes)

                    In this activity, you will assess three case scenarios of patients suffering from substance use disorders and with varying severity of self-harm and suicidal thoughts.

                    Step 1. Study

                    Analyze and study the three cases of patients suffering from substance use disorders:

                    75

                    Step 2.  Select and Propose

                    Select one case from Step 1 that matches your interest and propose a workable psychosocial support process/intervention for the chosen case that covers the following questions:

                    • What are the objectives/goals of the psychosocial intervention?
                    • Who is/are involved in the psychosocial intervention?
                    • What activities and actions are appropriate for the psychosocial intervention?
                    • What might be the challenges and barriers that may hinder the psychosocial intervention, and how to overcome these barriers?
                    • What are the expected outcomes of the intervention support process?

                    Step 3. Respond

                    Write a 300-600 word workable psychosocial support intervention plan for the chosen case that encompasses all the questions raised in Step 2 and which also includes a brief description of how the psychosocial support intervention may be modified and adapted to address the other two cases from Step 1. 

                    Step 4: Share

                    To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                    Step 5: Interact

                    To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

                  • Recommended Additional Readings
                  • Psychosocial Interventions for Self-harm, Suicidal Ideation and Suicide Attempt in Children and Young People: What? How? Who? and Where? URL

                    Read the entire article. (35 minutes)

                    BMJ Journals - 2017

                  • Rapid Access to Brief Psychological Treatments for Self-harm and Suicidal Crisis URL

                    Read the entire article. (9 minutes)

                    British Journal of General Practice - 2020

                • Module 5: Lesson 2: Substance Use and HIV

                  Learning Objectives:
                  Upon completion of this lesson, you will be able to:
                  • Explain how substance use (including alcohol and tobacco) interacts with HIV.
                  • Summarize the relationship between alcohol use and HIV, including the increased risk of HIV infection in those who consume alcohol.
                  • Explore the relationship between Substance Use Disorders and HIV infection.
                  Approximate time required for the readings for this lesson (at 144 words/minute): 11 hours and 57 minutes.

                  Click here to start this lesson

                  11 URLs, 1 Forum
                  • Required Learning Resources and Activities
                  • Substance Use Disorders and HIV URL

                    Read the entire webpage. (42 minutes)

                    HIVinfo.NIH.gov - 2021

                  • Smoking and HIV: What Are the Risks and What Harm Reduction Strategies do We Have at our Disposal? URL

                    Read the entire article. (13 minutes)

                    AIDS Research and Therapy - 2018

                  • HIV and Injection Drug Use URL

                    Read the entire webpage. (2 minutes)

                    CDC - 2021

                  • Alcohol and HIV Risk URL

                    Read the entire webpage. (4 minutes)

                    HIVinfo.NIH.gov - 2018

                  • Perceptions of Alcohol Use in the Context of HIV Treatment: a Qualitative Study URL

                    Read the following sections "Introduction," "Results" and "Discussion." (19 minutes)

                    Dove Press - 2017

                  • Treating Substance Use Disorder Among People With HIV URL

                    Read pages 3-9. (19 minutes)

                    The Substance Abuse and Mental Health Services Administration is - 2020

                  • Discussion Forum 6: Analysis of Substance Use Disorder Among HIV Patients (420 minutes)

                    In this activity, you will write an article that talks about the treatment and management of two substance use disorders among HIV patients.

                    Step 1. Review

                    Review all the learning resources for this lesson.

                    Step 2. Study

                    Study the given scenario:

                    Scenario

                    The mayor of your locality has observed a documented rise of substance use disorders among the HIV-infected population of your city. In order to address this issue, the mayor thought of disseminating information about substance use disorder and HIV on various platforms, primarily through your city’s official social media account. As the chief addiction medicine specialist of your city, the mayor requested you to draft the language for the first two social media posts:

                    Social media post 1: 

                    Two substance use disorders prevalent among the HIV-infected population.

                    Social media post 2:

                    Two useful self-help and well-being resources that people with mental health conditions and substance use disorders can use at their disposal.

                    Step 3. Respond

                    For social media post 1:

                    Write 200-500 words for a social media infographic post about two substance use disorders prevalent among the HIV-infected population with the following inclusions:

                    • The two substance use disorders chosen
                    • Prevalence of the two substance use disorders among the HIV-infected population
                    • Key risk factors for these substance use disorders among the HIV-infected population and/or key risk factors of getting infected with HIV for people using these substances
                    • Current status of the HIV-infected population with substance use disorders
                      • Treatment and management approaches 
                      • Challenges and barriers to treatment and management
                    • Recommendations and commendations 

                    Note: You can include graphics or pictures if relevant.

                    For social media post 2:

                    Write 200-400 words for a social media post identifying two useful self-help and well-being resources such as local and government websites for people suffering from mental health conditions and substance use disorders, including the following:

                    • Name of the resources and how to access them (e.g., insert a link to the website)
                    • Functions that these resources serve
                    • Types of information that the resources/websites can give
                    • Country of origin/Place of origin of these resources
                    • Source (e.g., government, national public health authorities, universities, etc.)

                    Note: You can include graphics or pictures if relevant.

                    Step 4: Share

                    To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                    Step 5: Interact

                    To complete the activity, you will need to reply to at least two posts made by your peers in a respectful and professional manner. Ensure that your post engages your peers' ideas by including a reflection on their comments, sharing ideas of other potential difficulties and parties involved, or asking thought-provoking questions. If a peer comments on your posting, please reply. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.”

                  • Recommended Additional Readings
                  • HIV and Substance Use URL

                    Read the entire webpage. (6 minutes)

                    HIVinfo.NIH.gov - 2021

                  • Interactions Between HIV Treatment and Recreational Drugs URL

                    Read the entire webpage. (9 minutes)

                    NAM - 2020

                  • A Client-centered Relational Framework on Barriers to the Integration of HIV and Substance Use Services: a Systematic Review URL

                    Read the Abstract, Background, Discussion, and Conclusion of the article. (18 minutes)

                    Harm Reduction Journal - 2019

                  • The Prevalence of Alcohol use Disorders Among People Living with HIV/AIDS: A Systematic Review and Meta-Analysis URL

                    Read the Abstract, Background, Discussion, and Conclusion of the article. (11 minutes)

                    Substance Abuse Treatment, Prevention, and Policy - 2019

                  • Key Risk Factors for Substance Use Among Female Sex Workers in Soweto and Klerksdorp, South Africa: A Cross-sectional Study URL

                    Read the entire article. (37 minutes)

                    PLOS One - 2022

                • Module 5: Lesson 3: Substance Use and Pregnancy

                  Learning Objectives:
                  Upon completion of this lesson, you will be able to:
                  • Describe the links between alcohol and other substance use and reproduction, and be able to discuss pregnancy planning and contraception methods with men and with women of childbearing age.
                  • Identify the potential risks of medications and substance use on the fetus or baby when providing care to a pregnant or breastfeeding woman.
                  • Explain how babies being breastfed by women on medications are monitored for adverse effects or withdrawal, and undergo comprehensive examinations if required.
                  Approximate time required for the readings for this lesson (at 144 words/minute): 3 hours and 36 minutes.

                  Click here to start this lesson

                  8 URLs
                  • Required Learning Resources and Activities
                  • Smoke, Alcohol and Drug Addiction and Female Fertility URL

                    Read the sections "Introduction" and "Conclusions." (10 minutes)

                    Reproductive Biology and Endocrinology - 2020

                  • Smoke, Alcohol and Drug Addiction and Male Fertility URL

                    Read the sections "Background" and "Conclusions." Also, have a look at Figure 1, "Effects of smoking, alcohol and drug abuse on spermatogenesis (left) and hormonal parameters (right) in males." (5 minutes)

                    Reproductive Biology and Endocrinology - 2018

                  • Pregnancy Planning for Women Treated for Opioid Use Disorder URL

                    Read the entire document. (7 minutes)

                    SAMHSA - 2019

                  • Substance Use in Women Research Report URL

                    Read "Substance Use While Pregnant and Breastfeeding" on pages 12-23. (19 minutes)

                    National institute on drug abuse - 2020

                  • Basics about FASDs URL

                    Read the entire webpage. (9 minutes)

                    CDC - 2022

                  • The Use of Psychotropic Drugs During Pregnancy URL

                    Read the entire article. (10 minutes)

                    Shanghai Archives of Psychiatry - 2017

                  • Perinatal Drug Abuse And Neonatal Drug Withdrawal URL

                    Read the entire article. (12 minutes)

                    StatPearls Publishing - 2021

                  • Recommended Additional Readings
                  • Queensland Clinical Guidelines - Perinatal Substance Use: Neonatal URL

                    Read the flowchart on page 3, as well as Section 2 "Initial newborn care," Section 3 "assessment," and Section 4 "Supportive care" on pages 8-15. (23 minutes)

                    Queensland Health - 2021

                • Module 5: Lesson 4: Substance Use Follow-Up, Self-Help, Well-Being, and the Community

                  Learning Objectives:
                  Upon completion of this lesson, you will be able to:
                  • Recognize when to refer patients - Assist the patient in acquiring healthy lifestyles, which can improve mental health and help manage substance use disorder triggers such as stress - Perform a general healthy weight assessment (BMI, weight, and height)."
                  • Explain how, at follow-ups, to reassess the person’s expectations of treatment, clinical status, understanding of treatment, and adherence to the treatment and correct any misconceptions.
                  • Explain how to continually monitor for treatment effects and outcomes, drug interactions with substances (alcohol and illicit drugs), and medicines (both naturopathic and traditional) and adjust accordingly.
                  • Explore involvement in self-help and family support groups, where available.
                  • Identify and mobilize possible sources of social and community support in the local area, including educational, housing, and vocational supports.
                  • Discuss the self-monitoring of symptoms and explain when to seek care immediately.
                  • Identify when it is appropriate to involve the carer or family member in the person’s care.
                  • Discuss autonomy and independent living in the community and discourage institutionalization.
                  • Explore useful self-help and well-being resources for Substance Use Disorder patients.
                  • Describe when to assist the patient in acquiring a healthy lifestyle, which can improve mental health and help manage substance use disorder triggers such as stress.
                  • Describe how to perform a general healthy weight assessment (BMI, weight, and height).
                  Approximate time required for the readings for this lesson (at 144 words/minute): 18 hours and 31 minutes.

                  Click here to start this lesson

                  27 URLs, 1 Quiz
                  • Required Learning Resources and Activities
                  • How to Know When to Refer a Client to Rehab: These Six Telebehavioral Tips Can Help URL

                    Read the entire webpage. (5 minutes)

                    The University of Arizona - 2019

                  • Can Addiction Be treated Successfully? URL

                    Read the entire webpage. (7 minutes)

                    National Institutes of Health - 2020

                  • Treating Addiction URL

                    Read the entire webpage. (3 minutes)

                    camh - 2021

                  • mhGAP Intervention Guide - Version 2.0 URL

                    Read No.5 "Follow-up" in the "Essential care and practice" section (pg. 13), as well as Sub 3 "Follow up" in the Disorders due to substance use" section (pgs. 128-129). (6 minutes)

                    WHO - 2016

                  • Targeting the Barriers in the Substance Use Disorder Continuum of Care With Peer Recovery Support URL

                    Read the entire article. (43 minutes)

                    NCBI - 2021

                  • Substance Use Disorder Patients’ Expectations on Transition from Treatment to Post-discharge Period URL

                    Read the sections "Introduction," "Findings" and "Discussion." (35 minutes)

                    SAGE Publications Ltd - 2020

                  • Appropriate Use of Drug Testing in Clinical Addiction Medicine URL

                    Read the Rational (pg. 163), Document Focus (pg. 163), and Clinical Recommendations 1, 2, and 3 (pgs. 165-168). (19 minutes)

                    Journal of addiction medicine - 2017

                  • Drug-drug Interactions in the Treatment for Alcohol Use Disorders: A Comprehensive Review URL

                    Read the sections "Abstract," "Introduction" and "Methodological considerations" with Tables 1-5. (13 minutes)

                    Elsevier B.V. - 2018

                  • Polydrug Use URL

                    Read the entire webpage. (6 minutes)

                    Alcohol and Drug Foundation - 2021

                  • Guidance Part 3: Supporting Service Users To get the Most out of Opioid Substitution Treatment (OST) URL

                    Read Sections 1 "Monitoring, support and review," 2 "What to do when a treatment and recovery care plan is not working?" and 3 "How to respond if OST is not working?" (34 minutes)

                    Public health England - 2021

                  • Recovery-Oriented Mutual Self-help Groups URL

                    Read the entire webpage. (15 minutes)

                    US Department of Veterans Affairs - 2020

                  • Resources for Families Coping with Mental and Substance Use Disorders URL

                    Read the entire webpage and watch the videos "Video: Family Drama" and "Can We Talk?" (3 minutes)

                    SAMHSA - 2021

                  • The mhGAP Community Toolkit: Field Test Version URL

                    Read section 4.2 "Vocational, educational, and housing support" on pgs. 83-84. (4 minutes)

                    WHO - 2019

                  • Integrating Vocational Services Into Substance Use Disorder Treatment URL

                    Read pages 1 to 7. (19 minutes)

                    SAMHSA - 2021

                  • Opioid Overdose: Learn the Warning Signs of Opioid Overdose URL

                    Read the entire webpage. (4 minutes)

                    SAMHSA - 2020

                  • Using Smartphones to Decrease Substance Use Via Self-monitoring and Recovery Support: Study Protocol for a Randomized Control Trial URL

                    Read the sections "Using Ecological Momentary Assessments (EMAs) to self-monitor and change behavior" and "Using EMA responses to predict risk" on page 2. (2 minutes)

                    Trials - 2017

                  • Family-focused Practices in Addictions: A Scoping Review Protocol URL

                    Read the introduction on pages 1-2. (9 minutes)

                    BMJ Open - 2018

                  • Substance Abuse Counselor Ethics, Confidentiality, and Boundaries URL

                    Read the section "Autonomy" on pages 5 to 9. (19 minutes)

                    Quantum Units Education - 2018

                  • The Psychological Toolkit URL

                    Read the sheets under the sections "Lifestyle: Exercise, diet & sleep" and "Meditation and relaxation." Although not required, you may read the other sheets from this resource. (30 minutes)

                    Black Dog Institute - 2017

                  • Self-help. URL

                    Read the webpage, and have a look at the tools "Alcohol and you Self Help" (click on "Alcohol and you Self Help" and then "Score yourself now" to access the tool) and "Cannabis and You Self Help." (30 minutes)

                    DACT (Drug and Alcohol Coordination Teams) - 2019

                  • The Benefits of Physical Exercise on Mental Disorders and Quality of Life in Substance Use Disorders Patients. Systematic Review and Meta-Analysis URL

                    Read the introduction (pgs.1-3), discussion, and conclusion (pgs. 27-31). (28 minutes)

                    International Journal of Environmental Research and Public Health - 2020

                  • Exercise and mental health URL

                    Read the entire webpage. (7 minutes)

                    State Government of Victoria - 2021

                  • Diet, Nutrition, and Substance Use Disorder URL

                    Read the entire webpage. (11 minutes)

                    Utah State University - 2020

                  • Mindfulness Meditation in the Treatment of Substance Use Disorders and Preventing Future Relapse: Neurocognitive Mechanisms and Clinical Implications URL

                    Read the sections "Introduction," "A neurocognitive perspective on the etiology of SUDs" and "Mindfulness meditation (MM)" on pages 103-105. (11 minutes)

                    Substance Abuse and Rehabilitation - 2018

                  • Defining Adult Overweight & Obesity URL

                    Read the entire webpage. (2 minutes)

                    CDC - 2021

                  • Adult BMI Calculator URL

                    Read the entire webpage. (2 minutes)

                    CDC - 2022

                  • Quiz: Module 5

                    To access the quiz, click on the name of the quiz provided above. On the following screen, click the attempt quiz button to respond to the questions.

                  • Recommended Additional Readings
                  • Substance Use Disorder Treatment for People With Co-Occurring Disorders URL

                    Read Chapter 3: "Screening and Assessment of Co-Occurring Disorders" (pages 31-68). (132 minutes)

                    SAMHSA - 2020

                • Module 6: Communication with People Seeking Care, Their Caregivers and Family

                  Competency covered in this module: 

                  • Communicate effectively with those to whom you provide care, their family, and caregivers.
                  • Module 6: Lesson 1: Communication Strategies

                    Learning Objectives:
                    Upon completion of this lesson, you will be able to:
                    • Demonstrate how to use simple and clear language.
                    • Demonstrate how to ask the person for their own understanding of the condition.
                    • Explain how to provide information to the person on their health status in terms that they can understand.
                    • Recognize that you must be friendly, respectful, and non-judgmental at all times.
                    • Recognize that communication is clear, empathic, and sensitive to age, gender, culture, and language differences.
                    • Demonstrate how to respond to the disclosure of private and distressing information (e.g., regarding sexual assault or self-harm) with sensitivity.
                    • Identify the typical family's reaction to knowledge of substance use issues in a family member.
                    • Demonstrate how to gain the consent of the person to keep carers informed about the person’s health status, including issues related to assessment, treatment, follow-up, and any potential side effects.
                    Approximate time required for the readings for this lesson (at 144 words/minute): 21 hours and 31 minutes.

                    Click here to start this lesson

                    22 URLs, 1 Forum, 1 Quiz
                    • Required Learning Resources and Activities
                    • Patient–Physician Relationship – Communication is the Key URL

                      Read the entire article. (7 minutes)

                      Indian Journal of Ophthalmology - 2018

                    • Health Literacy for Interprofessional Education (IPE) eToolkit URL

                      Read the overview, download and read the factsheet titled "Improving Oral Communication to Promote Health Literacy" and watch the video "Health literacy skit." (12 minutes)

                      Pacific University of Oregon - 2017

                    • Words Matter - Terms to Use and Avoid When Talking About Addiction URL

                      Read the entire webpage. (7 minutes)

                      NIH - 2021

                    • Effective Patient-Physician Communication – A Concise Review URL

                      Read the article from the Introduction to the end of the section "Many tools have emerged to aid in doctor-patient communication." (13 minutes)

                      Journal of the Association of Physicians of India - 2020

                    • Precision Communication: Physicians’ Linguistic Adaptation to Patients’ Health Literacy URL

                      Read the Introduction (pgs. 1-2) and discussion (pgs. 4-8). (25 minutes)

                      Science Advances - 2021

                    • 7 Tips for Clear Patient Communication URL

                      Read the entire article. (3 minutes)

                      Medical Economics Journal - 2021

                    • Effective Communication in Health and Social Care URL

                      Read the entire webpage. (15 minutes)

                      CPD Online College - 2021

                    • Patient-Centered Communication: Basic Skills URL

                      Read the entire article. (25 minutes)

                      American association of family physicians - 2017

                    • Non-Judgmental Care URL

                      Read the entire webpage. (2 minutes)

                      Minnesota Department of Health - 2022

                    • Cultural Respect URL

                      Read the entire webpage. (4 minutes)

                      NIH - 2021

                    • Advancing Health Equity at Every Point of Contact URL

                      Watch the video entitled "In Your Words." (7 minutes)

                      US Department of Health & Human Services - 2020

                    • The Value of Communicating With Patients in Their First Language URL

                      Read the entire article. (10 minutes)

                      Expert Review of Pharmacoeconomics & Outcomes Research - 2020

                    • Tips for Improving Communication with Older Patients URL

                      Read the entire webpage. (12 minutes)

                      NIH - 2017

                    • Supporting Patients Who Make Disclosures of Sexual Violence on Inpatient Wards URL

                      Read pages 13-22, as well as Appendix 1 on page 26. (25 minutes)

                      Royal College of Nursing - 2020

                    • Self-Harm Disclosures URL

                      Read the entire webpage. (5 minutes)

                      Hampshire Safeguarding Children Partnership - 2020

                    • Disclosures for the Protection of Patients and Others URL

                      Read the entire webpage. (13 minutes)

                      General Medical Council - 2017

                    • Parental Substance Misuse: Module 1: Understanding Substance Misuse URL

                      Read "Section Five: Relationships with Family." (30 minutes)

                      Social Care Institute for Excellence - 2022

                    • When a Parent Drinks too much Alcohol... What kids Want to Know URL

                      Read the entire resource, which covers how to talk to children of adults who drink too much. The way the questions are answered can be applied to other types of substance use as well (besides alcohol), providing that the relevant information for the substance is given instead. (15 minutes)

                      camh - 2022

                    • The Effect on the Family URL

                      Read the entire webpage. (3 minutes)

                      Adfam - 2018

                    • An Unknown Invisible Intrusion. Impact of an Adult Family Member’s Problematic Substance Use on Family Life: A Meta-Ethnography URL

                      Read the introduction (pages 1-2), results (pages 7-10) and conclusion (pages 11-12). (22 minutes)

                      Drugs: Education, Prevention and Policy - 2020

                    • Using and Disclosing Patient Information for Direct Care URL

                      Read the entire webpage, paying special attention to the section "Sharing information with those close to the patient." (12 minutes)

                      General Medical Council - 2018

                    • Peer Activity 3 - Group and Individual Therapy Sessions Script (480 minutes) Forum

                      In this activity, you will write a full script dialogue depicting effective communication incorporated in group and individual therapy sessions.

                      Step 1. Review

                      Review all the learning resources for this lesson. Additionally, gather information on how the group and individual therapies and counseling are conducted.

                      Step 2. Write

                      Assume the role of a psychiatrist specializing in addiction medicine, who runs a group therapy for five (5) individuals suffering from alcohol addiction and substance use disorders. Now, write a 600-1200 word script dialogue as a full response for three round-robin discussions within a group therapy and an individual therapy. Each round-robin discussion’s script dialogue must cover at least 200 words.

                      Each round-robin discussion is described by the following scenarios below. The script dialogue must also demonstrate how the psychiatrist reacted and acted effectively to address each scenario.

                      Round-Robin Discussion 1 Scenario:

                      The discussion will focus on self-monitoring logs for the patients’ alcohol or drug use for the past week. Each patient will then give a general picture of what their alcohol and drug use were like the past week. The group leader will respond accordingly.

                      Round-Robin Discussion 2 Scenario:

                      The discussion will focus on the patients’ personalized feedback summaries which basically show feedback about each patient’s alcohol and drug use over the course of the group therapy. The patients will take a look at their feedback summaries. The group leader will then ask each patient to share and comment within the group which information from their personalized feedback summary stands out for them. The group leader will also ask how well they understand their present condition based on the summaries. A member will surprisingly disclose very sensitive information, i.e., that she has started to harm herself while being in the course of therapy after being sexually assaulted by her boyfriend. The group leader will respond accordingly.

                      Round-Robin Discussion 3 Scenario:

                      The discussion will focus on group members’ reports of short- and long-term costs and benefits of changing their alcohol or drug use. Group members will be invited to comment on their perceptions of other members’ statements about the good and less good things related to their alcohol and drug use and what it would take to change. The group leader (psychiatrist) will notice that one member’s answers and comments are non-responsive and non-collaborative. The group leader will then arrange individual therapy with that particular member. The individual therapy will involve issues related to assessment, treatment, follow-up, and any potential side effects of the patient’s condition. Additionally, during the individual therapy, the psychiatrist will ask for consent from the patient to share the patient’s health status with his carer. 

                      Step 3. Finalize

                      Finalize your script dialogue by checking if all the required elements have been addressed. Also, check if all the learning outcomes have been demonstrated by the script dialogue.

                      Step 4: Share

                      To share your work, click on the “Add New Discussion” button under this post and paste your work in the “Message” box. Make sure to reference others’ intellectual property when necessary. All references should follow 7th Edition APA formatting. For further instructions, see the resource on the Himmelfarb Health Sciences Library: APA citation resource (N.B. references are excluded from word counts).

                      Step 5. Interact

                      Evaluate and categorize the work from one of your peers based on items A - E of the rubric below. Provide a rationale for the grade you have provided, as well as comments or suggestions for improvement. To post a reply, click “Reply” on a particular discussion, write your feedback and then click on “Post to forum.” You can use the list below as an example:

                      Item A is  .…. because….  My suggestions for improvement are….
                      Item B is  .…. because….  My suggestions for improvement are….
                      Item C is  .…. because….  My suggestions for improvement are….
                      Item D is  .…. because….  My suggestions for improvement are….
                      Item E is  .…. because….  My suggestions for improvement are….

                    • Quiz: Module 6

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                  • Final Exam

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                      To take the final exam, you must complete all quizzes and complete all the required activities. The final exam consists of 50 questions, and you will have 100 minutes to complete it. When the time is over, you will have two minutes to submit your attempt before it expires, and your progress is discarded. You will not be able to answer additional questions in the grace period.

                      To access the exam, click on the name of the exam provided above. On the following screen, click the attempt quiz button to respond to the questions.


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                  • Module 1: Introduction to Substance Use Disorder Services in Primary Care
                  • Module1: Lesson 1: General Information
                  • Module 2: Addressing Stigma and Protecting Human Rights
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                  • Module 3: Lesson 1: Tobacco Specific Information and Approaches
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                  • Module 5: Lesson 3: Substance Use and Pregnancy
                  • Module 5: Lesson 4: Substance Use Follow-Up, Self-Help, Well-Being, and the Community
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