Authors: Jose R. Feliberti, Juan R. Sosa, Lester E. Love, Donald M. Hilty
Relevance/Objectives: Substance use disorders are prevalent and can lead to disastrous clinical outcomes (e.g., opioid crisis). National surveys suggest that medical education training needs to be increased in psychiatry/mental health and medicine. A resident psychiatric rotation was created to meet training requirements and to help improve outcomes for a rural, diverse community’s high prevalence of substance use disorders. Methods: Patients were non-randomly assigned to one of two groups for a 90-day, outpatient Substance Abuse Intensive Outpatient Program: usual care; and the resident intervention group, which was assessment and treatment with supervision in place of other service visits. Patients’ graduation rates in were compared for two groups, with graduation defined by completing 14 individual therapy, 14 group therapy and 56 12-step meetings. Results: The groups did not differ in demographics, drug of choice (51% methamphetamine, 24% alcohol), number of substance disorders (mean 2.4) or frequency of visits (mean 3.2). Graduation rates were 41/743 (5.52%) for usual care and 21/42 (50%) for the resident intervention. Conclusions: Efforts to improve medical and graduate education training for patients with substance disorders should focus on longitudinal, integrated substance rotations built on academic-community partnerships. More research is needed on specific curricular interventions as part of health service delivery.
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