Medical education in substance abuse: from student to practicing osteopathic physician.

Substance use disorders (SUDs) have had a major impact on the health of the US population during the past decade. Osteopathic physicians have an important role among those who can make a positive impact on this problem. This article reviews the nature of the problem, how the osteopathic medical profession is currently addressing it, and a current strategy for improvement endorsed by the American Osteopathic Academy of Addiction Medicine. Early in 2004, the Office of National Drug Control Policy-backed by the US Surgeon General, the Center for Substance Abuse Treatment, the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, and the National Highway Traffic Safety Administration-has requested improvement in physician education on this health problem. This request culminated in the Office of National Drug Control Policy's establishing the Leadership Conference on Medical Education in Substance Abuse in December 2004. The osteopathic medical profession is represented in this critical review and formulation of recommendations for improving education on substance use disorders for the undergraduate, graduate, and practicing physician.

Opioid "mythstakes": opioid analgesics--current clinical and regulatory perspectives.

Barriers to appropriate prescribing of opioids include the deficit in educating medical students in core curricula. Other barriers include physicians' lack of knowledge of pain management, failure to educate their patients or include them in treatment options, and failure to take adequate medical histories and obtain records of their patients' previous treatment. In addition, physicians often lack the ability to distinguish the patient who is suffering pain from the addict. Patients, too, may fear that opioid therapy may cause addiction. This article provides an overview of guidelines and federal regulations for prescribing opioids, along with some caveats, in the hope that physicians and patients alike will appreciate that pain management is an integral part of treatment. And, that treatment is aimed at decreasing or eradicating pain and maintaining patients' function to the greatest possible degree while monitoring and treating side effects.