Core Curriculum Integration in Healthcare Profession Education

The 2022 National Drug Control Strategy (PDF | 2.6 MB) (NDCS) includes, among other efforts, one activity to expand the substance use disorder (SUD) health professions workforce through development of a core curriculum on SUD. The curriculum is for all medical and health professions programs so that every student is educated early in their academic careers on SUD and has basic knowledge of strategies to identify, assess, intervene, and treat addiction, as well as support recovery. The NDCS builds on work started in 2019 by the American Association of Medical Colleges (AAMC) and the American Association of Colleges of Osteopathic Medicine (AACOM), supporting medical schools to develop core curriculum to advance educational content related to pain and addiction.

The core curriculum elements also includes previous work SAMHSA conducted on Core Curriculum Elements developed in response to the Medication Access and Training Expansion (PDF | 3.7 MB) (MATE Act).

To achieve this goal, the Office of National Drug Control Policy (ONDCP) “Cascade of Care” initiative, in collaboration with the Substance Abuse and Mental Health Services Administration (SAMHSA), the federal agency responsible for training on SUD, and other federal partners, established an interagency group to implement the work.

The “Cascade Of Care” initiative combined three NDCS workforce expansion efforts:

• Increase SUD screening and case-finding by all health professionals;
• Increase training on SUDs by a broader representation of all health professionals; and
• Develop Core SUD curriculum elements for all health professions programs.

An outgrowth of this effort was to convene a panel of experts from across disciplines to draft core curriculum elements. The overall goal of the panel was to gain concurrence on essential elements or categories of information that should be included in a SUD core curriculum, that is publicly available, for any health profession academic program to utilize the elements or the entire curriculum.

ONDCP and SAMHSA convened the expert panel in August 2023 to review and draft core curriculum elements or categories of information that should be integrated into SUD curriculum.

The intended use for this core curriculum is for medical, physician associate, nurse practitioner, nurse, social worker, public health and counselor academic programs to:

• Receive training early in their academic careers about SUD and understand how to address stigma about this disease;
• Learn that SUD is a disease just like any other disease, such as diabetes and heart disease, that can be treated; and
• Increase access to SUD screening, assessments and services for the approximately 46 million Americans with SUDs, who are family, friends, and neighbors, and deserve access to care.

The expert panel agreed on several common themes and topics that should be considered as the curriculum is developed and implemented. Panel members considered strategies for integrating SUD curriculum into existing clinical academic content from four perspectives:

• didactic content as required learning;
• clinical rotation;
• case review; and
• their respective expertise.

Panel members urge SUD curriculum be provided beginning early and then throughout the students’ educational journey to address and minimize bias and stigma regarding SUD. Perceptions about use of medications for the treatment of SUD (MOUD) is a primary barrier for people in need of treatment and in terms of practitioners’ willingness to prescribe, especially for special populations such as adolescents and pregnant people. These perceptions feed into stigma, biases, stereotypes, and discrimination discourages people from seeking to following through on care.

Core Curriculum Topics

• General and Historical Context of history, policy, and regulations related to SUD and treatment
• Overview of SUD to include determinants of SUD, legal and ethical issues and prevention such as genetic factors and neurobiology of substance use, misuse and disorders, as well as SUD as a chronic disease
• Screening and Assessment for Patients with SUD to introduce screening, brief intervention, and referral to treatment for early intervention and treatment services, and to access the severity of substance use to identify appropriate level of evidence-based treatment.
• Treatment of SUD to cover various modalities for treatment and pharmacotherapies and include the initiation and management of Food and Drug Administration (FDA) approved medications to treat SUDs.
• Pain Management and Substance Misuse
• Inter-professional Education and Practice

In addition, the panel identified in the report discipline-specific core curriculum recommendations for physicians, nurse/nurse practitioners, physician associates, pharmacists, and social workers. Recommendations also include models of integration of content into curriculum.

Access the full Core Curriculum Elements on Substance Use Disorder for Early Academic Career Medical and Health Professions Education Programs (PDF | 408 KB) report for additional information.

View a listing of the recommended Core Curriculum Topics (PDF | 173 KB).

A literature review of SUD curriculum in medical, nursing, and physician associate (PA) schools was completed prior to the Expert Panel meetings. The literature review included peer reviewed literature, gray literature, and educational accrediting bodies, and curricula for medical, graduate-level nursing, and PA schools.

Learn more about the SUD curricula literature review (PDF | 3.7 MB).

SAMHSA’s Curriculum Integration Efforts in Healthcare Education

SAMHSA funds the Providers Clinical Support System - Universities (PCSS-Universities), to expand/enhance access to MOUD services for persons with a SUD seeking or receiving treatment through ensuring the education and training of students in the medical, physician associate, and nurse practitioner fields.

Visit the PCSS-Universities page to learn more about the work currently being completed at colleges/universities across the county on curriculum integration strategies and program outcomes.