Emphasizing Primary Prevention in the Curriculum to Mitigate Prescription Drug Abuse

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Antman et al1 have demonstrated leadership in integrating a critical educational component into medical school curricula to target primary, secondary, and tertiary prevention for prescription drug misuse. Although primary prevention is established within their 10 core competencies, we feel that the aspect of assessment and management of chronic pain should be enhanced to address a key underlying cause.
The University of Kansas School of Medicine is currently undertaking a transformation of its medical school curriculum. One directive has been to establish a “Thread Head” assigned to assimilate vital pain medicine education and assessment throughout the four-year curriculum. We believe a core component of prevention and management of prescription drug misuse is to assess and manage root causes before the specter of drug misuse manifests.
Our curriculum objectives for pain medicine focus on primary prevention by training medical students to recognize the difference between acute and chronic pain conditions and also distinguishing risk factors for the development of chronic pain syndromes. Opioid pharmacology and the disadvantages of long-term opioid utilization are highlighted. Educational strategies that hone knowledge of multimodal, nonopioid adjuncts for the management of pain are incorporated throughout all four years. Nonmedication alternatives that are emphasized include psychological and behavioral modalities, interventional techniques, self-management strategies, and complementary or integrative therapies that are evidence based. We feel this emphasis on primary prevention will empower future generations of physicians to mitigate prescription drug abuse through appropriate assessment and manage ment of these conditions across the spectrum of acute to chronic pain.
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