Pubdate: Thu, 14 Aug 2014
Source: Vancouver Sun (CN BC)
Copyright: 2014 Postmedia Network Inc.
Contact:  http://www.canada.com/vancouversun/
Details: http://www.mapinc.org/media/477
Author: Evan Wood
Note: Dr. Evan Wood is a professor of medicine and Canada Research 
Chair at the University of British Columbia and medical director, 
addiction services for Vancouver Coastal Health and Providence Health Care.
Page: 13

BETTER ADDICTION TRAINING ON HORIZON

Imagine a known and immensely costly medical condition. Consider this 
illness has been the subject of great study, with research 
breakthroughs providing a clear description of its causes and 
treatment. Imagine that, despite this, hospitals and physicians' 
offices are often clogged with consequences of this condition all 
because of the widespread failure of the medical community to apply 
what has been learned to effectively diagnose and treat it.

Sadly, you don't have to imagine. The illness is addiction to alcohol 
and other drugs. The failure to train physicians and other health 
professionals in addiction medicine helps explain why this remarkable 
set of circumstances has persisted for so long.

Why is this so?

The last several decades have seen remarkable advances in our 
understanding of the biology of addiction. This research has 
contributed to the clear consensus that substance dependence can be 
viewed as a chronic and relapsing disease of the brain resulting from 
measurable effects of a drug on the brain's reward and self-control circuitry.

Research has also helped us to understand how the brain specifically 
reacts to prolonged drug exposure and how addictive behaviours are 
further affected by stress and other environmental factors. Advances 
in genetic research have also enabled the identification of specific 
human genes that affect vulnerability to addictive disorders, which 
explains why it has long been know that addiction tends to run in families.

All of this improved understanding of the biology of addiction has 
contributed to the development of new psychological and social 
treatment approaches, as well as new medications that can 
significantly improve outcomes among substance-dependent individuals. 
As with most diseases, the early identification and treatment of 
addiction is extremely important for effective treatment. 
Unfortunately, research has shown that only about 10 per cent of 
patients with an addiction receive care that is consistent with 
recommended standards. The health system's seeming inability to 
effectively respond to such a common health issue - with enormous 
health and social costs - raises the question: "Why?"

One key explanation is the failure of medical education programs to 
adequately train physicians, nurses and other professionals in the 
prevention, diagnosis and treatment of addiction. In fact, despite 
the enormous burden of disease attributable to addiction in North 
America, there are exceptionally few opportunities for health 
professionals to obtain advanced skills in this area. This failure to 
support medical training explains the enormous gap between the 
science of addiction medicine and the care patients receive.

B.C. is addressing this problem with $3 million in new funding, part 
of which is specifically to help health professionals better treat 
addiction. Announced last week, this investment sets the stage for 
British Columbia to change the structural barriers to optimal patient 
care, and become an international leader in addiction education, 
treatment and research. Of the new funding, $1.5 million builds upon 
an initial $3-million donation to the St. Paul's Hospital Foundation 
by Goldcorp Inc. in 2012. Collectively, it will enable B.C.'s 
addiction medicine training program to become the largest in North 
America, and expand to include nurses and other health professionals.

The other $1.5 million is being paired with approximately $2.5 
million in funding to the University of British Columbia from the 
U.S. National Institutes on Drug Abuse. It is aimed at integrating 
health professional education with innovative addiction research that 
will enable British Columbia to establish new ways of effectively 
treating patients struggling with addictions.

The ultimate goal is the creation of a provincial Network for 
Excellence in Substance Dependence and Related Harms, similar to 
B.C.'s Centre for Excellence in HIV/AIDS. The integrated education, 
clinical care, and research programs led by this team have 
contributed to a more than 85 per cent reduction in HIV cases and a 
similar reduction in AIDS deaths in British Columbia. International 
guidelines for the treatment and prevention of HIV infection are 
regularly refined based on work conducted in British Columbia.

This approach to investing in health professional education and 
guiding expert care through world-leading research is the best 
approach to not only saving lives but also reducing the millions of 
dollars in avoidable health and social service expenditures that are 
linked to untreated addiction.
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MAP posted-by: Jay Bergstrom