Core Competencies

In the appropriate setting, using recommended and evidence-based methodologies, the graduating medical student should demonstrate the independent ability and/or knowledge to:

Primary Prevention Domain – Preventing Prescription Drug Misuse:
Screening, Evaluation, and Prevention

1. Evaluate a patient’s pain using age, gender, and culturally appropriate evidence-based methodologies.

2. Evaluate a patient’s risk for substance use disordersbyutilizinage, gender, and culturally appropriate evidence-based communication skills an assessment methodologies, supplemented with relevant available patient information, including but not limited tohealthrecords, family history, prescription dispensing records (e.g.the Presciption Drug Monitoring Program or “PMP”), drug urine screenings, and screenings for commonly co-occurring psychiatric disorders (especially depression, anxiety disorders, and PTSD).

3. Identify and describe potential pharmacological and non-pharmacological
treatment options including opioid and non-opioid pharmacological treatments for acute and chronic pain management, along with patient communication and education regarding the risks and benefits associated with each of these available treatment options.

Secondary Prevention Domain – Treating Patients At - Risk for Substance Use Disorders:  
Engage Patients in Safe, Informed, and Patient-Centered Treatment Planning
 
4. Describe substance use disorder treatment options, including medication-assisted treatment, as well as demonstrate the ability to appropriately refer patients to addiction medi cine specialists and treatment programs for both relapse prevention and co-occurring psychiatric disorders.

5. Prepare evidence-based and patient-centered pain management and substance use disorder treatment plans for patients with acute and chronic pain with special attention to safe prescribing and recognizing patients displaying signs of aberrant prescription use behaviors.
 
6. Demonstrate the foundational skills in patient-centered counselling and behavior change in the context of a patient encounter, consistent with evidence-based techniques.
 
Tertiary Prevention Domain – Managing Substance Use Disorders as a Chronic Disease:  
Eliminate Stigma and Build Awareness of Social Determinants

7. Recognize the risk factors for, and signs of, opioid overdose and demonstrate the correct use of naloxone rescue.
 
8. Recognize substance use disorders as a chronic disease by effectively applying a chronic disease model in the ongoing assessment and management of the patient.

9. Recognize their own and societal stigmatization and biases against individuals with substance use disorders and associated evidence-based
medication-assisted treatment.
 
10. Identify and incorporate relevant data regarding social determinants of health into treatment planning for substance use disorders.


Recommended Evidence-Based Methodologies for the Prevention and Management of Prescription Drug Misuse:

In the appropriate setting, and across all prevention areas, it is recommended that the graduating medical student have operational knowledge of:

- Diagnosis-Intractability-Risk-Efficacy (DIRE)

- Motivational Interviewing (MI)  
 
- Opioid Risk Tool (ORT)

- Safe Prescribing “Universal Precautions”

- Screening, Brief Intervention, and Referral to Treatment (SBIRT)

- Screener and Opioid Assessment for Patients with Pain (SOAPP)  

- Screening Tool for Addiction Risk (STAR)