Background: Biases related to people with substance use disorder (SUD) actually increase during time spent in formal medical education, and continue into practice. Leading health professional education groups across medicine, nursing, pharmacy, and social work, including the Association of American Medical Colleges (AAMC), have recognized addressing substance use disorders including stigma and bias as a critical need in health professional education. The majority of health professional schools and training programs currently lack curricula and tools to fulfill this charge. The setting of Covid-19 makes dismantling stigma even more compelling. Physical isolation measures taken to reduce disease spread are extremely challenging for people with substance use disorders. In fact, drug poisonings in May 2020 increased by 40% nationwide, and sky-rocketed by as much as 60% in parts of the country.
Purpose: In 2019, a group of multidisciplinary clinicians from the Dell Medical School departments of Internal Medicine, Psychiatry, and Medical Education performed an in-depth literature review related to how stigma of opioid use disorder limits access to care. The group synthesized the literature into consumable educational content for interprofessional trainees and healthcare practitioners, including original video content of people with lived experience. The content was reviewed by a group of external subject matter experts from across the United States. The Center for Health Communication at the University of Texas at Austin applied evidence-based health communication principles to develop digital content. The interactive modules were built into edX, an open-source educational platform. The work was supported by a grant from the Association of American Medical Colleges.
Description: The REducing Stigma Education Tools (ReSET) are two asynchronous online-based modules totaling 90 minutes of educational content. Topics covered include the origins of stigma, comparison of OUD to other chronic medical conditions, and discussion of stigma within a health equity framework. The modules provide actionable items participants can use to reduce stigma including use of appropriate language and motivational interviewing. Continuing medical education credits were approved for physicians, nurses, pharmacists, and social workers. Pre- and post-tests were incorporated to assess changes in knowledge and attitude after participation. The modules launched on August 13, 2020, received 70 registrations in the first 10 days, and had over 500 registrations by November 30, 2020. They are freely available at www.ResetStigma.org.
Conclusions: Stigma has contributed to the morbidity and mortality associated with the opioid epidemic in the United States. Participation in ReSET may offer one solution to this complex problem through widespread education on the impact of stigma and how to eliminate it. Outcomes will be closely assessed as utilization increases over the next 12 months.