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Academia and the Profession |

Integrating Addiction Medicine Into Graduate Medical Education in Primary Care: The Time Has Come

Patrick G. O'Connor, MD, MPH; Julie G. Nyquist, PhD; and A. Thomas McLellan, PhD
[+] Article and Author Information

From Yale University School of Medicine, New Haven, Connecticut; Keck School of Medicine, University of Southern California, Los Angeles, California; and The White House Office of National Drug Control Policy, Washington, DC.


Acknowledgment: The authors thank Garrett O'Connor, MD, president of the Betty Ford Institute and conference director, and Gail B. Jara, executive director of The Medical Education and Research Foundation for the Treatment of Alcoholism and Drug Dependencies and conference planning coordinator, for their thoughtful suggestions on this paper.

Grant Support: The Betty Ford Institute and the Norlien Foundation provided funding for this article and the conference that generated the recommendations.

Potential Conflicts of Interest: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M10-1885.

Requests for Single Reprints: Patrick G. O'Connor, MD, MPH, Yale School of Medicine, PO Box 208093, New Haven, CT 06520-8093; e-mail, patrick.oconnor@yale.edu.

Current Author Addresses: Dr. O'Connor: Yale School of Medicine, PO Box 208093, New Haven, CT 06520-8093.

Dr. Nyquist: Keck School of Medicine, University of Southern California, 210 Keith Administration Building (KAM-210), 1975 Zonal Avenue, Los Angeles, CA 90033.

Dr. McLellan: 623 South 9th Street, Philadelphia, PA 19147.

Author Contributions: Conception and design: P.G. O'Connor, T. McLellan.

Analysis and interpretation of the data: P.G. O'Connor.

Drafting of the article: P.G. O'Connor, J.G. Nyquist, T. McLellan.

Critical revision of the article for important intellectual content: P.G. O'Connor, J.G. Nyquist, T. McLellan.

Final approval of the article: P.G. O'Connor, J.G. Nyquist, T. McLellan.

Provision of study materials or patients:

Statistical expertise:

Obtaining of funding: T. McLellan.

Administrative, technical, or logistic support:

Collection and assembly of data:


Ann Intern Med. 2011;154(1):56-59. doi:10.7326/0003-4819-154-1-201101040-00008
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Substance use disorders create an enormous burden of medical, behavioral, and social problems and pose a major and costly public health challenge. Despite the high prevalence of substance use and its consequences, physicians often do not recognize these conditions and, as a result, provide inadequate patient care. At the center of this failure is insufficient training for physicians about substance use disorders.

To address this deficit, the Betty Ford Institute convened a meeting of experts who developed the following 5 recommendations focused on improving training in substance abuse in primary care residency programs in internal medicine and family medicine: 1) integrating substance abuse competencies into training, 2) assigning substance abuse teaching the same priority as teaching about other chronic diseases, 3) enhancing faculty development, 4) creating addiction medicine divisions or programs in academic medical centers, and 5) making substance abuse screening and management routine care in new models of primary care practice. This enhanced primary care residency training should represent a major step forward in improving patient care.

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