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More than 47,000 people died in 2017 due to opioid-involved overdoses. In addition, fatal overdoses from non-methadone synthetic opioids like fentanyl have risen dramatically over the past 7 years. The heavy flow of opioid-related overdoses in hospitals have pressured healthcare professionals to adapt to new treatment modalities while following state and federally mandated prescribing guidelines. However, even when evidence-based practices are followed, patients may be negatively affected by opioid and opioid use disorder (OUD) stigma. The importance of addressing opioid-related stigma among healthcare providers has emerged during this time as a way to decrease barriers faced by patients in need of treatment for substance use disorders (SUDs) and improve general patient outcomes. Health professional students will, one day, be on the front line of the opioid epidemic, and thus, multidisciplinary opioid-focused education is needed. Developing education to address opioid-related stigma early in training may be valuable, though limited research has focused on this approach.The research detailed in this dissertation aimed to address the opioid epidemic by leveraging health professional students’ opioid-related knowledge, perceptions, beliefs, and experiences toward the development of an educational intervention to reduce opioid and OUD stigma. The first study provided a quantitative analysis of health professional students’ opioid-related beliefs, experiences, and postgraduate intentions. In general, nurse practitioner (NP) students perceived the epidemic as more severe compared to other health professional students. NP students had more clinical experiences than their physician assistant (PA) and doctor of osteopathy (DO) student counterparts, and these experiences were associated with increased confidence in caring for patients with OUD.The second study aimed to explore health professional students’ perceived impact of the opioid epidemic on their future profession using qualitative descriptive methods. Collectively, students discussed 4 main effects of the opioid epidemic: (1) Profound Impact on the Medical Profession, (2) Treating Patients is More Difficult, (3) Prescribing Regulations and Exercising Caution, and (4) Drug Seeking and Distrust Toward Patients. Students feared causing an addiction in their patients and some stated they would be more comfortable referring to a pain specialist. Additionally, students’ distrust toward patients speaks to the presence of opioid and OUD stigma among health professional students and supports the need for anti-stigma interventions in medical curricula.The third study investigated the efficacy of a contact-based anti-stigma intervention geared toward preclinical medical students. This study revealed that both contact-based education and the attention control (i.e., a didactic lecture) were effective in reducing OUD stigma and encouraging postgraduate opioid-related work. Moreover, higher post-intervention OUD stigma was associated with avoidance of patients with OUD, while lower stigma was associated with increased intention to pursue medication assisted treatment (MAT) training after graduation. Thus, decreasing stigma in health professional students may make MAT training more attractive and could help bolster the MAT workforce. Collectively, the studies in this dissertation demonstrate a need for anti-stigma education in medical curricula. Health professional students are impacted by the opioid epidemic through various experiences which could influence their perceptions and opioid-related postgraduate intentions. Addressing OUD stigma could result in improved patient care and more MAT providers, though future studies are needed to investigate the longevity of these anti-stigma effects. |
