Educating Together, Improving
Together: Harmonizing
Interprofessional Approaches
to Address the Opioid Epidemic

Kathy Chappell, Eric Holmboe, Lauren Poulin, Steve Singer,
Elizabeth Finkelman, and Aisha Salman, Editors

WASHINGTON, DC
NAM.EDU

NATIONAL ACADEMY OF MEDICINE • 500 Fifth Street, NW • WASHINGTON, DC 20001

NOTICE: This publication has undergone peer review according to procedures established by the National Academy of Medicine (NAM). Publication by the NAM signifies that it is the product of a carefully considered process and is a contribution worthy of public attention, but does not constitute endorsement of conclusions and recommendations by the NAM. The views presented in this publication are those of individual contributors and do not represent formal consensus positions of the authors’ organizations; the NAM; or the National Academies of Sciences, Engineering, and Medicine.

Digital Object Identifier: https://doi.org/10.17226/27108

Library of Congress Control Number: 2022933212

Copyright 2021 by the National Academy of Sciences. All rights reserved.

Printed in the United States of America.

Suggested citation: Chappell, K., E. Holmboe, L. Poulin, S. Singer, E. Finkelman, and A. Salman, Editors. 2021. Educating Together, Improving Together: Harmonizing Interprofessional Approaches to Address the Opioid Epidemic. NAM Special Publication. Washington, DC: National Academy of Medicine.

“Knowing is not enough; we must apply.
Willing is not enough; we must do.”

—GOETHE

ABOUT THE NATIONAL ACADEMY OF MEDICINE

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Learn more about the National Academy of Medicine at NAM.edu.

ACTION COLLABORATIVE ON COUNTERING THE U.S. OPIOID EPIDEMIC HEALTH PROFESSIONAL EDUCATION AND TRAINING WORKGROUP

KATHY CHAPPELL (Co-Lead), American Nurses Credentialing Center

ERIC HOLMBOE (Co-Lead), Accreditation Council for Graduate Medical Education

STEVE SINGER (Co-Lead), Accreditation Council for Continuing Medical Education

DAVID BENTON, National Council of State Boards of Nursing

TIMOTHY BRENNAN, The Addiction Medicine Foundation

ROBERT CAIN, American Association of Colleges of Osteopathic Medicine

THERESA CAMPO, American Association of Nurse Practitioners

LEMREY “AL” CARTER, National Association of Boards of Pharmacy

JIANGUO CHENG, American Academy of Pain Medicine

DAVOREN CHICK, American College of Physicians

CHARLENE DEWEY, Vanderbilt University Medical Center

OMAR ESCONTRIAS, American Dental Education Association

RICK GARCIA, American Association of Colleges of Nursing

JAMES GIFFORD, Federation of State Medical Boards

LISA HOWLEY, Association of American Medical Colleges

MARGARET JARVIS, Geisinger Health System

BEVERLEY JOHNSON, Institute for Patient- and Family-Centered Care

RONEET LEV, Independent Emergency Physicians Consortium

LUCINDA MAINE, American Association of Colleges of Pharmacy

RAY MITCHELL, Georgetown University and Liaison Committee on Medical Education

DANIEL PACE, American Academy of Physician Assistants

MARGOT SAVOY, American Academy of Family Physicians

JOY RUCKER, Texas Harm Reduction Alliance (former)

DANIEL SLEDGE, Williamson County Mobile Outreach Team

NAM Staff

Development of this publication was facilitated by contributions of the following NAM staff:

ELIZABETH FINKELMAN, Senior Program Officer

AISHA SALMAN, Program Officer

NOAH DUFF, Associate Program Officer

EMMA FREILING, Research Assistant

JENNA OGILVIE, Deputy Director of Communications

MADELEINE DEYE, Senior Editorial Assistant

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REVIEWERS

This special publication was reviewed in draft form by individuals chosen for their diverse perspectives and technical expertise, in accordance with review procedures established by the National Academy of Medicine.

We wish to thank the following individuals for their contributions:

The reviewers listed above provided many constructive comments and suggestions, but they were not asked to endorse the content of the publication and did not see the final draft before it was published. Review of this publication was overseen by AISHA SALMAN, Program Officer, and ELIZABETH FINKELMAN, Senior Program Officer. Responsibility for the final content of this publication rests entirely with the editors and the NAM.

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CONTENTS

1 Executive Summary

2 Introduction

3 Literature Review (Study 1)

Objectives and Methods

Results

4 Educational Requirements Survey (Study 2)

Background

Objectives and Methods

Data Analysis and Synthesis

Results

5 Discussion

Collective Insights from the Literature Review

Variation in Regulatory Requirements to Address Pain Management and Substance Use Disorder

Limitations

6 Key Priorities

Key Priorities

Conclusions

Appendixes

A Search Strategy

B Search Strategy

C Coding Matrix for Articles on Practice Gaps

D Survey

E Organizations Providing Links to Requirements

F State CME Requirements for Prescribers

G State CE Requirements for Nursing

References

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BOXES AND TABLES

BOXES

1 A Call for Learning Leadership

TABLES

1 Literature Review Research Article Composition

2 Health Care Professionals by Type Represented in the Literature Review

3 Specialties Represented in Literature Review

4 Practice Environments Represented in Literature Review

5 Domains of Practice in Literature Review

6 Data Sources Used to Identify or Describe PPGs in the Literature

7 Patient Populations Referred to in Literature Review Articles

8 PPGs by Type or Stage in the Care Process Included in the Literature Review

9 Professional Practice Gap by Category in Literature Review

10 Summary of PPG Themes by Category

11 Policy Themes Identified in the Literature Review

12 Respondents by Type of Organization

13 Health Care Professional Type by Jurisdiction

14 Organizational Focuses

15 Requirements by Focus Area

16 Organizations’ Number of Requirements for Treating Acute and Chronic Pain by Type of Health Professional and Stage of Training

17 Count of Policies by Category

18 Focus and Type of Policy by Organization Category

19 Professional Practice Gaps Identified from Peer-Reviewed Literature

20 Summary of Requirements and Policies of Regulatory Agencies, Certifying Boards, and Accrediting Organizations

21 Taking Action on the Key Priorities—Who Can Affect Change and How?

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ACRONYMS AND ABBREVIATIONS