Evaluating pharmacy students' knowledge of substance use disorders (SUD) to assess gaps in substance-use training in schools across the United States

Introduction

Dear Future Pharmacists:

There is a lack of research on pharmacy students’ attitudes, comfort level, and knowledge of substance use disorders (SUD). Pharmacists play a crucial role in screening and treating SUDs as they are readily accessible to patients in the community. There is a shortage of addiction-related curricula in most pharmacy programs throughout the United States, and pharmacy students’ comfort level and attitudes on SUD topics remain largely unknown.

The purpose of this survey is to:

1.     To understand pharmacy students’ attitudes and comfort level discussing addiction.
2.     To assess pharmacy students’ knowledge of SUD
3.     To evaluate pharmacy students’ preparedness in screening, recognizing, and treating SUDs.

It would be greatly appreciated if you could complete this anonymous survey. This survey will take approximately 10- 15 minutes to complete. All information collected will be only used for research and will be kept confidential. There will be no connection to you specifically in the results or in a future publication of the results. Thank you for your time and consideration. If you have any questions about the study you may contact: ahmede1@stjohns.edu

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* 1. Please indicate your gender

Female

Male

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* 2. Please indicate your graduation year

2021

2022

2023

2024

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* 3. Which pharmacy school are you currently enrolled in?

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* 4. How comfortable are you collaborating with professionals regarding a patient with substance use disorder (SUD)?

Very comfortable

Comfortable

Neutral

Uncomfortable

Very uncomfortable

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* 5. Which of the following is the definition of addiction?

Withdrawal syndrome would occur if the medication is discontinued abruptly, dose is reduced rapidly, or an antagonist is administered

A greater amount of medication is needed to maintain therapeutic effect, or loss of effect over time

Behavior suggestive of addiction caused by under-treatment of pain

A biopsychosocial disorder characterized by continued compulsive use of a substance despite harm

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* 6. Which of the following is a stage of the addiction cycle?

Anticipation

Relapse

Contemplation

Maintenance

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* 7. Which of the following is NOT considered a risk factor for developing substance use disorder?

History of alcohol or cannabis use

Heavy tobacco use

History of severe depression or anxiety

History of opioid use

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* 8. Which of the following does NOT contribute to the comorbidity between substance use disorders and mental illnesses?

Common risk factors can contribute to both mental illness and substance use and addiction

Mental illness may contribute to substance use and addiction

Substance use and addiction can contribute to the development of mental illness

Mental illness will eventually lead to substance use and addiction

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* 9. In addition to the direct effects, substance use disorders can have an indirect negative impact on the management of the following:

Infectious Disease Transmission

Treatment Adherence

Tobacco Use

All of the above

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* 10. Which of the following is an appropriate word choice when referring to or speaking to a patient with substance use disorder?

Habit" over "drug addiction"

Return to use" over "relapse"

"Opioid dependence" over "opioid use disorder"

"Addicted baby" over "Baby born with neonatal abstinence"

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* 11. A patient must meet how many criteria DSM5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) over the course of one year in order to be diagnosed with Substance Use Disorder?

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* 12. A 42-year-old male presents in your pharmacy appearing diaphoretic, tachycardic, and is having auditory and visual hallucinations. All of the following substances may be causing these symptoms EXCEPT:

PCP

Cocaine

Marijuana

Alcohol

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* 13. Which of the following is an approved FDA therapy for addiction treatment?

Fentanyl

Morphine

Methadone

Naloxone

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* 14. A 22-year-old male student discloses to you that he drinks about 5-6 alcoholic drinks during the week, and binge drinks on the weekends with his friends. Which of the following is NOT indicative of the diagnosis of an alcohol use disorder?

Declining interest in hobbies once enjoyed

Showing up to class late

Interpersonal relationships are being maintained by the student

Increase in alcohol consumption

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* 15. A 28-year old female recently had her first treatment of chemotherapy. She has never received opioids in the past. Which of the following would be appropriate to initiate in this patient to effectively manage her pain?

Oxycodone IR

Oxycodone ER

Transdermal fentanyl

Methadone

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* 16. A patient comes into your community pharmacy wanting to fill a prescription for a controlled substance. Which of the following is a red flag when screening this patient for misuse or diversion?

Patient has insurance but wants to pay cash

Patient uses multiple pharmacies and doctors

Patient discloses she would like to give permission to her daughter to pick up the medication as she is in a lot of pain and does not want to wait

A & B

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* 17. A 45-year-old male patient with DSM5 of 2 for the past 1 year comes to your clinic for the first time. Would he be considered as having SUD?

Yes

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* 18. In which situation would an opioid not be considered first-line and appropriate to prescribe?

Cancer pain

Bone pain

Neuropathic pain

B & C

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* 19. Which of the following would be a reason to rotate a patient’s opioids?

Substantial variability in patient response

Patient does not have adequate pain relief

Patient cannot tolerate the side effects

All of the above

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* 20. A combination of which of the following drugs can increase the risk of overdose:

Oxycodone and Alprazolam

Fentanyl and Venlafaxine

Codeine and Bupropion

Methadone and Gabapentin

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* 21. How comfortable are you dispensing an opioid to a patient with SUD?

Very comfortable

Comfortable

Neutral

Uncomfortable

Very uncomfortable

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* 22. How likely are you to approach a patient and provide counseling regarding their SUD?

Very likely

Likely

Neutral

Unlikely

Very unlikely

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* 23. Do you think someone who suffers from addiction is weak?

Yes

Somewhat

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* 24. Do you think you receive enough didactic training at your school regarding SUD and treatment of SUD?

Yes

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* 25. Would you like more instruction and teaching on addiction as part of your pharmacy school curricula?

Yes