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Understanding illicit substance use in the real world
Author(s) -
Ciccarone Dan,
Jain Sharad,
Bourgois Philippe
Publication year - 2008
Publication title -
medical education
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.776
H-Index - 138
eISSN - 1365-2923
pISSN - 0308-0110
DOI - 10.1111/j.1365-2923.2008.03074.x
Subject(s) - substance abuse , modalities , context (archaeology) , medicine , harm , harm reduction , population , metropolitan area , curriculum , substance use , medical education , burnout , psychology , nursing , psychiatry , public health , clinical psychology , environmental health , social psychology , pedagogy , sociology , paleontology , social science , pathology , biology
Context and setting Illicit substance use is highly prevalent in US urban settings and impacts much of the patient population served by our faculty, residents and students. Our city has consistently ranked in the top 5 US metropolitan areas for emergency department drug episodes during the last decade. Drug overdose was the seventh leading cause of death for men in 2003–04. Why the idea was necessary There is an urgent practical need to have substance use issues taught to medical students. Patients who use illicit substances represent an especially vulnerable group and are over-represented as patients in teaching hospitals. Unfortunately, the so-called hidden curriculum often introduces clinical and interpersonal biases that interfere with best clinical practice. In addition, exposure to substanceusing individuals in clinical settings can be frustrating for inexperienced students and clinicians and may lead to burnout. Intermixing community-based experiences allows students to experience other philosophies and modalities in caring for urban poor populations and to develop an understanding of substance-using patients in their wider sociocultural contexts. What was done We designed a multi-disciplinary Year 4 elective to increase students understanding of the complexities of substance use in the social world outside clinical settings. This course was integrated with an elective on clinical care for urban poor populations. Both courses provide students with multiple community perspectives on providing care, including harm-reduction protocols, to marginalised populations. The 2-week substance use course is described below.