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Addiction and Chronic Pain: Training Addiction Psychiatrists
Ellen Lockard Edens1, Inbal Gafni2, John Encandela3
1Yale School of Medicine, New Haven, CT, USA. ellen.edens@va.gov.
Objective:
Addiction psychiatrists are increasingly asked to address chronic pain in patients with addiction. Because of historic "divisions of labor" between physicians who manage pain and addiction psychiatrists who manage addiction, limited guidance exists for preparing addiction psychiatry trainees to address this comorbidity.
Methods:
A 1-h focus group composed of five geographically well-distributed addiction psychiatry fellowship directors/faculty was conducted to explore existing curricula, identify themes, and build consensus regarding educational goals for addiction psychiatry fellows in the area of chronic pain management.
Results:
Discussion resulted in five broad categories of themes involving perceptions of the importance of chronic pain training for addiction psychiatrists; barriers to curriculum development (one notably being that the addiction psychiatrist's role in managing chronic pain is poorly articulated); facilitators to such development; and potential curricular content and roles of addiction psychiatrists in relation to chronic pain training.
Conclusion:
Educators in addiction psychiatry should clarify their role in the management of chronic pain and prioritize training in this area.
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