“I’m almost opioid-a-phobic”: family medicine residents’ perceptions of enhancing opioid analgesic and agonist treatment training in a Canadian setting

ABSTRACT

Purpose

As deaths from the illicit drug poisoning crisis continue to rise in Canada, increasing the number of healthcare professionals qualified to effectively prescribe opioids could be beneficial. The willingness of family medicine residents to undertake structured training in prescribing opioids for Opioid Agonist Treatment (OAT) and pain management have not been well described.

Materials and methods

Family medicine residents (n = 20) in British Columbia, Canada, were asked about their experience with and willingness to enrol in OAT training. Informed by the Consolidated Framework for Implementation Research, data were analysed thematically using NVivo software.

Results

Four themes were identified: (1) challenges to training implementation, (2) feelings and attitudes on prescribing practices, (3) helpful learning spaces and places of substance use training, and (4) recommendations for implementing training. Preparedness, exposure, and supportive learning environments for substance use education increased willingness to pursue OAT accreditation, while ineffective learning experiences, mixed feelings about opioid prescribing, and lack of protected time were the most common reasons for unwillingness.

Conclusions

Protected time and a range of clinical experiences appear to facilitate residents’ willingness to complete OAT and opioid training. Implementation strategies to enhance the uptake of OAT accreditation in family medicine residency must be prioritised.

KEYWORDS:

• Training
• opioid agonist treatment
• family medicine
• pain management
• opioids

Acknowledgments

We thank our colleagues, Stefania Rizzardo, Michee-Ana Hamilton, Aleah Ross, Mary McCracken, and Keaton Fraser for their assistance with the study. Thank you to the Residents for completing the focus group interviews and for their crucial work during this healthcare crisis.

Disclosure statement

No potential conflict of interest was reported by the authors.

Data availability statement

The data are not publicly available due to information that could compromise the privacy of research participants.

Author contributions

SN and JK drafted the manuscript; RM, JK, MM, SN and HB designed the study; and SN, JK, DD analysed the data. All authors were involved in data collection, study design, and reviewed the manuscript prior to submission. The authors declare they have no conflict of interest.

Additional information

Funding

The study was supported by the Canadian Institutes of Health Research under a 2020 Spring Project Grant. Dr. Klimas’ work on this project was funded, in part, by the European Commission’s Workforce in Addictions - Valorisation in Europe (Project nr. 101045870 JUST-2020-AG-DRUGS) project. The funding organisations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.