Enhanced Skills Program: Addiction Medicine Youth Addiction and Concurrent Disorders Service Rotation Goals and Objectives

Medical Expert

By the end of the rotation, the Addiction Medicine resident will be able to:

Knowledge

Demonstrate an understanding of resources for evaluation of the adolescent exposed to substances during gestation, specifically Fetal Alcohol Spectrum Disorders.
Recognize the effects of parental substance abuse and addiction upon the child and adolescent and identify resources available in the community for children of parents with substance-use disorders.
Demonstrate an understanding of available treatment options including differences in treatment philosophies, modalities, and settings appropriate for children and adolescents.
Understand the broad range of medical, mental health and social conditions that can co-occur with substance use disorders, or are directly caused or exacerbated by substance use
Demonstrate and understanding of family-oriented treatment approaches for families with affected children and adolescents.

Medical Assessment

Evaluate the effect of child and adolescent developmental status upon the diagnosis of and management of adolescent abuse and addiction.
Effectively employ substance use screening tools applicable to the child and adolescent; teach physicians and non-physicians how to utilize screening tools.
Recognize common psychiatric conditions as they occur among patients with substance use conditions, and know when to seek appropriate psychiatric consultation.
Recognize the relationship between the psychiatric diagnosis and the substance use condition.
Recognize and treat substance use conditions (e.g. intoxication, withdrawal, use disorders) in the setting of acute and chronic psychiatric conditions.

Clinical Judgment and Management

Provide anticipatory guidance about the impact of and the effects of psychoactive drug use, abuse and addictions to children, adolescents and their families.
Guide the child, adolescent and family throughout the treatment process
Identify, for the adolescent patient in addiction treatment, developmentally appropriate treatment goals, potential factors contributing to relapse, and identify strategies to prevent or minimize relapse
Evaluate and manage the child or adolescent who is intoxicated or withdrawing from psychoactive substances and provide non-pharmacological and pharmacological interventions to stabilize the patient.
Utilize office-based opioid treatment for the child and adolescent with opioid addiction.
Identify the appropriate treatment resources to meet the needs of the child, adolescent and other affected family members.

By the end of the rotation, the Addiction Medicine resident will be able to:

Demonstrate the ability to communicate to youth and their families the unique problems of children exposed to alcohol or other drugs in utero.
In communication with the family, identify the role of emotional, perceptive and cognitive dysfunction or distortions present, and use this information in formulating a plan
Use language appropriate to developmental stage when explaining a diagnosis and proposing treatment plans

By the end of the rotation, the Addiction Medicine resident will be able to:

Communicate with team members involved in intensive case management of individuals with addictive disorders
Work as part of a team involved in intensive case management of individuals with addictive disorders, including the assessment of the need for intensive case management.
Demonstrate an ability to work with the family as an important part of prevention, intervention, treatment and recovery

By the end of the rotation, the Addiction Medicine resident will be able to:

Build on others’ opinions. Support consensus-building efforts.
Set agenda and provides structure to team meetings. Take on extra tasks if necessary.

By the end of the rotation, the Addiction Medicine resident will be able to:

Understand the incidence, prevalence, morbidity, and mortality associated with use, abuse and addiction to psychoactive drugs of abuse.
Learn the predominant patterns of drug use, abuse and dependence for children and adolescents.
Understand the socioeconomic costs of substance use disorders specific to children and their families.
Learn applicable provincial laws, including ethical and confidentiality requirements of addiction treatment and legal notification and involvement of parents, as they relate to physician-patient communications and prescribing practices for children and adolescents.
Use information gained in the history and physical exam, from single and multiple patients and families, to conceive and formulate an understanding of the community’s licit and illicit drug use patterns, and the real or expected consequences to both the individuals and the community.
Understand the socio-cultural influences that might affect alcohol and other drug use in communities.
Demonstrate an understanding of the risks and protective factors that contribute to the initiation, maintenance and escalation of alcohol, tobacco, and other drug use in children and youth.
Acknowledge the role of the family, environment and community in prevention and treatment.
Understand the characteristics of evidence-based prevention programs and the individual, family, school and community-level characteristics that these preventive interventions are based upon.

By the end of the rotation, the Addiction Medicine resident will be able to:

Demonstrate an understanding of and a commitment to the need for continuous learning. Develops and implements an ongoing and effective personal learning strategy.

By the end of the rotation, the Addiction Medicine resident will be able to:

Respect patient privacy and autonomy.
Demonstrate a commitment to excellence in clinical care and personal ethical conduct. Exhibit proper professional behaviour. Including adhering to legal and ethical codes of practice.