PHARM 3012 - Assessment and Treatment of Addiction

North Terrace Campus - Semester 2 - 2018

This course will help you understand pathways from dependence to recovery and how we match the treatment to the patient's goals. First we will look at how we can identify risky use and intervene early. An extensive range of treatments is available to support people with moderate to severe dependence, depending on their goals. Some treatments will address physical dependence, while others focus on psychological factors and reintegration into the community. We will review the range of psychosocial and pharmacological treatments that can be used to support people to manage withdrawal and prevent relapse. Evidence-base of treatments, policy options and public health approaches will be reviewed. Population groups with special needs, and the rationale for addressing those special needs, will be discussed. The treatment of comorbidities, particularly mental health and substance use disorders, is an important example of special needs that will be addressed in some detail. Hurdles to access treatment will be reviewed as well as, the place of systematic reviews and guidelines in promoting the translation of evidence into practice.

  • General Course Information
    Course Details
    Course Code PHARM 3012
    Course Assessment and Treatment of Addiction
    Coordinating Unit Medicine
    Term Semester 2
    Level Undergraduate
    Location/s North Terrace Campus
    Units 3
    Contact Up to 5 hours a week.
    Available for Study Abroad and Exchange Y
    Prerequisites HLTH SC 2104
    Assumed Knowledge HLTH SC 2104 and PHARM 3101
    Course Description This course will help you understand pathways from dependence to recovery and how we match the treatment to the patient's goals. First we will look at how we can identify risky use and intervene early. An extensive range of treatments is available to support people with moderate to severe dependence, depending on their goals. Some treatments will address physical dependence, while others focus on psychological factors and reintegration into the community. We will review the range of psychosocial and pharmacological treatments that can be used to support people to manage withdrawal and prevent relapse. Evidence-base of treatments, policy options and public health approaches will be reviewed. Population groups with special needs, and the rationale for addressing those special needs, will be discussed. The treatment of comorbidities, particularly mental health and substance use disorders, is an important example of special needs that will be addressed in some detail. Hurdles to access treatment will be reviewed as well as, the place of systematic reviews and guidelines in promoting the translation of evidence into practice.
    Course Staff

    Course Coordinator: Associate Professor Linda Gowing

    Course coordinators:

    Associate Professor Linda Gowing
    DASSA Principal Research Officer (Evidence-Based Practice)
    Associate Professor, Discipline of Pharmacology
    linda.gowing@adelaide.edu.au

    Dr Abdallah Salem
    Head of Discipline Pharmacology
    abdallah.salem@adelaide.edu.au
    Course Timetable

    The full timetable of all activities for this course can be accessed from Course Planner.

  • Learning Outcomes
    Course Learning Outcomes

    On successful completion of this course students will be able to:

    1

    Describe the use of tools for screening and assessment of addiction

    2

    Identify broad types of intervention for the treatment of addiction, and their aims

    3

    Demonstrate understanding of the complexity of recovery from addiction and the place of different treatments in it

    4

    Identify the conditions that are most likely to occur as comorbidities with addiction

    5.

    Discuss the differing perspectives of treatment providers, patients, families and government

    6.

    Identify the main factors that might be used to tailor treatment approaches to the individual

    7.

    Identify major outcomes that might be used to assess progress in treatment

    8.

    Identify current directions in addiction treatment

    9.

    Demonstrate skills in critical appraisal of information relating to the treatment of addiction

    University Graduate Attributes

    This course will provide students with an opportunity to develop the Graduate Attribute(s) specified below:

    University Graduate Attribute Course Learning Outcome(s)
    Deep discipline knowledge
    • informed and infused by cutting edge research, scaffolded throughout their program of studies
    • acquired from personal interaction with research active educators, from year 1
    • accredited or validated against national or international standards (for relevant programs)
    1-7
    Critical thinking and problem solving
    • steeped in research methods and rigor
    • based on empirical evidence and the scientific approach to knowledge development
    • demonstrated through appropriate and relevant assessment
    9
    Teamwork and communication skills
    • developed from, with, and via the SGDE
    • honed through assessment and practice throughout the program of studies
    • encouraged and valued in all aspects of learning
    1,5
    Career and leadership readiness
    • technology savvy
    • professional and, where relevant, fully accredited
    • forward thinking and well informed
    • tested and validated by work based experiences
    1,3,5,9
    Intercultural and ethical competency
    • adept at operating in other cultures
    • comfortable with different nationalities and social contexts
    • Able to determine and contribute to desirable social outcomes
    • demonstrated by study abroad or with an understanding of indigenous knowledges
    5,6,8
    Self-awareness and emotional intelligence
    • a capacity for self-reflection and a willingness to engage in self-appraisal
    • open to objective and constructive feedback from supervisors and peers
    • able to negotiate difficult social situations, defuse conflict and engage positively in purposeful debate
    3,5
  • Learning Resources
    Required Resources
    Relevent textbook and other resources including journal papers to be advised as part of lecture handouts.
    Recommended Resources
    G. Hussein Rassool, Alcohol and Drug Misuse. A Guide for Health and Social Care Professionals, 2nd Edition 2018
    Routledge, ISBN9781138227576
    Online Learning
    Online resources will be used extensively to help with both bridging and extending students. We will offer interactive tools on drugs, case studies and perspectives from professionals. We will also use video or lecture material from local and international experts to provide a rich learning experience.
  • Learning & Teaching Activities
    Learning & Teaching Modes
    In this course we will use interactive lectures and online resources to  provide the students with new material to increase their understanding of the topic. The workshops will be used to discuss the nuances in  smaller groups such as looking at life trajectories and lived experiences and help them to discuss issues in a professional and culturally sensitive way. We feel it is important to help students understand the human angle, show the stories behind the people with addiction to help them understand life trajectories.
    Workload

    The information below is provided as a guide to assist students in engaging appropriately with the course requirements.

    The total weekly workload for this course is 12 hours per week with a contact time upto 5 hours per week;
    Learning Activities Summary

    Week

    Lecture

    Lecture

    Tutorial and Workshop

    1


    Identifying addiction

    Key features of addiction (overview of biological basis, ICD & DSM criteria). What do we know about addiction and comorbidity at population level?

     Introduction to case
    studies

    Presentation of information on the case studies that will be
    discussed at several points during the course.


    Course information
    session

    2

    The recovery journey

    What is recovery? Stakeholder perspectives; implications of
    biological adaptations.

    The recovery journey 
    Context of treatment, diversity of needs, matching treatment
    to needs and stage of recovery. Introduce role of comorbidities.

    Exploring the case studies

    Small group work, identifying why the cases might be
    addicted, or at risk of addiction, contexts in which addictive behaviour might
    be identified.

    3

    Prevention and early intervention

    Concepts of primary and secondary prevention, screening,
    settings, barriers
    Prevention and early intervention

    What strategies have been used in Australia for prevention
    of use and harm reduction for alcohol and tobacco, with what effect?

    Case studies in
    recovery

    What might recovery look like for each of the
    cases? What issues might need to be addressed to aid recovery? What strengths
    and weaknesses are there toconsider?

    4

    Psychosocial interventions

    Overview of types of psychosocial interventions, brief
    compared to structured interventions, introduction to stages of change.

    Brief intervention

    Overview of research evidence about
    effectiveness of brief interventions

     

    Prevention and early intervention
    Case study of smoking: where do e-cigarettes fit?

    5

    Managing withdrawal

    Aims, setting, role of medications, complications, adjunct therapies.

    Managing withdrawal

    Case studies using real-life scenarios to expand on
    principles. How to choose optimal treatment and setting based on existing
    comorbidities.

    Brief intervention

    Case studies of assessment with the ASSIST, linked to brief
    intervention in different settings.



    6

     Relapse prevention

    Defining relapse; biological basis and triggers for relapse; implications for relapse prevention strategies.

    ncreasing resilience

    Relapse prevention: Substitution treatment

    Principles, current status, why it is relapse prevention and not maintenance of addiction. Risk of not  treating comorbidities

    Managing withdrawal

    Group work – review of withdrawal syndromes by drug class,
    and treatment responses with consideration of settings in which withdrawal
    might occur.

    7

    Support, living skills and community care

    Rationale for support services, types of services (including
    self-help), why they work and for whom.

    Support, living skills and community care.

    Overview of therapeutic community approach, evidence of
    effectiveness, limitations of research evidence.

     Relapse prevention

    Case study of naltrexone – principles and effectiveness in
    treatment of alcohol or opioid dependence, interaction with psychosocial
    support.

    8

    Supporting special populations

    What defines “special populations”? Special services or coordination to meet special needs?

    Supporting special populations

    Examples: Correctional services, indigenous, adolescents, pregnancy, families

    Support, living skills and community care.

    Return to case studies: what sort of support might these
    people need? Where do self-help options fit in?

    9

    Treatment of comorbidities

    Association between substance use and mental health problems
    – extent, and cause and effect, including substance-induced psychosis. Treatment responses to treat comorbid anxiety, depression and other common comorbidities.
    Treatment of comorbidities: Managing care

    Principles of responding to both mental health and substance
    use disorders. Service delivery challenges and approaches.

     Presentations

    Student presentations (10% of overall grade), on addiction issues focusing on one of the special populations.

    10

    Public Health and policy responses

    Australian and international framework for responding to alcohol and other drug use. How can policy support treatment of comorbidity?

     Public Health and policy responses

    Injecting drug use as case study of public health response and harm-reduction approach

    Treatment of comorbidity

    Workshop on promoting behavioural change in context of
    mental health comorbidities

    11

    Promoting engagement in treatment

    Realistic goals and expectations. Specialist or primary care setting? Stigma. Role of coerced and mandatory treatment. Australian issues (access, distance, costs).

    Balancing expectations

    Australian experience of heroin prescription, rapid detox,
    and naltrexone, as an example of how addiction policy needs to balance public expectation with the biological realities of addiction.

    Public health and policy responses

    If cannabis were legalised, what public health and policy responses might be appropriate?

    12

    Advances in treatment of addiction

    Current trends in addiction that the treatment system needs
    to respond to (prescription opioids, naloxone for overdose prevention, novel substances, regulatory controls in the internet era, treatment of hepatitis C and HIV).

    Advances in treatment of addiction

    How might addiction treatment develop: genetics and personalised treatment; adapting to individual strengths and needs; e-interventions.

    Feedback session

    Course overview and exam preparation

  • Assessment

    The University's policy on Assessment for Coursework Programs is based on the following four principles:

    1. Assessment must encourage and reinforce learning.
    2. Assessment must enable robust and fair judgements about student performance.
    3. Assessment practices must be fair and equitable to students and give them the opportunity to demonstrate what they have learned.
    4. Assessment must maintain academic standards.

    Assessment Summary

    ASSESSMENT TASK

    TASK TYPE

    WEIGHTING

    COURSE LEARNING OUTCOME(S)

    Weekly online quizzes

    Formative

    0%

    1-8

    3x Online test

    Summative

    15%

    1-8

    Workshop participation

    Summative

    15%

    1-8

    Presentation

    Summative

    10%

    2,3,,5-9

    Assignment

    Summative

    15%

    9

    Exam

    Summative

    45%

    1-8

    Assessment Detail
    Weekly online quizzes (0%) - students will have
    access to weekly online quizzes to test their understanding of the topics.

    Online tests (15%) - students will sit three online content tests (assessment, types of treatment, recovery) of 5% each to test their
    understanding of the content.

    Workshop participation (15%) - student attendance and participation will contribute to 15% of the grade.

    Assignment (15%) – 1000 words critical appraisal of paper on an aspect of treatment

    Presentation (10%) - groups of students will be asked to research one aspect of the treatment of addictions and present to the class the significance of their topic to translation of knowledge into practice.

    Exam (45%) - students will sit an individual closed book exam to test their knowledge and understanding of the content.

    Submission
    The majority of tasks will be submission through MyUni.

    Late submissions of any student work are not acceptable. Coursework received  after the deadline will be penalised as follows:10% of total available points will be penalised per day (24 hour period or fraction thereof). An automatic zero mark will be applied after 7 days.
    Course Grading

    Grades for your performance in this course will be awarded in accordance with the following scheme:

    M10 (Coursework Mark Scheme)
    Grade Mark Description
    FNS   Fail No Submission
    F 1-49 Fail
    P 50-64 Pass
    C 65-74 Credit
    D 75-84 Distinction
    HD 85-100 High Distinction
    CN   Continuing
    NFE   No Formal Examination
    RP   Result Pending

    Further details of the grades/results can be obtained from Examinations.

    Grade Descriptors are available which provide a general guide to the standard of work that is expected at each grade level. More information at Assessment for Coursework Programs.

    Final results for this course will be made available through Access Adelaide.

  • Student Feedback

    The University places a high priority on approaches to learning and teaching that enhance the student experience. Feedback is sought from students in a variety of ways including on-going engagement with staff, the use of online discussion boards and the use of Student Experience of Learning and Teaching (SELT) surveys as well as GOS surveys and Program reviews.

    SELTs are an important source of information to inform individual teaching practice, decisions about teaching duties, and course and program curriculum design. They enable the University to assess how effectively its learning environments and teaching practices facilitate student engagement and learning outcomes. Under the current SELT Policy (http://www.adelaide.edu.au/policies/101/) course SELTs are mandated and must be conducted at the conclusion of each term/semester/trimester for every course offering. Feedback on issues raised through course SELT surveys is made available to enrolled students through various resources (e.g. MyUni). In addition aggregated course SELT data is available.

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  • Policies & Guidelines
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