$1.2M Grant Will Train Nurses in Addiction Problems

BUFFALO, N.Y. -- The School of Nursing at the University at Buffalo will incorporate specialized training in addictive disorders and mental-health conditions into its family nurse practitioner program this fall, making it one of the first nursing schools to offer such training for primary-care nurses.

The new graduate training program will be funded by a three-year, $1.2 million grant from the federal Health Resources and Services Administration. Two new semester-long, three-credit courses will be incorporated into the existing family nurse practitioner curriculum, and revisions will be made to some existing courses.

The new curriculum will be offered through traditional on-campus classes, as well as via distance learning to family nurse practitioner students living in rural and underserved areas. Graduates will qualify for dual certification in family-health nursing and advanced-practice addictions nursing.

"It's unusual to see patients in primary-care settings who don't have some type of addiction or mental-health issue, which complicates many primary-care problems," said Nancy Campbell-Heider, Ph.D., UB associate professor of nursing and principal investigator on the grant.

"Many are lifestyle problems that co-exist with mental-health problems. Addiction and mental-health conditions could, and should, be identified in the primary-care setting, but there is little specialty training available. Providers know these problems exist, but frequently aren't trained to focus on them."

Addictions that impair health include a spectrum of problematic activities, many of which are interrelated, noted Campbell-Heider. They include use and abuse of illicit and prescription drugs, use and abuse of alcohol and nicotine, compulsive gambling, sex addiction and the eating disorders of anorexia, bulimia and obesity. Co-occurring disorders such as depression and anxiety add to the complexity of primary-care management of these addictions.

Current education in addictions for primary-care providers often amounts to less than three hours of specialty training, said Campbell-Heider. The inadequacy of this amount of training was revealed in a study conducted by Campbell-Heider and a team from the UB School of Nursing that surveyed 213 nurse practitioners and other advanced-practice nurses in New York State. Only 12 percent of respondents

reported having six or more hours of training in addiction disorders, while 57 percent had fewer than three hours of training. Sixty-two percent considered addictions training to be "moderately" or "very" valuable. Three percent considered it of "no value."

In addition, a review of the clinical logs of 10 family-nurse-practitioner graduates revealed a considerable disconnect between the numbers of patients with addictions that were being diagnosed in their clinical practice sessions compared to expected national averages.

Results of the review showed that depression was the only condition diagnosed with the expected frequency out of nine common addictive and mental-health conditions that could be diagnosed and treated at the primary-care level. Only 1 percent of anticipated cases of illicit drug use, 2 percent of anorexia nervosa cases and 3 percent of drug- and alcohol-dependence cases were identified. Of anticipated cases of nicotine use, heavy drinking, obesity and anxiety, only 12 percent, 14 percent, 24 percent and 44 percent, respectively, were identified.

"Problems related to addictions are a major public-health problem facing contemporary American society," said Campbell-Heider. "Clearly we need to train primary-care professionals to diagnose these problems early. Education also in needed to eliminate the negative perceptions of health providers toward patients with alcohol, drug or obesity problems, which can interfere with diagnosis and treatment."

For more information or to apply to the program, contact Campbell-Heider at 716-829-3325 or nheider@buffalo.edu.