12/2/2023 0 Comments Hidden in plain sight ct3,5,6 Contemporary views also endorse addiction as a treatable, chronic disease involving interactions among genetics, brain circuitry, and environmental and personal variables. 3 These strategies convey a more favorable prognosis and highlight the availability of effective treatments. 2Īdditional efforts to increase addiction literacy include public health campaigns, attending of Alcohol Anonymous meetings by trainees, and the use of neutral language toward these patients. 3 As awareness of the hidden curriculum and its effects has increased, so has interest in mitigating it. 3 The SUD population exhibits significant gaps in preventive care and carries serious medical and psychiatric comorbidities that may go untreated. Such beliefs may affect clinical decisions, often in ways that may worsen patient outcomes. One study 3 found that one-third of PCPs did not believe in the effectiveness of pharmacotherapy for OUD despite strong empirical evidence to the contrary. Although this concept remains ambiguous, it generally refers to the unwritten, informal teachings that trainees learn for better or worse from mentors. The authors 4 attributed this improvement to direct contact with peers and family who shared stories of suffering and recovery addressing the “hidden curriculum” in addiction. 2 Of note, there was statistically significant improvements in this measure after the training, which persisted for 6 months. The variable of interest was the Medical Condition Regard Scale, which measures the extent to which a respondent perceives individuals with a given disease to be likable, treatable, and deserving of medical resources. Participants learned about effective treatments and heard stories from patients in recovery. One recent study by Sundaresh et al 4 published in the PCC evaluated the effects of training in reducing SUD stigma among medical residents. 2 When this happens, the authenticity of patient-reported symptoms may be called into question, complicating care. 2 Indeed, knowledge that a person drinks heavily may decrease ratings of a patient’s likability even prior to the first interview. In response, many practitioners reflexively view them as persona non grata. 2,3 Some of these patients may feign symptoms to access controlled medications. To be fair, patients with SUD present with multifaceted biopsychosocial problems that are often difficult to treat. 3 The degree of stigma correlated inversely with the likelihood of considering standard care for these patients. 2 Available data on the attitudes of primary care physicians (PCPs) toward individuals with opioid use disorder (OUD) reveal that PCPs consider these individuals dangerous and desire social distance from them. In the case of persons with substance use disorders (SUDs), it has been widely documented, and physicians are not immune. Now, while we no longer mark vagabonds and thieves in this fashion, stigma still is very much alive. 1 Branding of the face with various letters was used as a punishment from antiquity all the way through 19th century England. To the Editor: Stigma refers to “a mark of disgrace,” and its use has always implied a kind of permanence.
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