This application seeks to establish a research training program on the topic of addiction medicine in primary care at UCLA. The rationale reflects both the significance of the program and recent developments in the field. First, problem use and abuse of psychoactive substances, which is highly prevalent among primary care patients, is one type of "chronic disease." Primary care physicians frequently manage chronic diseases within the context of the "medical home" and as such, represent an important opportunity to reduce personal, fiscal and social impacts of addiction using medical management of addiction problems in primary care. Secondly, four medications have been brought on market for treating opioid, alcohol and nicotine seven dependence over the past decade. There is a significant gap in the evidence describing how these new and standard addiction medications can be optimally integrated into primary care to improve quality of life and to reduce suffering for those afflicted. The goal of this training program is to provide physician and behavioral trainees with the research, academic training and mentored professional development to transition into independently funded clinical researchers in the emerging area of research on the topic of addiction medicine in primary care. The application brings together 14 faculty clinical research mentors at UCLA whose expertise covers the lifespan and includes family medicine, pediatrics, general internal medicine and geriatrics. The program includes a Program Director who has conducted extensive clinical research on addiction medicine in primary and specialty care settings, an Associate Director with outstanding experience in conducting research on under-represented populations and an Executive Committee that provides guidance and oversight that is comprised of senior faculty mentors and a fellow representative. A plan for providing continual evaluation of trainee progress and mentorship quality is described, complete with procedures for corrective action to address deficiencies in progress, should these arise. An energetic plan for the recruitment of trainees is described, including a plan for recruitment and retention of minority investigators.
This training program for physicians and postdoctoral scholars will prepare the next generation of health care providers in detecting, caring for and treating patients with substance abuse problems. The high prevalence and the significant health and social costs of drug use, abuse and dependence in this country justify the need for substance abuse to be addressed in primary care settings.
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