April 2025 

Project title: “Vocational training in illicit drug addiction: Equipping health care practitioners with addiction treatment competences and techniques” (CARE4SUD)

2022-1-LT01-KA220-VET-000086077

Elaborated by: Direcția de Asistență Socială și Medicală                                

 

Context

Illicit drug addiction affects millions of people in the European Union (EU) and globally. The European Drug Report 2023 estimates that 83 million adults in the EU (i.e., 28.9% of the adult population) have used illicit drugs at least once during their lives. In 2019, at least 5,150 overdose deaths occurred in the EU, with a steady increase every year since 2012. Throughout Europe, the ratio between treatment services, such as residential programmes, therapists, psychiatrists, and counselors, is shrinking. As drug and alcohol consumption continues to spread at rapid rates, there are more people in need of help, and more addiction counselors are needed every year to meet the growing demand for professional addiction treatment.

These challenges are compounded by inadequate curricular time devoted to addiction medicine as well as the absence of trained faculty. Not surprisingly, healthcare workers have been found to feel ill-prepared to address the unique needs of their patients with substance use disorder (SUD). Research also indicates that stigma and a self-perceived lack of competence in handling SUDs have been cited as important factors that contribute to negative professional attitudes, such as having low regard for persons with SUD and a reluctance to work with them. Along the same line, the World Health Organization (WHO) ATLAS-SU survey on resources for the prevention and treatment of SUDs highlighted the deficiencies in training programmes on SUDs globally.

It is in this context that the CARE4SUD project came about. The Care4SUD | Vocational training in illicit drug addiction: Equipping health care practitioners with addiction treatment competencies and techniques is a project funded by the Erasmus + Programme of the European Union (KA 220  VET – Cooperation partnerships in vocational education and training)  and it is developed by Klaipėdos Ernesto Galvanausko Profesinio Mokymo Centras (Lithuania) in partnership with Inštitut za raziskave in razvoj Utrip (Slovenia), Sosu Ostjylland (Denmark),  Universidade do Porto (CIIE/FPCEUP | Portugal), Direcția de Asistență Socială și Medicală Cluj-Napoca (Romania) and Institute of Social Solidarity and Wellbeing: Social Mind (Greece).

The project’s overall objective is to ensure a higher professionalism of the healthcare workforce in the illicit drug addiction field at national and European levels. The target group of the project is formed by health care practitioners in the primary health sector inexperienced in illicit drug addiction and/or physicians who seek to enter the field of addiction to enhance their knowledge and skills required for employment and professional development; addiction professionals (social workers, psychologists, psychiatrists working in illicit drug abuse settings); Vocational Education and Training (VET) Educators, experts in the SUD  field, VET providers, social care professionals, as well as targeted policymakers. 

Within work package n°2 – Review and Analysis Report: Sharper lens on illicit drug addiction educational programmes, the partners explored all available national educational courses including vocational and online short courses that have potential to increase healthcare professionals’ skills in identifying and managing patients whose medical problems are caused or may be exacerbated by illicit drug use disorders. Six National Reports defining the gaps and shortages in practical and forward-looking skills in the illicit drug addiction healthcare industry at regional level as discussed with healthcare professionals and patients themselves were elaborated.

To understand the context of each of the countries that are part of the CARE4SUD project, a Transnational report on needs and gaps in illicit drug addiction was elaborated within the project, focusing on the legal and social framework regarding illicit drug addiction, the training offers that exist, and the perceptions of the participants in this project – drug users (or who have been) and health experts/workers in this field in the six partner countries. All partners acknowledged a tremendous lack of knowledge among healthcare workers in their countries on how to manage people who use drugs and a lack of interventions to reduce discriminatory attitudes. Despite the prevalence of medical illness among this population, their high utilization of health care services, and the increasing availability of effective treatment options, large numbers of individuals with substance use disorders still do not receive treatment and appropriate guidance and referrals. More than that, most healthcare professionals in Lithuania, Denmark, Greece, Slovenia, Romania, and Portugal do not receive sufficient education about addiction during medical school and residency, leading to a healthcare workforce that is inadequately equipped to provide substance abuse treatment services.

Aim of the policy brief: to present the needs and shortages in the practice context in the addiction training for healthcare professionals in the six participating countries and provide recommendations which could improve competencies in illicit drug addiction counseling skills related to screening, brief intervention, and referral to treatment.

Training in the addiction field: needs/gaps and recommendations

The common needs/gaps in all partner countries which were highlighted in the Transnational report and their subsequent recommendations are:

  • Lack of a holistic approach to patients’ health | Recommendation: Improving the cooperation between psychiatry, addiction doctors, general practitioners, and other parts of the health service. Facilitating the framework for a holistic approach to patients’ health.
  • Lack of skills and knowledge of healthcare workers in the field of addiction | Recommendation: Equipping healthcare workers for the tasks in the field of addiction with more tools and skills, such as communication and motivational skills, knowledge of treatment options, activity analysis, and collaboration with addiction therapists and other cross-sectoral partners.
  • Lack of competency validation and research in the field of addiction | Recommendation: Acknowledgement of importance of pooling and validating competencies in a unit that can develop and implement education and training, as well as a higher degree of research use to promote evidence-based interventions in the field of addiction.
  • Lack of continuing education of healthcare workers in the field of addiction | Recommendation: Participants pointed out that there is no specific continuing education for doctors, health, or social professionals in the field of addiction. There is a clear need for formalized, quality-assured, and specialized training opportunities and certification requirements.

Additional needs/gaps highlighted in Romania and their subsequent recommendations:

  • Lack of training courses for healthcare practitioners in approaching and treating substance users | Recommendation: Facilitating access of healthcare practitioners to training courses in regards to approaching and treating substance users to improve their knowledge in the field;
  • Lack of practical training courses, focused on how to recognise substance users, the main categories of drugs and their side effects, how to carry out an anamnesis, how to approach and manage these cases from a medical point of view and beyond | Recommendation: Developing more practical training courses in the field of addiction focused on how to recognise substance users, the main categories of drugs and their side effects, how to carry out an anamnesis, how to approach and manage these cases from a medical point of view and beyond;
  • The need for updates in curricula and introduce a new core subject on addictions during university studies in the healthcare field | Recommendation: Updating the curricula/introducing a new core subject on addictions during university studies in the healthcare field;
  • The need to develop protocols and best practice guidelines in this area | Recommendation: Developing protocols and best practice guidelines in this area to improve the intervention of healthcare practitioners in dealing with substance users and to facilitate the referral process;