170 - Adolescent Substance Use, Addiction and Opioid Overdose: Identifying Knowledge Gaps in Pediatric Residency Training

Publication Number: 1159.170

Gabrielle Padilla, Joseph M. Sanzari Children's Hospital Hackensack University Medical Center, Morristown, NJ, United States; Andy J.. Reyes Santos, Hackensack University Medical Center, Bloomingdale, NJ, United States; Edward Jung, Joseph M. Sanzari Children's Hospital Hackensack University Medical Center, Fort Lee, NJ, United States; Susan G.. Mautone, Joseph M. Sanzari Children's Hospital, Hackensack University Medical Center, Hackensack, NJ, United States

Background: Drug overdose was the third leading cause of death among U.S. adolescents in 2022. Thus, substance abuse and overdose should be at the forefront of pediatric resident education. Literature reviews identified harm reduction such as naloxone training as a gap in medical education. We undertook a baseline assessment of residents' knowledge of addiction and the current opioid crisis.

Objective: To identify gaps across training levels in pediatric resident knowledge of adolescent substance use and addiction, including recognition and management of opioid overdose

Design/Methods: A 20 question anonymous survey was completed by all 24 program residents. Questions were written by the authors with help from a statistician. There were 17 knowledge questions (7 general addiction, 10 overdose related) and 3 comfort questions which used true/false format to assess confidence in connecting patients to resources, recognizing overdose, and administering naloxone. Comparison between classes used a two tailed t test with a two sample t test with unequal variance (n=8 per class). Scores were also compared between subject areas, using a paired two tailed t test. The percent of residents answering "true" for the three comfort questions was calculated.

Results: Overall knowledge scores were nonsignificantly higher with each year of training (Fig 1). Knowledge about addiction was significantly higher than knowledge about overdose and naloxone for all PL levels (0.89 vs 0.69, p=0.0004). PL-3 residents overall felt significantly more comfortable helping those with addiction, recognizing an overdose, and administering naloxone (0.88 vs 0.71). 66% percent of all residents knew how to assist someone who wanted to quit using drugs. Strikingly, only 21% of residents knew that the most common route of U.S. drug overdose deaths since 2022 is via smoking, and only 12.5% were aware of the free availability of naloxone in our state for anyone 14 years and older.

Conclusion(s): This resident survey identified key areas of our existing substance use and addiction curriculum in need of enhancement. Knowledge of opioid overdose and management was lower than knowledge of addiction in general, highlighting the need for resident education in these areas. One third of residents did not know how to assist a patient who wants to quit using drugs, identifying another area for focused resident education. This information can serve to guide the focus of annually updated resident education on adolescent substance use in other residency programs, so future pediatricians are equipped to help those suffering from addiction and treat overdose.

Resident Scores by Category and Year of training
Figure 1: Average of class scores in each category. PL = Pediatric Level