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Infusing Opioid Addiction into the BSW Curriculum: A Teaching Note

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Title: Infusing Opioid Addiction into the BSW Curriculum: A Teaching Note
Language: English
Authors: Hash, Kristina M., Tower, Leslie E.
Source: Journal of Teaching in Social Work. 2022 42(5):571-577.
Availability: Routledge. Available from: Taylor & Francis, Ltd. 530 Walnut Street Suite 850, Philadelphia, PA 19106. Tel: 800-354-1420; Tel: 215-625-8900; Fax: 215-207-0050; Web site: http://www.tandf.co.uk/journals
Peer Reviewed: Y
Page Count: 7
Publication Date: 2022
Sponsoring Agency: National Institute on Alcohol Abuse and Alcoholism (NIAAA) (DHHS/NIH)
Intended Audience: Teachers
Document Type: Journal Articles
Reports - Descriptive
Education Level: Higher Education
Postsecondary Education
Descriptors: Narcotics, Addictive Behavior, Social Work, Undergraduate Students, College Curriculum, Curriculum Development, Curriculum Evaluation
Geographic Terms: West Virginia
DOI: 10.1080/08841233.2022.2120159
ISSN: 0884-1233
1540-7349
Abstract: Opioid addiction is a widespread problem that social workers will undoubtedly face in practice. Curricular infusion is an approach that has gained recognition in social work education for integrating critical, contemporary topics into courses. This paper details a project that infused opioid addiction in baccalaureate of social work (BSW) courses, including human behavior in the social environment (HBSE), policy, and research. When implemented and evaluated, this effort was found to be beneficial to student learning and has implications for integrating this and other contemporary issues into the curriculum.
Abstractor: As Provided
Entry Date: 2023
Accession Number: EJ1370708
Database: ERIC
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  Value: <anid>AN0160050397;8am01nov.22;2022Nov08.05:12;v2.2.500</anid> <title id="AN0160050397-1">Infusing Opioid Addiction into the BSW Curriculum: A Teaching Note </title> <p>Opioid addiction is a widespread problem that social workers will undoubtedly face in practice. Curricular infusion is an approach that has gained recognition in social work education for integrating critical, contemporary topics into courses. This paper details a project that infused opioid addiction in baccalaureate of social work (BSW) courses, including human behavior in the social environment (HBSE), policy, and research. When implemented and evaluated, this effort was found to be beneficial to student learning and has implications for integrating this and other contemporary issues into the curriculum.</p> <p>Keywords: curricular infusion; undergraduate social work; social work education; opioid addiction</p> <hd id="AN0160050397-2">Background and purpose</hd> <p>Opioids are a group of drugs that include heroin and prescription pain killers (such as Oxycodone). In 2016, over 11 million individuals over the age of 12 misused opioids, with the majority abusing pain killers. Over 9 million people aged 12+ misused opioids in 2020 (SAMHSA, [<reflink idref="bib17" id="ref1">17</reflink>]). Furthermore, over 50,000 people died from opioid overdoses in the United States in 2019 and opioids accounted for 70% of all drug overdose deaths (Centers for Disease Control (CDC), [<reflink idref="bib4" id="ref2">4</reflink>]). Addiction to opioids has become a critical problem in the Appalachian region as counties there have seen over 70% more opioid overdose deaths than in other areas (National Association of Counties (NACo) and Appalachian Regional Commission (ARC), [<reflink idref="bib13" id="ref3">13</reflink>]). This region consists of the state of West Virginia, and parts of Alabama, Georgia, Kentucky, Maryland, Mississippi, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, and Virginia. About half of the Appalachian Region is rural and it has historically been equated with poverty and geographic isolation but also with the independent nature and resilience of its residents (Appalachian Regional Commission, [<reflink idref="bib2" id="ref4">2</reflink>]., Hilly, 2015). In 2018, the state of West Virginia, within this region, had the highest percentage of opioid related deaths and the highest opioid prescription rate in the country (National Institute on Drug Abuse (NIDA), [<reflink idref="bib14" id="ref5">14</reflink>]).</p> <p>Social workers working with persons suffering from opioid dependence are likely to be involved in intervention, education, advocacy, and research associated with these issues (Byrne et al., [<reflink idref="bib3" id="ref6">3</reflink>]). Given the misuse, dependence, and overdoses in West Virginia and surrounding areas, two professors at a large, public university were committed to infusing content related to this issue in BSW-level HBSE, policy, and research courses. In addition, one of the instructors had attended the Alcohol and Other Drugs Education Program (AOEP) Fellowship for social work educators funded by NIH/HIAAA, and integrated knowledge gained from the training into courses.</p> <p>Curricular infusion of specialty topics is not new to social work education. When a separate course on a particular topic is not possible or warranted, infusing content across courses can integrate important themes and contemporary practice issues into the curriculum (Kahn & Scher, [<reflink idref="bib8" id="ref7">8</reflink>]; Kopels & Gustavsson, [<reflink idref="bib9" id="ref8">9</reflink>]; Singleton, [<reflink idref="bib16" id="ref9">16</reflink>]). The purpose of this particular infusion effort was to provide students with an understanding of a contemporary and regionally relevant practice issue through the lenses of human behavior theories, policy analysis, policy-practice, and research skills, which span various system levels. The instructors purposely selected non-practice courses to provide a less traditional route for integrating the issue, giving students the opportunity to think about opioid addiction from theoretical and macro perspectives. All activities were designed with regard to (and matched with) EPAS competencies. (Council on Social Work Education (CSWE), [<reflink idref="bib5" id="ref10">5</reflink>]).</p> <hd id="AN0160050397-3">Curricular infusion efforts</hd> <p>Several curricular infusion efforts were undertaken in undergraduate social work HBSE, policy, and research courses at West Virginia University. As noted, these courses specifically were chosen so that students could gain a deeper understanding the issue of opioid addiction from non-practice specific perspectives. The HBSE sequence includes two courses, the first which covers human development within the family context and the second that focuses on human behavior within groups, organizations, and communities. In these courses, students were exposed to guest speakers, documentaries, journal articles, and exercises that showed how the problem affects individuals at various stages in the life course and impacts (and in turn is impacted by) families, groups, organizations, and communities (Council on Social Work Education (CSWE), [<reflink idref="bib5" id="ref11">5</reflink>], EPAS Competencies 3 & 7).</p> <hd id="AN0160050397-4">Human Behavior in the Social Environment</hd> <p>One film was integrated into both HBSE courses. "Recovery Boys" (Sheldon, [<reflink idref="bib15" id="ref12">15</reflink>]) is a Netflix documentary that follows a group of young men living in a farm-based, residential substance abuse recovery program and chronicles their past traumas, relationships with their families and home communities, their current struggles to overcome addiction, and the connections they form with other residents and staff. The film is set in a county adjacent to the university and the recovery program was founded largely in response to the opioid epidemic in the state, hence it was particularly relevant in terms of the region. In the first HBSE course, the film was shown in its entirety during the unit on young adulthood. After viewing the film, the class discussed the risk and protective factors related to substance abuse from childhood to young adulthood and how substance abuse might impact Erik Erikson's stage of intimacy versus isolation, and the transition to adulthood (Matto, [<reflink idref="bib10" id="ref13">10</reflink>]). The class also considered what it might take to overcome addition in this stage of the life course. The documentary was again used in the second HBSE course to exemplify human behavior in groups. (Only clips that showed group therapy and highlighted the group living situation were shown from the film in this course.) Discussion revolved around the application of the definition of a group, different types of groups (primary/secondary, treatment/task, therapy/support/educational/ growth/socialization), and what groups can provide for persons in recovery (as differentiated from individual treatment). Related to this documentary, a social worker who was an alumnus of the school's MSW program, who was employed as a therapist at the recovery program featured in "Recovery Boys," provided a guest lecture related to organizations and communities. He addressed the culture of the organization and what made it successful, how problems among group members are addressed, how the community where the organization is located interacts with and impacts the organization and its members, and how, in general, communities can influence persons who are dealing with addiction.</p> <hd id="AN0160050397-5">Policy</hd> <p>The second policy course, Social Welfare Policy and Services II, prepares students to formulate, influence and advocate for policy consistent with social work values. Furthermore, students are expected to articulate the impact of policy choices on people from diverse backgrounds, and other populations-at-risk in the USA, with emphasis upon rural communities.</p> <p>In this course, students apply policy-practice skills used to influence the development and implementation of opioid policy in the state. Students identified stakeholders and estimated the values and facts that framed the Opioid Response Plan for the State of West Virginia, developed by the State Office of Drug Control Policy, which was created by the 2017 West Virginia State Drug Control Policy Act (Competency 8). Students tracked the policy process of opioid bills: researching bill sponsors, tracking bills, and advocating, for or against, opioid legislation by calling, emailing, or writing legislators prior to key votes, in committee, on the floor. Decisions on whether to support or oppose opioid legislation relied on the NASW Code of Ethics, Social Work Speaks, and the West Virginia State Opioid Response Plan (Gupta, [<reflink idref="bib6" id="ref14">6</reflink>]; NASW, [<reflink idref="bib11" id="ref15">11</reflink>], [<reflink idref="bib12" id="ref16">12</reflink>]).</p> <hd id="AN0160050397-6">Research</hd> <p>The unifying theme of the research course was the importance of evidence-based practice. Content prepares students to develop, use, and effectively communicate empirically based knowledge. Research knowledge is used to provide high-quality services; initiate change to improve practice, policy and social service delivery; and evaluate one's own practice at all levels. In the research course, scholarly articles on the topic were reviewed in terms of methodology and approach to the problem (Competency 9).</p> <p>The course is largely organized around sections commonly found in empirical articles: introduction, ethics, literature, hypotheses/research questions, design, sample, measurement, data analysis, limitations, implications, & future research questions, with additional content infused throughout, as appropriate. As each unit is covered, two in-class activities are conducted: development of a research proposal and critique of an empirical study. For the research proposal, the instructor leads the class through discussions to develop a research proposal. Each week this draft proposal is expanded, applying the new unit's content and identifying strengths and weaknesses of methodological options. The article critique is facilitated in small groups. Using a rubric, students identify and evaluate the unit's content using an empirical article provided by the instructor.</p> <p>Content on the opioid crisis was infused by the addition of two empirical articles on opioid use (Andrabi et al., [<reflink idref="bib1" id="ref17">1</reflink>]; Heidari et al., [<reflink idref="bib7" id="ref18">7</reflink>]) to in-class activities, In the design unit, where students focused on the sample size, design, and how findings were presented, to determine whether a study was quantitative or qualitative, Heidara replaced a quantitative article. In the measurement unit, where students compared the strengths and weaknesses of sample, reliability, validity, and practicality of two loci of control scales, Andrabi and colleagues added a third scale for comparison. Near the end of the semester, as a review, students used the opioid articles again to apply the article critique rubric to evaluate all research articles in a single class session. They then were asked to determine what, if anything, they might apply in their upcoming field placement.</p> <hd id="AN0160050397-7">Evaluation</hd> <p>Instructors for the courses implemented a brief evaluation of these efforts. This evaluation showed these efforts to be beneficial to student learning. The evaluation consisted of the course Student Evaluation of Teaching (SET) survey, which was anonymously collected at the end of each course. (Faculty are required administer SETs for all courses.) SETs are comprised of items selected by the provost, college, and course instructor. The items reported herein were written by the course instructors. Unfortunately, the items for the research courses did not appear on the SET survey, making it impossible to report.</p> <p>On a 5-point Likert style scale, students were asked if the material on the opioid epidemic increased their knowledge of it (mean = 4.57, <emph>SD </emph>= 0.802, <emph>n </emph>= 67) or was beneficial to their learning (mean = 4.63, <emph>SD </emph>= 0.706, <emph>n </emph>= 51). The means from each of the 5 course sections ranged from 4.36 (<emph>SD </emph>= 1.08, <emph>n </emph>= 22) to 4.90 (<emph>SD </emph>= 0.30, <emph>n </emph>= 21). More detail about the findings are provided in Table 1.</p> <p>Table 1. Summary of the evaluation of opioid discussion in SOWK 310, 330, and 350.</p> <p> <ephtml> <table><thead><tr><td /><td>SOWK Policy 2 (Spring 2019) n = 21</td><td>SOWK HBSE I (Fall 2019) <italic>n = </italic>16</td><td>SOWK HBSE I (Fall 2018) <italic>n = 14</italic></td><td>SOWK HBSE 2 (Spring 2019) <italic>n = 22</italic></td><td>SOWK HBSE 2 (Spring 2019) <italic>n = 15</italic></td></tr></thead><tbody><tr><td>The films, discussions, and speakers helped my knowledge of the opioid epidemic?</td><td /><td>4.69 (0.48)</td><td>4.50 (1.09)</td><td>4.36 (0.95)</td><td>4.80 (0.41)</td></tr><tr><td>The content related to opioid addiction in WV and its impact on policy was beneficial to my learning.</td><td>4.90 (0.30)</td><td>4.63 (0.62)</td><td>4.36 (1.08)</td><td /><td /></tr></tbody></table> </ephtml> </p> <hd id="AN0160050397-8">Discussion</hd> <p>Integrating critical topics should be a more utilized approach, as it can better prepare students for the real world, and contextually relevant challenges that they will face in professional practice. Accomplishing this in non-practice specific courses can also offer a uniquely beneficial view. Given the multi-course exposure, we believe students can gain much broader knowledge and more effective tools to intervene in these issues. As such, additional projects aimed at infusing a contemporary topic into multiple required courses is highly recommended (Kahn & Scher, [<reflink idref="bib8" id="ref19">8</reflink>]).</p> <p>A few limitations of this project, however, are apparent. First, not all students completed the SETs. Also, we did not keep track of students who were present for the content and those who were not, and data were also not collected for infusion in the research course. Future initiatives would benefit from a more robust evaluation, so a more detailed assessment of student learning would be achieved. A longitudinal look at the retention of knowledge gained from these courses could also be accomplished by surveying students in their field placements, and when they are engaged in professional practice.</p> <hd id="AN0160050397-9">Conclusion</hd> <p>Opioid addiction is a continuing problem across the U.S. and social workers can expect to work with individuals, families, as well as communities, facing this devastating problem. Infusing this topic across courses in the undergraduate or graduate social work curriculum can prove beneficial to students and can allow them to attach various course concepts to a particular practice issue that they are likely to encounter in their field experience and career.</p> <hd id="AN0160050397-10">Acknowledgments</hd> <p>The authors would like to acknowledge the incredible support of this project from the WVU School of Social Work Bachelor of Social Work Students, BSW Program Director Linda Ferrise and BSW Program Coordinator Carol Amendola, and Elias Tancin, MSW, therapist at Jacob's Ladder at Brookside Farm, LLC. The first author would also like to thank the Alcohol and Other Drugs Education Program (AOEP) Fellowship directed by the University of Denver School of Social Work and funded by the National Institutes of Health/National Institute on Alcohol Abuse and Alcoholism for allowing her to be part of their excellent training on substance abuse treatment methods on how to integrate the content into the social work curriculum.</p> <hd id="AN0160050397-11">Disclosure statement</hd> <p>No potential conflict of interest was reported by the author(s).</p> <ref id="AN0160050397-12"> <title> References </title> <blist> <bibl id="bib1" idref="ref17" type="bt">1</bibl> <bibtext> Andrabi, S. A., Dhobi, M. R., & Akther, S. (2019). Exploration of locus of control among substance abusers and non-abusers. International Journal of Indian Psychology, 7 (1), 373 – 382. https://doi.org/10.25215/0701.042</bibtext> </blist> <blist> <bibl id="bib2" idref="ref4" type="bt">2</bibl> <bibtext> Appalachian Regional Commission. (nd.). The appalachian region. https://<ulink href="http://www.arc.gov/appalachian%5fregion/TheAppalachianRegion.asp">www.arc.gov/appalachian%5fregion/TheAppalachianRegion.asp</ulink></bibtext> </blist> <blist> <bibl id="bib3" idref="ref6" type="bt">3</bibl> <bibtext> Byrne, M. H., Lander, L., & Ferris, M. (2009). The changing face of opioid addiction: Prescription pain pill dependence and treatment. Health & Social Work, 34 (1), 53 – 56. https://doi.org/10.1093/hsw/34.1.53</bibtext> </blist> <blist> <bibl id="bib4" idref="ref2" type="bt">4</bibl> <bibtext> Centers for Disease Control (CDC). (2020). Data Overview. The drug overdose epidemic: Behind the numbers. CDC, National Center for Health Statistics; https://<ulink href="http://www.cdc.gov/opioids/data/index.html">www.cdc.gov/opioids/data/index.html</ulink>.</bibtext> </blist> <blist> <bibl id="bib5" idref="ref10" type="bt">5</bibl> <bibtext> Council on Social Work Education (CSWE). (2015). Educational policy and accreditation standards (EPAS). Author.</bibtext> </blist> <blist> <bibl id="bib6" idref="ref14" type="bt">6</bibl> <bibtext> Gupta, R. (2018). Opioid Response plan for the State of West Virginia. Department of Health and Human Resources Bureau of Public Health. https://dhhr.wv.gov/bph/Documents/ODCP%20Response%20Plan%20Recs/Opioid%20Response%20Plan%20for%20the%20State%20of%20West%20Virginia%20January%202018.pdf</bibtext> </blist> <blist> <bibl id="bib7" idref="ref18" type="bt">7</bibl> <bibtext> Heidari, M., Ghodusi, M., Akbari, A., & Naseh, L. (2018). Self-esteem and locus of control in the initial and final stages of drug withdrawal among addicts attending rehabilitation centers. Rawal Medical Journal, 43 (2), 309 – 313. https://<ulink href="http://www.rmj.org.pk/fulltext/27-1487326752.pdf">www.rmj.org.pk/fulltext/27-1487326752.pdf</ulink></bibtext> </blist> <blist> <bibl id="bib8" idref="ref7" type="bt">8</bibl> <bibtext> Kahn, M., & Scher, S. (2002). Infusing content on the physical environment into the BSW curriculum. The Journal of Baccalaureate Social Work, 7 (2), 1 – 14. https://doi.org/10.18084/1084-7219.7.2.1</bibtext> </blist> <blist> <bibl id="bib9" idref="ref8" type="bt">9</bibl> <bibtext> Kopels, S., & Gustavsson, N. S. (1996). Infusing legal issues into the social work curriculum. Journal of Social Work Education, 32 (1), 115 – 125. https://doi.org/10.1080/10437797.1996.10672289</bibtext> </blist> <blist> <bibtext> Matto, H. C. (2019). Young adulthood. In E. D. Hutchison (Ed.), Dimensions of human behavior: The changing life course (6th) ed., pp. 231 – 268). SAGE.</bibtext> </blist> <blist> <bibtext> NASW. (2017) Code of ethics. Author.</bibtext> </blist> <blist> <bibtext> NASW. (2018). Social work speaks (11th. ed.).</bibtext> </blist> <blist> <bibtext> National Association of Counties (NACo) and Appalachian Regional Commission (ARC). (2019), Opioids in appalachia: the role of counties in reversing a regional epidemic, may 2019. https://<ulink href="http://www.naco.org/sites/default/files/documents/Opioids-Full.pdf">www.naco.org/sites/default/files/documents/Opioids-Full.pdf</ulink></bibtext> </blist> <blist> <bibtext> National Institute on Drug Abuse (NIDA). (2020). Opioid summaries by state. https://<ulink href="http://www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state">www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state</ulink></bibtext> </blist> <blist> <bibtext> Sheldon, E. M. (2018). Recovery boys (Film). Director. Netflix.</bibtext> </blist> <blist> <bibtext> Singleton, J. L. (2006). Infusing gerontology throughout the BSW curriculum. Journal of Gerontological Social Work, 48 (1–2), 31 – 46. https://doi.org/10.1300/J083v48n01_03</bibtext> </blist> <blist> <bibtext> Substance Abuse and Mental Health Services Administration (SAMHSA). (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. https://<ulink href="http://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf">www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf</ulink></bibtext> </blist> </ref> <aug> <p>By Kristina M. Hash and Leslie E. Tower</p> <p>Reported by Author; Author</p> <p></p> <p>Kristina M. Hash , LICSW, PhD, is Professor, School of Social Work, Eberly College of Arts and Sciences, West Virginia University.</p> <p>Leslie E. Tower , MSW, PhD is Director, Women's Resource Center (WRC) and Professor & Assessment Coordinator in the School of Social Work, Eberly College of Arts and Sciences, West Virginia University.</p> </aug> <nolink nlid="nl1" bibid="bib17" firstref="ref1"></nolink> <nolink nlid="nl2" bibid="bib13" firstref="ref3"></nolink> <nolink nlid="nl3" bibid="bib14" firstref="ref5"></nolink> <nolink nlid="nl4" bibid="bib16" firstref="ref9"></nolink> <nolink nlid="nl5" bibid="bib15" firstref="ref12"></nolink> <nolink nlid="nl6" bibid="bib10" firstref="ref13"></nolink> <nolink nlid="nl7" bibid="bib11" firstref="ref15"></nolink> <nolink nlid="nl8" bibid="bib12" firstref="ref16"></nolink>
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  Data: Opioid addiction is a widespread problem that social workers will undoubtedly face in practice. Curricular infusion is an approach that has gained recognition in social work education for integrating critical, contemporary topics into courses. This paper details a project that infused opioid addiction in baccalaureate of social work (BSW) courses, including human behavior in the social environment (HBSE), policy, and research. When implemented and evaluated, this effort was found to be beneficial to student learning and has implications for integrating this and other contemporary issues into the curriculum.
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      – SubjectFull: Undergraduate Students
        Type: general
      – SubjectFull: College Curriculum
        Type: general
      – SubjectFull: Curriculum Development
        Type: general
      – SubjectFull: Curriculum Evaluation
        Type: general
      – SubjectFull: West Virginia
        Type: general
    Titles:
      – TitleFull: Infusing Opioid Addiction into the BSW Curriculum: A Teaching Note
        Type: main
  BibRelationships:
    HasContributorRelationships:
      – PersonEntity:
          Name:
            NameFull: Hash, Kristina M.
      – PersonEntity:
          Name:
            NameFull: Tower, Leslie E.
    IsPartOfRelationships:
      – BibEntity:
          Dates:
            – D: 01
              M: 01
              Type: published
              Y: 2022
          Identifiers:
            – Type: issn-print
              Value: 0884-1233
            – Type: issn-electronic
              Value: 1540-7349
          Numbering:
            – Type: volume
              Value: 42
            – Type: issue
              Value: 5
          Titles:
            – TitleFull: Journal of Teaching in Social Work
              Type: main
ResultId 1