title: Stigmatization of substance use disorders among internal medicine residents.
abstract: BACKGROUND
  Evidence suggests that some physicians harbor negative attitudes towards patients with substance use disorders (SUDs). The study sought to (1) measure internal medicine residents' attitudes towards patients with SUDs and other conditions; (2) determine whether demographic factors influence regard for patients with SUDs; and (3) assess the efficacy of a 10-hour addiction medicine course for improving attitudes among a subset of residents.
  
  
  METHODS
  A prospective cohort study of 128 internal medicine residents at an academic medical center in New York City. Scores from the validated Medical Condition Regard Scale (MCRS) were used to assess attitude towards patients with alcoholism, dependence on narcotic pain medication, heartburn, and pneumonia. Demographic variables included gender, postgraduate training year, and prior addiction education.
  
  
  RESULTS
  Mean baseline MCRS scores were lower (less regard) for patients with alcoholism (41.4) and dependence on narcotic pain medication (35.3) than for patients with pneumonia (54.5) and heartburn (48.9) (P < .0001). Scores did not differ based upon gender, prior hours of addiction education, or year of training. After the course, MCRS scores marginally increased for patients with alcoholism (mean increased by 0.16, P = .04 [95% confidence interval, CI: 0.004-0.324]) and dependence on narcotic pain medication (mean increased by 0.09, P = .10 [95% CI: 0.02-0.22]).
  
  
  CONCLUSIONS
  Internal medicine residents demonstrate less regard for patients with SUDs. Participation in a course in addiction medicine was associated with modest attitude improvement; however, other efforts may be necessary to ensure that patients with potentially stigmatized conditions receive optimal care.
authors.affiliation: a Division of Medical Ethics, Department of Public Health , Weill Cornell Medical College , New York , New York , USA.
authors.forename: Ellen C
authors.initials: EC
authors.lastname: Meltzer
authors.forename: Alexandra
authors.initials: A
authors.lastname: Suppes
authors.forename: Sam
authors.initials: S
authors.lastname: Burns
authors.forename: Andrew
authors.initials: A
authors.lastname: Shuman
authors.forename: Alex
authors.initials: A
authors.lastname: Orfanos
authors.forename: Christopher V
authors.initials: CV
authors.lastname: Sturiano
authors.forename: Pamela
authors.initials: P
authors.lastname: Charney
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Fins
mesh_terms: D001291:Attitude of Health Personnel; D003479:Curriculum; D004503:Education, Medical, Graduate; D005260:Female; D006356:Heartburn / Q000523:psychology; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D011014:Pneumonia / Q000523:psychology; D011446:Prospective Studies; D013240:Stereotyping; D019966:Substance-Related Disorders / Q000523:psychology*