Table 2 The actual number and average of teaching sessions per medical school identified by curriculum co-ordinators

Bio-psycho-social models of addiction

1a. Define substance misuse, dependence and addictive behaviour and distinguish between acceptable and problematic use

1b. Demonstrate awareness of the range of substances that can be misused, the different types and classes of addictive substances, their alternative and colloquial names and their effects

1c. Demonstrate awareness of the psychological, social, biological and genetic causes of dependence and addiction, the interactions between such factors in the individual and the different models used to describe addiction

1d. Describe the absorption, distribution, excretion and metabolism of drugs of addiction

1e. Describe the physical effects of addiction, including the key effects of drug addiction on neurotransmitter systems, mechanisms of drug tolerance and the physiological effects of withdrawal

Professionalism, fitness to practice and students’ own health

2a. Demonstrate a professional attitude towards substance misusers which incorporates a non-judgemental approach and respect for a patient's autonomy

2b. Describe the risk factors for substance misuse in themselves, in medical students and in healthcare workers

2c. Describe the sources of help for students and doctors with drug and alcohol related problems

2d. Describe how substance misuse problems may affect a healthcare professional’s judgement, performance and care for their patients

2e. Describe the need to balance due concern for the health of a colleague with responsibilities for the safety and welfare of patients

2f. Outline the role of the GMC and medical schools in ensuring students and doctors’ fitness to practice

2g. Demonstrate understanding of iatrogenic addiction

Clinical assessment of patients

3a. List the major clinical features of alcohol and drug dependence

3b. Describe the range of clinical outcomes of addiction and discuss the prognosis and management

3c. Take a focussed drug and alcohol history

3d. Elicit signs of alcohol or drug misuse through physical and mental state examinations and identify and prioritise medical and psychosocial problems associated with substance misuse

3e. Demonstrate appropriate skills for communicating sensitively with patients about substance misuse issues and for dealing with difficult, aggressive or intoxicated patients, balancing assessment need with their own safety and that of others

3f. Appropriately order and interpret urine and blood screening tests for drugs of addiction, use standardised screening and assessment instruments to detect alcohol and drug levels and describe other special investigations and how to interpret results

3g. Carry out a psychological assessment of a patient’s readiness to implement change

Treatment interventions

4a. Describe the basic treatment regimens for various addictions and withdrawal states

4b. Describe the basis of commonly used therapies for addiction, such as Brief Intervention therapy

4c. Describe the variety of UK agencies to which patients with addiction problems can be referred and how and where to make appropriate referrals for treatment

4d. Advise a patient on risk-reduction strategies for drug use

4e. Demonstrate awareness of risk related to needle use and disposal for healthcare workers and patients

4f. Advise a patient appropriately on reducing or abstaining from drinking and smoking and implement a treatment plan with the patient

4g. Advise addicted women on how to stabilise/discontinue substance use to minimise impact on foetal and maternal health

4h. Demonstrate awareness of the need to assess patients’ capacity to consent to treatment

4i. Describe the impact of substance misuse on concordance with treatment including Discharge Against Medical Advice and drug interactions

Epidemiology, public health and society

5a. Describe UK policies on drug use, drug dispensing and prescribing and on alcohol and smoking

5b. Describe UK legislation on controlling drugs, alcohol and tobacco, including the legal limits for alcohol and driving and the recommended maximum limits for alcohol consumption

5c. Describe UK strategies for the prevention of drug misuse

5d. Describe international policies and strategies to limit drug supply and demand

5e. Describe the epidemiology of alcohol consumption, smoking, drug misuse in the general population and specifically in doctors and other healthcare professionals

5f. Describe the problems associated with self-medication

5g. Demonstrate awareness of the risks in different work environments and the need for employers to have drug and alcohol policies

5h. Describe the effects of addiction on individuals, their families, friends and colleagues in a range of age-groups; from children and adolescents to older people

5i. Describe the long-term social consequences of various types of addiction and substance misuse, including the economic consequences and the links between crime and substance misuse

5j. Describe the risks to the children of addicted parents including child protection policies and a doctor’s duty to implement these

5k. Demonstrate an understanding of the principles of rational prescribing and the use of psycho-active medication

Specific disease and speciality topics

6a. Recognising life-threatening complications of substance misuse, including septicaemia, pulmonary emboli and overdose and be able to carry out appropriate interventions

6b. Describe and explain the links between substance misuse and accidents; lung disease, specifically smoking; anxiety, depression, dementia, schizophrenia; self-harm and suicide; heart disease and hypertension; liver disease, pancreatitis and gastritis; infectious diseases, including HIV and hepatitis B and C; cancers; sleep disorders; weight problems

6c. Show awareness of substance misuse in the aetiology of neurological conditions including seizures, par aesthesia and stroke

6d. Describe the effects of addiction, drug and alcohol use on pregnancy