Source	Overview and Objectives	Core Competencies	Overlapping Themes and Key Takeaways	Professional Practice Gaps Mapping Results
American Society of Addiction Medicine (ASAM) - Standards of Care for Addiction Specialists (2014) https://www.asam.org/docs/defaultsource/practice-support/quality-improvement/asam-standards-of-care.pdf?sfvrsn=10	Intended for any physician/practitioner assuming the responsibility for caring for addiction and related disorders. Standards aim to “raise the bar” of expectations and account-abilities by describing what is expected of physicians during different points in the addiction care process.	Standards: I.Assessment and diagnosis II.Withdrawal management III.Treatment planning IV.Treatment management V.Care transitions and care coordination VI.Continuing care management	Overlapping Themes: diagnostic criteria, medical interventions, biopsychosocial interventions, treatment alternatives and advantages/disadvantages, physical exam, patient history, coordinating team-based care, specialist referrals, safety and risk evaluations, patient-involved clinical decision making Key Takeaways: collecting medical/social history/family history, sharing information and protecting privacy, documentation	Clinical knowledge Communicating with other members of the care team Patient demographics Referral resources Provider-patient relationship
ASAM - Competencies of Addiction Medicine Recognition Program (2015) https://www.asam.org/docs/default-source/education-docs/asam-fundamentals-recognition-program-learning-objectives-and-competencies-final-10-1-15.pdf?sfvrsn=2	Intended for health care professionals treating addiction and SUD. ASAM Fundamentals Curriculum Planning Committee identified nine competencies in addiction medicine for the purpose of continuing education. Learners are expected to display professionalism in all activities and interactions with patients and professional colleagues, demonstrate commitment to the health/well-being of individuals and society through ethical practice, profession-led regulation, and high personal standards of behavior.	Nine core competencies and fundamentals: 1.Professional communication and interaction with patients and professional colleagues 2.Identify patient feelings and attitudes impacting therapeutic responses 3.Understanding addictive disorders as developmental biopsychosocial disorders 4.Evidence-based approach to detecting SUD 5.Counseling strategies for positive SUD screening results 6.Motivational Interviewing (MI) 7.Conducting biopsychosocial/developmental ambulatory assessment to match patient with appropriate care 8.Indications, contraindications, and duration of evidence-based pharmacotherapy; referral to specialty care 9.Behavioral interventions for patients and family (formal/intensive, informal, community-based)	Overlapping Themes: core medical knowledge on substances, SUD, and commonly associated medical/mental disorders, screening, interviewing, biopsychosocial approach, respectful/nonjudgmental/non-stigmatizing communication with patients, recognize SUD as chronic medical illness, ability to access resources, team-based care, referral to specialty care and formal/informal treatment programs, MI skills, medication-assisted treatment (MAT), community support Key Takeaways: establishing healthy personal boundaries with patients/families, gender/cultural awareness, patient confidentiality, nondiscriminatory communication, recognizing health literacy, barriers to access and factors impacting therapeutic responses	Clinical knowledge Practice guidelines Communication with care team Communication with patients/families Patient demographics and reported differences Provider-patient relationship Attitudes and biases Referral resources Access resources and information as needed
American Board of Addiction Medicine (ABAM) - Core Competencies for Addiction Medicine (2012) https://acaam.memberclicks.net/assets/docs/Core-Competencies-for-Addiction-Medicine.pdf	Intended for medical residents and fellows specializing in addiction medicine. Competency goals are focused on prevention and treatment of addiction and substance-related health conditions for a diverse spectrum of drugs.	Core competencies: 1.Patient care 2.Medical knowledge 3.Practice-based learning and Improvement 4.Interpersonal skills and communication 5.Professionalism 6.Systems-based practice	Overlapping Themes: recognizing common issues and medical conditions related to SUD, psych/social/functional indicators of subclinical addiction disorders, interpreting lab findings/diagnostic tests, physical exams, nonjudgmental communication, use of standardized screening instruments, MI strategies, diagnostic tests, specialist referrals Key Takeaways: medical emergencies, psychiatric emergencies, special contexts, continuous improvement, and professional development	Clinical knowledge practice guidelines Use of evidence, tools, and resources Referral resources Patient demographics Communication with patients/families Mandatory continuing education Communication with other care team members Patient-provider relationship
Dental Education Core Competencies - Massachusetts Dental Schools (2016) https://www.mass.gov/files/documents/2017/08/31/governors-dental-education-working-group-on-prescription-drug-misuse-core-competencies.pdf	Intended for Massachusetts (MA) dental students (cross-institutional). Working group acknowledges the need to integrate behavioral health in dentistry and the dental field lacks a specialty for orofacial pain. Core curriculum aims to provide dental students with a foundation in prevention, management, and identification of SUD and familiarity with chronic pain. Competencies focus on reducing opioid prescribing, counseling, appropriate referral, and interprofessional collaboration.	Core competencies are organized into three domains based on prevention level (non-exclusive). Domains (by prevention level): 1.Primary: prevention of prescription drug misuse; 1–3 focus on the screening, evaluation, and prevention of substance misuse during the diagnosis of dental and orofacial pain 2.Secondary: treating patients at-risk for SUD; 4–6 focus on engaging patients in safe, informed, and patient centered treatment planning 3.Tertiary: managing SUD as a chronic disease; 7–10 focus on eliminating stigma and building awareness of social determinants	Overlapping Themes: diagnosis, pharmacological and non-pharmacological treatment options for pain and SUD, risks and benefits, proper use of available screening instruments and protocols, screening/evaluation, communication with patient/family, provide referrals to addiction specialists and treatment programs, engage in interprofessional care teams Key Takeaways: evidence-based foundational skills in patient-centered counseling and behavior changes in context of patient encounter	Patient demographics Differences in prescribing practices Appropriate referral Use of evidence-informed tools and resources Patient-reported differences Communication with care team Interprofessional collaboration, interest, and trust
Medical Education Core Competencies - Massachusetts Medical Schools (2015) https://www.mass.gov/doc/medical-education-core-competencies-for-the-prevention-and-management-of-prescription-drug-1/download	Intended for MA medical students (cross-institutional). Competencies set clear baseline standards for prevention skills and knowledge in the areas of screening, evaluation, treatment planning, and supportive recovery. Implementation aims to support future physicians over the course of medical education w/skills and foundational knowledge in the prevention of prescription drug misuse.	Domains (by prevention level): 1.Primary: preventing prescription drug misuse; 1–3 focuses on the screening, evaluation, and prevention of substance misuse 2.Secondary: treating patients at-risk for SUD; 4–6 focuses on engaging patients in safe, informed, and patient centered treatment planning 3.Tertiary: managing SUD as a chronic disease; 7–10 focuses on eliminating stigma and building awareness of social determinants	Overlapping Themes: diagnostic criteria for pain and SUD, recognize risk factors of SUD and overdose, awareness of social determinants, treatment options, risks and benefits, incorporate relevant data into treatment planning, MI Key Takeaways: apply chronic disease model, recognizing own/societal stigmatization and bias affecting SUD and treatment outcomes	Clinical knowledge Communication strategies with patients Use of evidence-informed data and tools Patient demographics Differences in prescribing practices Attitudes and biases
Core Competencies for Pain Management and SUD - University of California Medical Schools (2020) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8921611/	Intended for California (CA) medical students (cross-institutional). Working group (six CA med schools) includes diverse specialty and disciplinary representation for subjects related to pain and SUD. Competencies are included in the UC Clinical Performance Examination (CPX) administered to 4th-year medical students. Competencies aim to educate CA medical students on safe and effective pain management, safe opioid prescribing, and identification and treatment of SUD.	Competencies are organized into three sections: two sections (pain and SUD) have four domains, one section (public health) has one domain. Pain and SUD domains: 1.Understanding the condition 2.Assessment and measurement 3.Treatment 4.Context Public health: 1.Lessons learned from opioid epidemic	Overlapping Themes: biological/social/environmental influences on pain and SUD, diagnostic differentials, harm reduction, secondary prevention, recognizing the role of societal biases/stigma in pain and SUD outcomes, appropriate referrals, use of assessment tools, communication skills, integrated/multidisciplinary care Key Takeaways: ability to differentiate substance use terminology, ability to recognize patient preferences	Clinical knowledge Attitudes and biases Communication with patients/families and care team members Patient-provider relationship Constraints in practice settings Institutional guidelines
Statewide Curriculum for Pain and Addiction - Arizona Health Professional Programs (2018) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649998/	Intended for students of all health professional programs. Working group comprised representatives from all 18 medical, osteopathic, physician assistant (PA), nurse practitioner (NP), dental, podiatry, and naturopathic programs in Arizona (AZ). Proficiency level is assessed by a rubric. Curriculum aims to redefine pain and addiction as multidimensional public health issue; competencies were designed to be relevant to all provider types.	Competencies are structured around 10 core components, each supported by evidence-based objectives. Core components: 1.Redefine pain and addiction (objectives 1–3) 2.Apply evidence-based, whole person approach to pain and addiction (objectives 4–7) 3.Integrate care with a systems perspective (objectives 8–10)	Overlapping Themes: current approaches, biological/social/environmental factors contributing to pain/addiction, treatment plans and prevention strategies, model destigmatizing language, ability to utilize a patient-centered, team-based care approach Key Takeaways: acknowledge industry influence on opioid use disorder (OUD)/pain care	Clinical knowledge Attitudes and biases Use of evidence-informed tools and resources Referral resources Institutional guidelines
Interprofessional Consensus: Pain Management Core Competencies for Pre-licensure Clinical Education (2012) https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3752937/	Intended for all health professionals undergoing pre-licensure education programs in pain management. Core competencies and supporting values were developed by an interprofessional expert group; contributing members represented medicine, dentistry, nursing, pharmacy, physical therapy, psychology, social work, acupuncture, and veterinary medicine. Domains align with outline categories of International Association for the Study of Pain curricula. Core competencies in pain management were developed as a basis for delivering comprehensive and high-quality pain care.	Core competencies for pain management categorized within four domains: 1.Multidimensional nature of pain: What is pain? 2.Pain assessment and measurement 3.Management of pain: How is pain relieved? 4.Clinical care: How does context influence pain management? Core values integral and embedded within all domains and competencies: Advocacy Collaboration Communication Compassion Comprehensive care Cultural inclusiveness Empathy Ethical treatment Evidence-based practice Health disparities reduction Interprofessional teamwork Patient-centered care	Overlapping Themes: recognizes pain as complex/multidimensional, present pain theories, terminology for pain and associated conditions, proper use of screening/assessment tools, factors impacting assessment/treatment, effective communication, patient education, evidence-based treatment options, benefits/risks of available options, special populations, patient-centered care plan Key Takeaways: social/environmental impact on pain management, impact of pain on society, shared decision making, differentiate substance use and pain terminology, self-management strategies, assessment/management across settings, interprofessional contributions	Clinical knowledge Evidence-informed tools and resources Patient demographics Communication with patients Patient/provider relationship Interprofessional collaboration
Statewide Medical School Curriculum – Pennsylvania Physician General Task Force (2017) https://pubmed.ncbi.nlm.nih.gov/28339890/	Intended for all Pennsylvania (PA) medical students (cross-institutional). Task force conducted a literature review and survey of graduating medical students to then develop, review, and approve core competencies for education on opioids and addiction. Competencies aim to improve student knowledge and attitudes in these subject areas to thus improve patient outcomes. PA legislation passed in 2016 requires state boards for health professions create safe opioid prescribing curriculum.	Core competencies (nine domains): 1.Core aspects of addiction 2.Patient screening for SUD 3.Specialty referral for evaluation/treatment of SUD 4.Proper pain/SUD assessment 5.Multimodal treatment options for acute pain 6.Opioid use for acute pain (and alternatives) 7.Opioid use for chronic non-cancer pain 8.Risk assessment for opioids and treating chronic non-cancer pain; assessment of SUD/increased risk of aberrant drug-related behavior 9.Patient education/monitoring, treatment initiation, and d/c opioids for chronic non-cancer pain.	Overlapping Themes: diagnostic criteria and differentials, SUD treatment and interfering factors, common co-occurring medical conditions/health issues with pain/SUD, conducting patient-focused history, physical exams, screening, specialist referrals, nonjudgmental communication Key Takeaways: describing the importance of pain assessment and referral process with patient, “warm handoff” referral process, patient education	Referral for specialty evaluation and treatment Use of evidence-informed tools and resources Differences in prescribing practices Patient-reported differences Patient education Provider-patient relationship Communication with patients/families
American Society of Health-System Pharmacists (ASHP) - Strategies for Opioid Prescribing (2018) https://academic.oup.com/ajhp/article-abstract/76/3/187/5301698#no-access-message	Intended for pharmacists in hospitals, health systems, and ambulatory care clinics. Commission members were selected from pharmacy, medicine, nursing, public health, health care associations, regulatory agencies, and academia. Strategies aim to optimize prescribing and monitoring of opioids while minimizing the risks of addiction and preventable harm associated with over-utilization of opioids.	Five domains: 1.Role of leadership in managing the use of opioids 2.Optimizing opioid prescribing practices 3.Opioid management in transitions of care 4.Education and training 5.Use of technology and data	Overlapping Themes: knowledge of evidence-based, non-opioid and non-pharmacologic therapies, identifying and adopting available tools and resources for pain management, coordinating multidisciplinary care, community engagement, treating special populations, minimizing risks, proper use of data and technology (EHR and telehealth) Key Takeaways: community engagement, treating special populations	Patient demographics Use of evidence-informed tools and resources Patient-reported differences Interprofessional collaboration Insurance coverage Other gaps: patient access to specialty care, community engagement
American Association of Colleges of Pharmacy (AACP) - Pharmacy Education on SUD (2020) https://www.ajpe.org/content/ajpe/84/11/8421.full.pdf	Intended for pharmacy students; applies to practicing pharmacists and pharmacy techs. Guidelines comprise six educational outcomes (competencies) mapped into four content groups (domains); each domain focuses on a core topic on substance use pharmacy education. Competencies aim to endorse continuing professional development for currently practicing pharmacists and pharmacy technicians to manage SUD.	Four content areas/domains: I.Psychosocial aspects of substance use II.Pharmacology and toxicology of substances of misuse III.Screening, treatment, and stigma IV.Legal and ethical issues Six educational outcomes/competencies: 1.Patient provider (I, II, III) 2.Interprofessional team (I, III) 3.Population health promoter (I, II, III, IV) 4.Information master (I, II, III) 5.Practice manager (III, IV) 6.Self-developer (III, IV)	Overlapping Themes: interdisciplinary evidence-based practice, specialist referrals, interprofessional collaboration, identify individuals at-risk for SUD, patient education, use of non-stigmatizing language and communication, community engagement, ongoing professional development Key Takeaways: policies and regulations related to treatment access, harm reduction approach, patient-centered goals, environmental influences, payment models, roles and responsibilities of different government agencies/organizations	Patient demographics Patient communication Providing referrals Interprofessional collaboration Litigation, legal/ethical issues Differences in prescribing practices Competing tasks and demands Insurance coverage Attitudes and biases
American Society of Clinical Oncology (ASCO) - Recommendations for Chronic Pain Management in Adult Cancer Survivors (2016) https://asco-pubs.org/doi/full/10.1200/JCO.2016.68.5206	Intended for all health care practitioners providing care to cancer survivors. Target population: any adult diagnosed with cancer and experiencing pain lasting over three months, irrespective of cause. Prevalence—40% of cancer survivors report chronic pain. Competencies aim to provide evidence-based guidance on the optimum management of chronic pain in adult cancer survivors.	Key Recommendations: 1.Screening and comprehensive assessment 2.Treatment and care options a.Non-pharmacologic interventions b.Pharmacologic interventions i.Miscellaneous analgesics ii.Opioids 3.Risk assessment, mitigation, and universal precautions with opioid use. Guidelines advise clinicians to consider prescribing a trial of opioids in carefully selected cancer survivors with chronic pain who do not respond to more conservative management.	Overlapping Themes: patient screening, conducting a comprehensive and multidimensional pain assessment, physical exam, knowledge of multi-modal care plans, non-pharmacologic and pharmacologic (opioid/non-opioid) treatment options, diagnostic testing, individual risk factors, ability to engage patient/family throughout pain assessment and management, educate patients and families on benefits/risks of treatment, proper tapering and discontinuation of opioids, specialist referral Key Takeaways: past pain treatments, roles and responsibilities within care team, address myths/misconceptions about medication use, ability to recognize patient’s literacy level and determine need for interpreters, laws/regulations for prescribing controlled substances, culturally-aware communication	Clinical knowledge Provider-patient relationship Interprofessional collaboration, interest, and trust Differences in prescribing practices Mandatory continuing education Patient-reported differences
American Psychological Association (APA) - Core Competencies for Emerging Specialty of Pain Psychology (2018) https://psycnet.apa.org/record/2018-37353-001	Intended for practicing and emerging pain psychologists. Competencies were developed based on interdisciplinary foundational principals published by Fishman et al. Competencies were created to address the gap in psychology and pain care and establish a curriculum for the emerging specialty of pain psychology. Competencies define what is expected of a practicing pain psychologist; learners are expected to have at least foundational competencies in identified domain rather than expertise.	Domains: 1.Multidimensional nature of pain: What is pain? 2.Pain assessment and measurement 3.Management of pain: How is pain relieved? 4.Clinical care: How does context influence pain management?	Overlapping Themes: recognizing pain as complex and multidimensional, knowledge of substance abuse, biopsychosocial model, individual/systemic factors affecting pain, social determinants of health, common medical/mental health issues associated with pain, ability to educate and communicate patient/family, evidence-based pain and risk assessments, MI skills, proper use of screening tools/resources, patient-centered approach, interprofessional care approach, pharmacological/non-pharmacological treatments and risks/benefits, recognition of stereotyping/bias affecting care, technology-based interventions (telehealth) Key Takeaways: relevant and evolving pain theories, pain paradigms, behavioral health intersections with pain, mindfulness/coping skills training, pre/post-surgical evaluations, patient expectations and goals	Clinical knowledge Attitudes and biases Use of evidence-informed resources Communication strategies Education and training guidelines Interprofessional collaboration Litigation Insurance coverage
University of California (UC) Davis Primary Care Pain Management Fellowship Program (2017) https://journals.lww.com/academic-medicine/Full-text/2021/02000/UC_Davis_Train_the_Trainer_Pri-mary_Care_Pain.41.aspx	Intended for primary care fellows (licensed physicians, pharmacists, NPs, PAs). Curriculum incorporates competency and hybrid-based educational models of in-person/distance-based learning and direct faculty-fellow mentoring to train PCPs in pain care and prepare them to train others. Multidisciplinary mentoring team comprises health professionals from a variety of specialties to reflect the biopsychosocial nature of pain and management and need for interdisciplinary and interprofessional care. Competencies aim to directly address the education gap among post-licensure providers and provide high-quality training to manage pain and SUDs.	Four domains: 1.The multidimensional nature of pain 2.Pain assessment and measurement 3.Safe and effective management 4.Pain and context Competencies in each domain emphasizes: 1.Recognizing and treating SUDs 2.Promoting safe use of controlled substances 3.Reducing reliance on opioid prescribing 4.Developing communication skills to navigate difficult conversations with patients	Overlapping Themes: knowledge of biopsychosocial approach, recognizes pain as complex and multidimensional, individual factors impacting pain assessment and management, unique needs for special populations, current pain theories, opioid risk assessment, interprofessional care, diagnostic criteria for pain disorders and SUD, factors interfering with pain assessment/management, terminology for pain/SUD and commonly associated conditions, benefits and risks of treatment options, ability to provide patient-centered care Key Takeaways: differentiation between different types of pain, teach-back method, ability to adjust plan of care as needed, roles and responsibilities within care team	Clinical practices and guidelines Interprofessional collaboration Evidence-informed tools and resources Patient-provider relationship Patient-reported differences
U.S. Food and Drug Administration’s (FDA’s) Opioid Analgesic Risk Evaluation and Mitigation Strategies (REMS) - Education Blueprint for Health Care Professionals (HCPs) (2018) https://www.fda.gov/media/99496/download	Intended for prescribers, pharmacists, and nurses but relevant for all HCPs who participate in the treatment and monitoring of pain. FDA released updated REMS on opioid prescribing to include all opioid analgesics (immediaterelease, extended-release, longacting) in the outpatient setting. REMS on opioid prescribing focuses on acute and chronic pain management; blueprint was created to provide HCPs with a contextual framework for safe and effective opioid prescribing. FDA posted education blueprint for continuing education (CE) providers to use as they develop CE materials and activities.	Section 1: Basics of pain management I. The need for comprehensive pain education II. Definitions and mechanisms of pain III. Assessing patients in pain Section 2: Creating the pain treatment plan I. Components of an effective treatment plan II. General principals of non-pharmacologic approaches III. General principals of pharmacologic analgesic therapy a. Non-opioid medications b. Opioid analgesics IV. Managing patients on opioid analgesics a. Initiating treatment with opioids—acute pain b. Initiating treatment with opioids—chronic pain c. Ongoing management of patients on opioid analgesics d. Long-term management e. How to recognize/intervene upon suspicion/identification of OUD f. When to consult with a pain specialist g. Medically directed opioid tapering h. Importance of patient education V. Addition medicine primer	Overlapping Themes: fundamental concepts of pain and addiction, identify risk factors for OUD, identify/manage patients with OUD, pain assessments, physical exam, pharmacologic (opioid/non-opioid) and non-pharmacologic treatment options, patient-centered approach, counseling patients/families on safe opioid use, specialist referrals, evidence-based tools and scales (prescription drug monitoring program [PDMP]), psych/social evaluation, diagnostic studies, interprofessional care, roles and responsibilities within care team, special populations, destigmatizing language Key Takeaways: initiating/titrating/discontinuing opioids, counseling patients/families harm reduction and safety strategies, state/federal regulations, medical specialty guidelines on pain/opioid prescribing, proper documentation, family planning (initial assessment), discussing patient goals and expectations	Differences in prescribing practices Constraints in practice setting Communication with other members of the care team Attitudes and bias Use of evidenceinformed tools and resources Patient demographics Patient-reported differences Institutional guidelines Provider-patient relationship
Vanderbilt University Medical Center (VUMC) - Guidelines for Teaching Proper Prescribing of Controlled Prescription Drugs (CPD) (2020) https://medsites.vumc.org/cph/home	Intended for clinical teachers of VUMC; specifically instructors for student prescribers (physicians, dentists, advanced NP, PA). Authors acknowledge misprescribing is the leading cause of CPD abuse and produces a range of serious consequences for patients, prescribers, and the community. Many physicians are unaware of prescribing guidelines and how their prescribing impacts the CPD epidemic. 40% receive training on prescription drug abuse/addiction, 55% routinely recommend appropriate treatment for patients who abuse prescription drugs. Guidelines were created to address the gap in pre-licensing education and safe prescribing practices, to educate physicians on prescribing guidelines and how misprescribing impacts the CPD epidemic, to prepare physicians to identify and manage drug-seeking patients, and to reduce the consequences of misprescribing.	Core teaching tips and objectives: 1.How to avoid misprescribing 2.U.S. Drug Enforcement Agency’s (DEA) Practitioner’s Manual 3.Patient assessments and prescribing—apply Center for Professional Health Provider Decision Aid and Four-Step Systematic Approach 4.Screening for substance misuse/abuse using screening, brief intervention, and referral to treatment (SBIRT) 5.Motivational Interviewing (MI) skills 6.Identifying SUD, iatrogenic addictions, and CPD misuse using available assessment tools 7.Appropriate pain treatment 8.Adjuvant treatments 9.Five A’s on follow-up visits for chronic pain 10.Registering and using state PDMP 11.Interprofessional team approach 12.SUD and resources for patients 13.Early prevention, identification, intervention for patients at-risk for overdose 14.Following new state prescribing laws and teaching consequences of misprescribing 15.Provide informed consent and pregnancy prevention for women of childbearing potential 16.How to manage conflict using effective communication techniques	Overlapping Themes: screening for substance misuse/abuse, MI skills, identify SUD, CPD misuse, knowledge and proper use of available clinical tools/resources, PDMP, assessment, treatment options for pain, interprofessional care, counseling patients on SUD, SUD resources for patients, risk factors for SUD and overdose, follow new state prescribing laws, effective communication Key Takeaways: consequences of misprescribing, informed consent, special populations, conflict management	Communication strategies Litigation Patient demographics Interprofessional collaboration Differences in prescribing practices Education and training guidelines Patient-provider relationship Use of evidence-informed tools and resources Roles and responsibilities within the care team
Tennessee (TN) Department of Health - Guidelines for Chronic Pain (2019) https://www.tn.gov/content/dam/tn/health/healthprofboards/painmanagement-clinic/ChronicPainGuidelines.pdf	Intended for clinicians and health professionals treating outpatient chronic pain. TN Governor’s Commission on Pain and Addiction Medicine education comprises representatives from TN’s medical educational institutions. Guidelines aim to help providers reduce problems associated with prescription opioids while maintaining access to compassionate care and appropriate medications for chronic pain patients. Competencies set the minimum expectations for educating and training health professionals on pain management, SUD, and opioid prescribing. Long-term goals of appropriate pain management are to improve symptoms, functionality, and overall quality of life while minimizing adverse effects, addiction, overdose deaths, and neonatal abstinence syndrome (NAS).	Guidelines helped develop the 12 core competencies for current and future curricula and are organized into three sections: I. Prior to initiating opioid therapy for chronic nonmalignant pain II. Initiating opioid therapy for chronic nonmalignant pain III. Ongoing opioid therapy for chronic nonmalignant pain 12 core competencies: 1.Epidemiology and population level 2.Pain evaluation 3.Pharmacologic and non-pharmacologic treatment of pain 4.Practical aspects of prescribing and communication 5.Conflict prevention and resolution 6.Chronic pain plans 7.Acute pain care for chronic pain patients 8.Interoffice and interprofessional focus 9.SUD risk evaluation 10.Developing a treatment plan for SUD 11.Management of overdose risk 12.Professional and legal standards	Overlapping Themes: core knowledge of pain, screening/assessment/evaluation of pain, recognizing signs of SUD, communication strategies Key Takeaways: conflict resolution, patient expectations and goals, how do opioids/benzodiazepines work, patient education, informed consent	Clinical practices and guidelines Differences in prescribing practices Communication strategies with patients Patient-provider relationship Institutional guidelines Interprofessional collaboration Professional and legal standards Patient-reported differences Patient demographics Use of evidenceinformed tools and resources Informed consent Mandatory continuing education
Substance Abuse and Mental Health Services (SAMHSA) - Prevention Core Competencies https://pttcnetwork.org/sites/default/files/2021-06/PEP20-03-08-001.pdf	Intended for current and rising professionals in mental health and substance use disorder prevention fields. Competencies aim to provide professional direction in the preventative field and offer guidance for training programs and service delivery qualification. To accept new professional standards as an integral part of job descriptions, staff qualifications, and development of transferable skills. KSAs (knowledge, skills, and abilities) are separated into two categories: Technical and Behavioral. Technical KSA measures acquired knowledge and “hard” technical skills and enables the evaluation of these elements. Behavioral KSA measures “soft” skills and includes the attitudes and approaches applicants take into work. Factors are more related to human characteristics and skills, such as attitude, work approach, and collaborative abilities.	Three-phase work plan: I.Identify prevention domains and cross-cutting principals II.Develop substance use prevention core competencies and definitions III.Develop KSAs for each competency Cross-cutting competencies: 1.Interdisciplinary foundations (substance use and mental health) 2.Role of multiple systems and systems thinking 3.Family dynamics 4.Ethical practice and professional responsibility 5.Basic knowledge 6.Communication Interdisciplinary foundations: 1.Understanding SUD and impact on individuals, interpersonal relationships, and communities 2.Prevention of mental, emotional, and behavioral (MEB) disorders 3.Mental health promotion 4.Treatment and recovery 5.Application to practice Prevention interventions for SUD/MEB: 1.Universal: targeted to individuals in general population who have not been identified on the basis of individual risk 2.Selective: targeted to subgroup with higher than average probability of developing an SUD/MEB 3.Indicated: targeted to high-risk individuals identified as having minimal but detectable signs/symptoms foreshadowing SUD/MEB	Overlapping Themes: core knowledge of SUD, communication strategies, navigating health care systems, intersections with mental/behavioral health, family-centered care, eliminating stigma Key Takeaways: ethical practices, professional responsibilities and development, understanding the impact of SUD on individuals, interpersonal relationships, and communities	Clinical knowledge/best practices Communication strategies with patients/families Communication with care team members Interprofessional collaboration Patient/provider relationship
SAMHSA - Addiction Counseling Competencies in Professional Practice (2005) https://store.samhsa.gov/sites/default/files/d7/priv/sma12-4171.pdf	Intended for all practitioners dealing with SUD and emphasized for professional substance abuse treatment counselors. Competencies (updated from 2000) have been applied to curriculum/course evaluation and design for higher education, designing professional development and continued education programs, certification standards/exams across the United States and internationally. Updated with feedback-based improvements of 2000 revised version and adds relevant literature published literature, several practice dimensions (particularly those addressing clinical evaluation and treatment planning) were rewritten to reflect current best practices. KSAs define the knowledge, skills, and attitudes necessary for competency.	Section 1. Transdisciplinary foundations (KSAs needed by all disciplines) categorized by four discrete building blocks: 1.Understanding addiction 2.Treatment knowledge 3.Application to practice 4.Professional readiness Section 2. Professional practice dimensions (KSAs needed for addiction counselors) categorized by eight competencies 1.Counseling 2.Professional and ethical responsibilities 3.Service coordination 4.Documentation 5.Client, family, and community education 6.Referral 7.Clinical evaluation 8.Treatment planning	Overlapping Themes: core knowledge of addiction, treatment options for addiction, recognizing contextual variables, symptoms of SUD and common co-occurring medical and mental health conditions, openness to information that may differ from personal views/attitudes Key Takeaways: basic concepts of social, political, economic, and cultural systems and their impact, appreciating differences between and within cultures, willingness to work with people who display and/or have mental health conditions	Clinical knowledge/best practices Attitudes and biases Communication with patients/families Providing referrals Patient demographics Patient/provider relationship Use of evidence-informed tools and resources Other gaps: documentation, accessing resources
Association for Multidisciplinary Education and Research in Substance Use and Addiction (AMERSA) - Specific Disciplines Addressing Substance Use (2018) https://amersa.org/wp-content/uploads/AMERSA-Competencies-Final-31119.pdf	Intended for physicians, nurses, pharmacists, social workers, and physician assistants working in SUD treatment and prevention programs; applicable to most educational/professional levels. Revision to 2002 strategic plan for interdisciplinary faculty development, provides updated evidence-based guidance to support health professionals in effectively assessing/treatment patients using alcohol and other drugs. Provides HCPs with an overview of scientific literature, review of discipline-specific perspectives on SUD training, and summary of core KSAs needed in all health professional disciplines to effectively identify, intervene with, and refer patients with SUD. Competencies aim to provide a practical interprofessional guide for HCPs working with diverse populations across health care settings (community health centers [CHCs], federally qualified health centers [FQHCs], primary care practitioner [PCP] offices) with a focus on prevention, intervention, treatment, and recovery supports for persons affected by substance use. Competencies aim to help HCPs engage and patients in change-oriented, bi-directional conversation, help patients understand risks associated with using alcohol and drugs, provide evidence-based treatment, and encourage patients to accept referral to holistic, coordinated care for their substance use, mental health, and/or medical problems.	SUD core competencies (shared by two or more disciplines): 1.Recognizing signs and symptoms 2.Utilize evidence-based measures for screening and assessment 3.Intervene with at-risk patients and reinforce healthy behaviors for low-risk patients 4.Utilize established protocols for safe care 5.Individualized, patient-centered care plan according to state/federal mandated scope of practice 6.Identify and address legal/ethical issues impacting care 7.Patient-centered language to mitigate stigma associated with substance use 8.Identify referral sources and ensure linkage to treatment 9.Promote use of statewide peer assistance programs/groups and alternative discipline programs Comprehensive list of SUD core competencies per discipline appear at the conclusion of each discipline-specific chapter. Four essential elements for care team: 1.Leadership and organization commitment 2.Team development 3.Team process 4.Team outcomes	Overlapping Themes: screening tools, risk assessment, MI skills, specialist referral, evidence-based pharmacological treatment options, specialist referral, recognize/reduce stigma associated with SUD, community support, recognizing SUD as a chronic medical disease, commonly associated medical/mental health issues, special populations, barriers to treatment, team-based care Key Takeaways: behavioral interventions, patient confidentiality and rights, special populations, legal/ethical issues impacting care, strategies to address/prevent own negative biases	Clinical knowledge/best practices Providing referrals Patient demographics Litigation Insufficient time/resources Referral resources Institutional guidelines Interprofessional collaboration Other gaps: patient confidentiality and rights
National Center on Substance Abuse and Child Welfare (NCSACW) - Technical Assistance (TA) Tool/Guide for Professionals Referring to SUD Treatment (2018) https://ncsacw.acf.hhs.gov/files/understandingtreatment-508.pdf	Intended for professionals referring patients to SUD treatment. Office of the Assistant Secretary for Planning and Evaluation (ASPE) found that caseworkers, courts, and other providers misunderstand how SUD treatment works and lacks guidelines on how to incorporate service into child welfare practices. Tool includes a list of questions child welfare/court staff can ask treatment providers to ensure that effective linkages are made. TA tool was designed to provide professionals who refer parents to SUD treatment with fundamental understanding of SUD and treatment, so professionals can make informed referral decisions for services that meet the parent and family’s needs. The ultimate goal of SUD treatment is recovery. SAMHSA created working definition of recovery that incorporates four major principals: health, home, purpose, and community.	The treatment process: 1.Screening 2.Comprehensive assessment 3.Stabilization 4.SUD treatment 5.Continuing care and recovery support Comprehensive assessment dimensions (to assess appropriate level of care): 1. Acute intoxication and/or withdrawal potential 2.Biomedical conditions and complications 3.Emotional, behavioral, and cognitive conditions and complications 4.Readiness to change 5.Relapse, continued use, or continued problem potential 6.Recovery/living environment	Overlapping Themes: evidence-based treatments and screening tools, identifying potential misuse/SUD, past/current treatment history, medical history, “whole-patient/patient-centered” approach, knowledge of stigma around MAT, barriers to recovery, community support, interprofessional collaboration, and culturally appropriate services Key Takeaways: MAT, family-centered care, conflict resolution with families, gender-appropriate services	Providing referrals Referral resources Opportunities for interprofessional collaboration Communication with patients and families Patient/provider relationships Other gaps: information sharing, supporting others in the care team
International Association for the Study of Pain (IASP) - Pain Curriculum for Social Workers (2018) https://www.iasp-pain.org/education/curricula/iasp-curriculum-outline-for-pain-in-social-work/	Intended for social workers (entry-level, pre-licensure). Fundamental concepts focus on complexity of pain, how pain is observed and assessed, collaborative approaches to treatment options, and applying competencies across the lifespan in the context of various settings, populations, and care-team models. Curriculum aims to help social workers develop pain-specific knowledge to better assess and advocate for appropriate care, employ evidence-informed interventions that contribute to the team management of pain and related suffering, and to identify the need for referrals from pain specialists.	Curriculum: I.Multidimensional nature of pain II.Pain assessment and measurement III.Management of pain IV.Clinical conditions	Overlapping Themes: core knowledge of pain, screening and assessment, treatment options, team-based care, high-risk populations, the role of stigma and eliminating stigma, specialist referrals Key Takeaways: pain management in the context of social work, ethically challenging situations, barriers to accessing treatment, special populations	Clinical knowledge/best practices Patient-reported differences Attitudes and biases Communication with members of care team and patients Access to resources Insurance coverage
Board of Pharmacy Specialties (BPS) - Content Outline for Board Certified Psychiatric Pharmacist (BCPP) Credential (2017) https://www.bpsweb.org/wp-content/uploads/PSYContentOutline2017.pdf	Intended for students specializing in psychiatric pharmacy (pre-certification). Certification exam is organized by domain/sub-domain (major responsibility or duty), task (activity that elaborates on domain/sub-domain), and knowledge statement (essential to competent task performance). Knowledge statements clarify the expectations for newly certified pharmacists and providing comprehensive medication management (CMM) to persons with psychiatric and related disorders.	Domains: I.Patient-centered care (55% of exam) II.Translation of evidence into practice and education (30% of exam) III.Health care policy, advocacy, practice management (15% of exam)	Overlapping Themes: MI skills/principals, social/cultural factors affecting outcomes, therapeutic alliance, proper use of screening and scaling tools/resources, physical exam, individualized treatment and monitoring, shared decision making, pharmacologic/non-pharmacologic therapies, special populations, transitioning care Key Takeaways: managing conflict, cost-effectiveness of treatments (pharmacoeconomic studies), models of care (mobile, telehealth, peer support), patient education, health literacy, regulatory and ethical issues related to researching patients, applying and generalizing research findings	Clinical knowledge Patient/provider relationship Patient-reported differences Differences in prescribing practices Litigation Access to resources Use of resources Use of evidence-informed tools and resources Institutional guidelines Education/training guidelines Interprofessional collaboration Communication with care team members Other gaps: barriers to treatment, patient privacy laws, patient education and effective procedures, health literacy
American College of Clinical Pharmacy (ACCP) - Patient Care Process for Delivering Comprehensive Medication Management (CMM) (2018) https://www.accp.com/docs/positions/misc/CMM_Care_Process.pdf	Intended for patients, clinical pharmacists, primary and health care providers, payers, students, and educators. Research-based framework was developed to address the misuse, underuse, and overuse of medications as an opportunity to meet cost/quality benchmarks and improve patient care. Authors used common language so patients, clinicians, payers, students, and educators could utilize this resource. Key strategies for CMM aim to optimize medication use in patient-centered, team-based care settings (outpatient and ambulatory care) for patients with multiple chronic conditions.	Essential functions: 1.Collect and analyze information 2.Assess the information and formulate a medication therapy problem list 3.Develop care plan 4.Implement care plan	Overlapping Themes: patient-centered care, comprehensive review of patient history, social history, concurrent substance use, team-based care, factors influencing treatment access and medication adherence, proper use of data and technological tools/resources, discuss patient treatment goals, physical exam, identify monitoring parameters, understanding scope and responsibilities of care team members, interprofessional communication. Key Takeaways: translating evidence into practice	Evidence-informed tools and resources Insurance coverage Mandatory continued education Patient demographics Patient-reported differences Attitudes and biases Patient/provider relationship Access to resources Other gaps: health literacy