Saudi pharmacy students show low addiction and opioid knowledge

A cross-sectional survey of 310 Doctor of Pharmacy students at King Abdulaziz University in Saudi Arabia found low knowledge of addictive drugs and opioid overdose management, with only 9.0% of respondents meeting the study’s predefined threshold for adequate knowledge. The median composite score was 4 out of 12, with an interquartile range of 2–6, and 11.9% demonstrated high opioid knowledge. Because the study included students from one institution, the results identify concerns within that program but do not establish how common the gaps are across pharmacy education internationally.

Researchers surveyed students in Years 3 through 6, including interns in Year 6, with a content-validated 29-item questionnaire. It assessed knowledge of addictive drugs, opioid-related clinical knowledge, legal awareness and students’ perceptions of curriculum coverage. Adequate knowledge was defined before analysis as a composite score of at least 9 out of 12, or 75%.

Multiple linear regression was used to identify predictors of knowledge. As a single-centre, cross-sectional study, the survey did not track learning over time or test whether a particular educational intervention improved students’ competence. Median composite scores rose across the later stages of the degree: 3 out of 12 for Year 3 students, 4 for Year 4, 4.5 for Year 5 and 5 among interns in Year 6.

The respective interquartile ranges were 2–6, 2–6, 3–6.5 and 3–7. Differences among Years 3 through 5 were minimal, while scores were higher in the intern year. Even then, the intern-year median remained below the predefined 9-point threshold.

The survey therefore shows a measured association between academic stage and knowledge scores, but it does not identify what produced the differences. The opioid-specific questions exposed gaps in recognizing an urgent overdose sign and identifying first-line treatment. Correctly identifying naloxone as the first-line treatment for opioid overdose was achieved by 56.1% of students, while 44.2% recognized slow or shallow breathing as the primary overdose sign.

These percentages describe responses to a questionnaire rather than clinical behaviour during an emergency. They indicate that substantial proportions of respondents did not answer these two knowledge items correctly. Students’ perceptions of the curriculum added detail to the low questionnaire scores.

The area most frequently reported as missing was the pharmacist’s role in addiction recovery, selected by 40.6% of respondents, followed by legal aspects of Saudi drug regulations at 37.7%. Pharmacological management of substance-use disorders was reported as missing by 33.9%, and 40.0% described patient-counselling skills as inadequately covered. Overall, students reported deficiencies in addiction recovery, patient counselling, pharmacological management and Saudi drug regulations.

The authors said the observed gaps broadly resembled deficits reported internationally, but the supplied findings do not provide direct international comparisons from this survey. The sample was confined to students at a single Saudi university, and its cross-sectional design could not determine whether academic-stage differences reflected coursework, clinical experience or other factors associated with progression through the program. The results also cannot determine whether comparable patterns occur in other institutions, regions or professional programs.

The authors therefore called for confirmation through multi-institution and international studies. Convergence between the questionnaire results and students’ assessments of missing content gives the study a specific curricular dimension. At the same time, students reported several of these topics as absent or inadequately covered.

The study did not test a revised curriculum or evaluate an educational intervention, so it cannot establish whether any specific change would improve learning or clinical competence. Instead, the findings support the authors’ call for integrating addiction-related competencies longitudinally into the Doctor of Pharmacy curriculum at King Abdulaziz University and comparable programs. The present study does not demonstrate clinical benefits, changes in prescribing behaviour or effects on patient outcomes.

Its defensible conclusion is narrower: among 310 students at one Saudi institution, measured addiction and opioid knowledge was limited, and students reported gaps in several related areas of the curriculum.

Subject of Research: Cross-sectional assessment of addiction and opioid knowledge among Saudi pharmacy students

Article Title: Addiction and opioid knowledge gaps among pharmacy students at King Abdulaziz University, Saudi Arabia: a cross-sectional study with implications for global curriculum review

Article References: Baamer, R. (2026). Addiction and opioid knowledge gaps among pharmacy students at King Abdulaziz University, Saudi Arabia: a cross-sectional study with implications for global curriculum review. BMC Medical Education. https://doi.org/10.1186/s12909-026-10668-y

Image Credits: AI Generated

DOI: 10.1186/s12909-026-10668-y

Keywords: pharmacy education, addiction knowledge, opioid overdose, naloxone, King Abdulaziz University, Saudi Arabia, curriculum gaps, student competency, cross-sectional survey, Addiction, opioid, knowledge