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

Background Evidence regarding pharmacy students’ addiction-related education is limited in Saudi Arabia. This study assessed pharmacy students’ knowledge of addictive drugs, opioid overdose management, and perceptions of curriculum adequacy at King Abdulaziz University. Methods A cross-sectional survey was conducted among 310 PharmD students in Years 3–6 at King Abdulaziz University, Saudi Arabia. A content validated 29-item questionnaire was used to assess knowledge of addictive drugs, opioid-related clinical knowledge, legal awareness, and perceptions of curriculum coverage; adequate knowledge was predefined as a composite score of ≥ 9/12 (75%). Multiple linear regression was used to identify predictors of knowledge. Results The median composite knowledge score was 4/12 (IQR: 2–6), rising from 3/12 (IQR: 2–6) in Year 3 to 4/12 (IQR: 2–6) in Year 4, 4.5/12 (IQR: 3–6.5) in Year 5, and 5/12 (IQR: 3–7) among interns (year 6); only 9.0% achieved adequate knowledge and 11.9% demonstrated high opioid knowledge. Naloxone was correctly identified as first-line overdose treatment by 56.1% of students, and 44.2% recognized slow or shallow breathing as the primary overdose sign. Knowledge scores were higher in the intern year (year 6), with minimal differences among Years 3–5. Students reported deficiencies in addiction recovery, patient counselling, pharmacological management, and Saudi drug regulations. Students most frequently reported the pharmacist’s role in addiction recovery (40.6%) and legal aspects of Saudi drug regulations (37.7%) as missing curriculum content, and pharmacological management of substance use disorders (33.9% missing) and patient counselling skills (40.0% inadequately covered) as further deficiencies. Conclusion These findings identify critical competency gaps in addiction and opioid stewardship among pharmacy students at a single Saudi institution, that broadly resemble deficits reported internationally. Given the single-centre, cross-sectional design, confirmation in multi institutions and international studies is needed; and support the longitudinal integration of addiction-related competencies within this and comparable PharmD curricula.