Sunday Conference News

Society News

Live Learning Center To Offer PowerPoints from Presentations
A highlight of the Medical-Scientific Conference has been the launch of some parts of ASAM’s Live Learning Center, which allows users to view educational presentations online and earn CME credits.

All of the presentations from the conference can be accessed from the ASAM home page (www.asam.org) and clicking on the Live Learning Center link. Starting in May, anyone who registered for the Conference will have access to audio files from 91 recorded sessions synched to PowerPoint presentations and handouts as an attendee benefit.

While only 22 hours of CME credit are physically available at the conference, users can earn up to 51 credits through the Live Learning Center.

The content in the center will continue to expand with information from other education opportunities after the conference.

Conference attendees can log on to the site to see what CME credit they earned by attending sessions, and they can print out certificates from home or work.

“This is a great, simple process,” said Lisa Watson, ASAM director of meetings and conferences. “While members are at the conference, they should keep record of which courses they have attended. Then they can either come by the ASAM Exhibit Booth (No. 303) where we’ll have computers available for them to log their hours, or log them on their own computer.”

The Live Learning Center will be available at the end of May after the conclusion of the Medical-Scientific Conference through a link on the ASAM home page (www.asam.org).

ASAM Board Approves Document Defining Addiction, Other Actions
The ASAM Board of Directors met Monday and Tuesday, before the Medical-Scientific Conference to address several key measures concerning the Society.

The Board approved a document defining addiction following a presentation from the DDATG Action Group Co-chairs Michael Miller, M.D., FASAM, and Raju Hajela, M.D., M.P.H., FASAM. Approved were the short version, which is online, and the long version, which will be available soon on the ASAM website. This is considered an important step in bringing recognition to addiction medicine.

In other actions, the Board:

Approved 11 public policy statements related to addiction among health care providers. They will be posted on ASAM’s public policy web pages following the conclusion of the conference.

Lori Karan, M.D., FACP, FASAM, Chair of the Publications Council, presented details of a five-year agreement with the publishers of the Journal of Addiction Medicine, which will include exciting opportunities. The agreement was approved.

Dr. Karan also made a presentation about a collaboration with The Change Companies (TCC) regarding the ASAM Patient Placement Criteria for the Treatment of Substance-Related Disorders. David Mee-Lee, M.D., Senior Vice President of TCC, also spoke.

ABAM President Kevin Kunz, M.D., M.P.H., FASAM, updated the Board on the certification of residency training programs.

David K. Mineta, M.S.W., Deputy Director of Demand Reduction, White House Office of National Drug Control Policy (ONDCP) made a strategies and initiatives update on addiction policy.

Thanks to Volunteers at Medical-Scientific Conference
ASAM would like to thank the Medical-Scientific Program Committee for all of its hard work and efforts this year.

A special thanks to Gavin Bart, M.D., FASAM, Chair of Program Committee who also provided guidance on the Med-Sci Daily News.

Also thanks to ASAM physicians who reviewed content for the Med-Sci Daily News: Judith Martin, M.D.; Edwin A. Salsitz, M.D.; Raju Hajela, M.D., M.P.H, FASAM

All Conference Attendees Registered for PCSS-M and PCSS-P Projects
All Medical-Scientific Conference attendees are automatically registered for ASAM’s Physician Clinical Support System-Methadone (PCSS-M) and Physician Clinical Support System-Primary Care (PCSS-P) projects.

Look for your confirmation email with opt-out instructions when you return home from the conference.

ASAM Offers Education Courses Throughout the Year
ASAM offers several more education courses throughout the year. Don’t miss out on these courses.

  • Opioid Dependence Treatment Targeting Under-Served and Rural Areas, Advanced Clinical Best Practices, April 30, 2011, Asheville, N.C.
  • Comprehensive MRO: Toxicology Testing and the Physician’s Role in the Prevention and Treatment of Substance Abuse, June 3-5, 2011, Chicago, and December 2-4, 2011, Washington, DC
  • State of the Art in Addiction Medicine, October 27-29, 2011,  Washington, DC
  • Review Course in Addiction Medicine, September 20-22, 2012, Nashville, TN

Scholarship Winners, Medallion Recipients Honored at Fox Reception

ASAM members re-connect with colleagues Friday night during the Ruth Fox Foundation Reception, which recognized scholarship winners and medallion winners.

ASAM members re-connect with colleagues Friday night during the Ruth Fox Foundation Reception, which recognized scholarship winners and medallion winners.

Six Ruth Fox Scholarship winners and medallion recipients were recognized Friday night during the Ruth Fox Donor Reception. The event also recognizes contributors to the Ruth Fox Endowment Fund, which funds the scholarships.

Additional funding for the scholarships was provided by the National Institute on Drug Abuse and the Christopher D. Smithers Foundation. The reception was sponsored by Dr. & Mrs. Joseph E. Dorsey, M.D., FASAM, and Tommie E. Lauer, M.D., FASAM.,

For information about making a pledge, contribution, bequest, memorial tribute, or to discuss other types of gifts in confidence to support the Endowment Fund, please contact Claire Osman at (800) 257-6776 or (718) 275-7766, or via email at: asamclaire@aol.com.

All contributions to the Endowment Fund are tax-deductible to the full extent allowed by law.

Max Schneider, M.D., FASAM, received an award for his years of service as chairman of the Ruth Fox Endowment Fund and chairman of the Ruth Fox Scholarship Program.

The 2011 Ruth Fox Scholarship recipients are: Timothy J. Cordes, M.D., Ph.D.,  Madison, WI; Katherine Grieco, D.O., New Haven, CT; Vanessa Lentz, M.D., M.S., Montreal; Jennifer Nguyen, M.D, Bethesda, MD; Carla M. Reese, M.D., M.S., Baltimore, MD; James Yeh, M.D., Cambridge, MA.

Also during the reception, medallions were presented to longtime supporters of the Ruth Fox Endowment Fund. Not all recipients were able to attend the reception.

  • Receiving a gold medallion was Dr. Terry Rustin
  • Receiving silver medallions were Dr. Sarz Maxwell, Dr. Michel Sucher, Dr. Ramsay Farah, and Dr. Michael Liepman
  • Receiving bronze medallions were Mrs. Laura Rustin, Dr. Theodore Hunter, Dr. Rohinton Merchant, Dr. Norman Wetterau, Dr. Richard C. McKinley, and Mrs. Cheryl S. McKinley

Member Value Among the Top Goals for ASAM CEO

Penny S. Mills, M.B.A.

Penny S. Mills, M.B.A.

Penny S. Mills, M.B.A., has been Executive Vice President and Chief Executive Officer of ASAM for a limited time — less than a year — but the Society’s accomplishments under her leadership are already noteworthy.

ASAM has made significant progress on four primary goals — increasing member values, strengthening communications with members, supporting members in their practices, and educating primary care physicians about addiction.

“First, we really want to focus on strengthening and increasing member value, and we are offering several new benefits to do that,” Mills said. “We have also tried to make pricing more favorable for members in terms of registering for programs and products.”

Two programs have been launched this year, and a third starts next month. The Career Center started in February to connect members with potential employers on an online job center. In March, ASAM Weekly was launched to keep members up-to-date on all the news concerning the Society and its members. In late May, the Live Learning Center will be launched.

“Strengthening our communications with members to keep them up to date on what is happening with ASAM and within addiction medicine is important,” Mills said. Publications are key, including ASAM Weekly and the Med-Sci Daily News, distributed during the Conference. In addition, the ASAM website will be updated in the last quarter to offer richer content and improve navigation.

An example of supporting members was Wednesday’s Legislative Day, in which ASAM officials and members visited members of Congress to discuss issues of importance, such as the Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008, which took effect January 1.

“We met with representatives in the House and Senate to ensure that the regulations associated with the implementation of that legislation really help to implement the spirit of the law,” Mills said.

ASAM is also helping members with legislative and regulatory issues in their states, such as “medical” marijuana.

The education of primary care physicians got a boost last week with the launch of the Physician Clinical Support System for Primary Care (PCSS-P), the latest addition to ASAM’s mentor network. An online skills training program, Screening, Brief Intervention, and Referral to Treatment (SBIRT) will be launched this spring.

Finally, Mills wants to meet more members to find out what is on their minds.

“If they have a question or concern, they should feel free to contact me at pmills@asam.org,” she said. “I have had the opportunity to meet more members at educational programs and chapter meetings, and I look forward to continuing to do that.”

The Switch to EHR: What You Need to Know

Trusandra Taylor, M.D., M.P.H., FASAM, discusses the future of EHR.

Trusandra Taylor, M.D., M.P.H., FASAM, discusses the future of EHR.

The workshop “The Interface of Electronic Health Records and Addiction Medicine: What You Should Know and How It Will Affect Your Practice,” gave an overview of electronic health records (EHR), advice for switching over, and a review of confidentiality and legal issues. Oh — and the knowledge that it won’t be so bad.

“Once you do it, you’re never going to want to go back to paper,” said Richard N. Rosenthal, M.D., Chairman, Department of Psychiatry, St. Luke’s Roosevelt Hospital Center, New York.

As of 2008, 44 percent of physicians were using EHR for billing, but less than 10 percent had full, comprehensive systems. Now there are incentives and federal assistance centers to help practitioners switch.

Trusandra Taylor, M.D., M.P.H., FASAM, Medical Director, JEVS Human Services, Philadelphia, explained that providers could get incentives to adopt EHR-certified technology. The Medicare incentive provides up to $44,000; the Medicaid incentive up to $64,000. Both amounts are available this year and next, and the incentives change in subsequent years.

An audience member advised not trying for the incentive this year if you don’t already have a system that can easily be adapted or upgraded. Instead, aim for October 2012.

Providers who need assistance in adopting EHR can contact one of the 62 Regional Extension Centers set up by the U.S. Department Health and Human Services, or get information online at HealthIT.gov.

Dr. Taylor noted the distinction between Electronic Medical Records — which are legal records of the provider and do not contain info from other providers — and Electronic Health Records, are owned by the patient, can contain information from multiple providers, and are a subset of each provider’s EMR.

Who owns the medical information in electronic records is a gray legal area. Dr. Rosenthal explained that historically, clinicians and insurers owned the container — the paper — and patient had the right to see it and correct it. Now, “It’s a trickier business. HITECH (Health Information Technology for Economic and Clinical Health Act) doesn’t resolve who owns the information, nor does federal, state, copyright. or patent law,” he said.

Dr. Rosenthal gave advice on how to evaluate EMR/EHR vendors. He said major components of the records system should be based in your institution’s operating system; contain state of the art security; and be customizable, with a flexible database you can tweak.

“You need to be able to control your data,” he said.

Most importantly, the system must let you bill with ICD-10. “Come 2013, everyone’s going to be coding with ICD-10 — if you don’t, you won’t get paid.”

Dr. Rosenthal also discussed how the issues of confidentiality and disclosure relate to electronic records and addiction medicine.

Addiction treatment programs are HIPAA-covered entities and must abide by the privacy rule — and they also fall under 42 CFR.

Dr. Rosenthal elaborated on 42 CFR. “It’s super-confidentiality. It requires that providers of addiction medicine be held to higher standards of confidentiality than psychiatric records, far higher than general medical encounters.”

In answer to an audience question, Dr. Rosenthal gave an example of how a certain treatment might be handled, records-wise.

“So with a patient getting treatment for hepatitis, their expectation is medical treatment, not addiction treatment. So it’s not covered by 42 CFR, but ‘Yes’ on HIPPA.”

However, he said if you’re giving suboxone treatment, then that’s under 42 CFR, and you have to get them to fill those out. “It’s a pain, but welcome to the 21st century.”

PCSS-M Program sees strong growth

After launching two years ago, the Physician Clinical Support System for Methadone (PCSS-M) is producing positive results.

The free nationwide program, through which health care providers needing information and mentoring on methadone treatment for opioid addiction and/or pain can connect with experts in the field, has nearly 500 registered participants, and the number continues to grow.

“We are hoping to enroll a lot more participants, but it does seem like we’re cutting a pretty wide swath in terms of the types of practitioners out there who would use methadone in their practices,” said PCSS-M Medical Director Andrew Saxon, M.D., Professor of Psychiatry at the University of Washington School of Medicine, and Director of the Addiction Treatment Center at the VA Puget Sound Health Care System. “I think we’re hitting the type of people we want to be in contact with.”

The network has 25 mentors and three clinical experts in 22 cities in 17 states.

“The areas that have been addressed are criteria for treatment, monitoring of other drug use, appropriate methadone dosing, and how to transfer people from other opioids to methadone,” Dr. Saxon said. “We have a robust qualitative evaluation so far, so I can say the topics that have come up for which participants have been mentored on are very critically important topics in prescribing methadone either for opioid addiction or chronic pain.”

Of the registered participants, 45 percent are from primary care, 20 percent are from psychiatry, 14 percent are from addiction medicine, and 5 percent are from pain management, with the remaining 16 percent split among anesthesiology, palliative care medicine, emergency medicine, and other specialties.

In terms of practice settings, 45 percent of participants are from private practice, 2 percent are from opioid treatment programs, 17 percent are from additional treatment programs, 13 percent are from academic institutions, 2 percent are from the Veterans Affairs, and 19 percent fall into the “other” category.

PCSS-M mentors provide telephone, email and on-site support. PCSS-M is coordinated by ASAM in conjunction with other leading medical societies.

The network’s website, www.pcssmethadone.org, has had more than 20,000 visits during the last two years.

“The website’s getting a lot of traction,” Dr. Saxon said.

This project is funded by a grant from The Department of Health and Human Services, Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Substance Abuse Treatment (CSAT).

Addiction, Sleep Disorders Go Hand-in-Hand

Saturday's symposium about links between sleep disorders and addiction drew a standing-room-only crowd, as well as many questions during a discussion period.

Saturday’s symposium about links between sleep disorders and addiction drew a standing-room-only crowd, as well as many questions during a discussion period.

Addiction and sleep disorders form an uneasy partnership, an observation shared by of one of the speakers during symposium “Sleep and Addiction: Understanding the Problem and the Need to Act.”

“It is almost unheard of for us to see patients who come in for addiction treatment who do not have sleep problems,” said Michael Varenbut, M.D., FASAM, Assistant Clinical Professor of Sleep Medicine, University of Toronto. “We all as a group do a fairly poor job of diagnosing and treating sleep problems.”

He recommended adhering to a plan of action when patients present with a complaint of insomnia, rather than just writing a prescription for a drug. A study conducted 10 years ago showed that primary care physicians asked only 2.2 questions of their patients before prescribing a sedative narcotic, in contrast to the 45 minutes it takes to perform a proper sleep assessment.

Dr. Varenbut suggested a sleep assessment package that would involve such things as intake questionnaires, sleep diaries, and screenings. The first take-home pearl he suggested is not to prescribe medications for insomnia, followed by another pearl that insomnia is not a diagnosis but rather a symptom. A particularly important pearl is to screen everyone for sleep apnea.

“When patients are referred to us in the sleep disorder center with substance disorders, the No. 1 diagnosis that comes back is sleep apnea,” he said.

It’s equally important to get to the bottom of insomnia: What are the insomnia symptoms? What is causing it? Which type is it? Dr. Varenbut said that the International Classification of Sleep Disorders shows more than 100 sleep diagnoses. At least 50 percent have insomnia as a cardinal feature.

An insomnia diagnosis requires associated daytime dysfunction. If the patient is not suffering during the daytime because of their sleep, there’s no need to treat it, he said. Insomnia is primarily diagnosed through clinical evaluation, not sleep studies. A sleep history should include specific insomnia complaints: initiation insomnia (getting to sleep), maintenance insomnia (staying asleep) or terminal insomnia (waking early).

At least 50 percent of those who come to the sleep disorders lab with a diagnosis of insomnia will have another co-morbid condition, most often another psychiatric diagnosis, such as anxiety or depression. It’s also important to learn about sleep-wake patterns and other sleep symptoms like snoring. Furthermore, all substances of abuse affect sleep.

“There’s no point in us trying to fix their sleep problem while they are actively using,” Dr. Varenbut said.

Conrad Iber, M.D., Director of Pulmonary and Critical Care Medicine, Hennepin County Medical Center, Minneapolis, reported on substances and sleep interactions. One interaction that might be over-rated is central sleep apnea and opiates, he noted.

“The population I see more commonly as a burden is an intersection between obesity, sleep apnea, and narcotic use, which I see as a major problem,” Dr. Iber said. “There are tremendous interactions between insomnia and alcohol, narcotics, and benzodiazepenes. The interaction between the diagnosis of hypersomnias and stimulant abuse is something I see commonly as well.”

ABAM Certifies First 10 Residency Training Programs

The first 10 addiction medicine residency training programs have recently been accredited by the American Board of Addiction Medicine Foundation (ABAM).

The establishment and recognition of accredited physician training in addiction completes the core elements of addiction medicine as a specialized field of medical practice. The residencies build on the groundwork set by ASAM over the last 57 years, and on a broadly accepted, consensus definition of the field of addiction medicine.

The defining documents of the specialty were finalized this year, after a four-year consensus process. These include the ADM Scope of Practice, Core Competencies, Compendium of Educational Objectives, and Program Requirements for postgraduate medical training. These are available on the American Board of Addiction Medicine (ABAM) website (www.ABAM.net).

Like certification of individual physicians in addiction medicine, accreditation of these residencies gives assurance to the family of medicine, to health care organizations, and to physicians and the persons they care for, that a standard of excellence has been set, and is a key requirement for addiction medicine residency programs and the physicians who complete a residency.

The accreditations are viewed by the ASAM and ABAM directors as a watershed event, and a milestone for the goal of creating 25-40 certified residency programs, after which time the ABAM Foundation will request from the Accreditation Council for Graduate Medical Education (ACGME) acceptance of these programs. The present residencies are modeled after the ACGME criteria in place for the nation’s other, 8,000-plus residencies, but are the very first accredited programs of any type in addiction medicine.

The development of the accreditation process started in 2007 and has its roots  deep in ASAM, said Richard D. Blondell, M.D., a member of the ABAM board. Beginning in 2005, the ASAM leadership and members encouraged and assisted with the start-up of  ABAM as a separate organization.

ASAM was ready to move the field forward, and the next steps, of setting standards and processes that would eventually meet the requirements of ACGME and the American Board of Medical Specialties (ABMS), required a separate organization dedicated to these objectives.

Kevin Kunz, M.D., M.P.H., FASAM, President of ABAM and the ABAM Foundation agreed, saying, “ASAM and its members wanted to take the next steps and to formally join the family of medicine. To do that, the requirement of an independently incorporated board, meeting clear criteria set by ABMS had to be met.

“ASAM and ABAM working together have a critical role today. It is the mutual goal of ASAM physicians and ABAM to advance patient care and the education and training of physicians. Both organizations are driven by those mutual goals, but there are distinct responsibilities.”

ABAM sets standards and certifies expert physicians. The ABAM Foundation has formally defined the field of addiction medicine, and set guidelines and requirements for residency training, Dr. Kunz said. ASAM is the membership organization that promotes patient care and physician education from the position of the practicing clinician, caring for patients, families and communities; educating and supporting physician in all medical specialties, and advocating for appropriate care of all persons affected by addiction.

“The medical field of addiction medicine has come to maturity with these residencies,” Dr. Kunz said. “A new, formally acceptable field of medicine needs to have specific  elements.

“With residencies coming on line, the field of addiction medicine now has these. We now have a core set of documents that describe the field of addiction medicine, a plan to train physicians, residency programs, and a means to accredit programs and certify physicians.”

ASAM Awards Presented at Luncheon

The new class of ABAM Diplomates gathered in one large space for a group photo Saturday after they were honored during the ASAM Awards Luncheon.

The new class of ABAM Diplomates gathered in one large space for a group photo Saturday after they were honored during the ASAM Awards Luncheon.

The most prestigious awards in addiction medicine were presented Saturday during the annual ASAM Awards Luncheon. Awards recognized outstanding service or achievements to the practice, science, or advocacy of addiction medicine and ASAM.

The special surprise Employee Achievement Award was given by ASAM Immediate Past President Louis E. Baxter Sr., MD, FASAM, to Claire Osman in recognition of her 40 years of outstanding dedication and service to ASAM. She was also recognized for her notable achievements in promoting education and training in addiction medicine; for being instrumental in establishing ASAM as a viable, thriving Society; for tirelessly soliciting and supporting the Society’s fundraising and sponsorship programs including the Ruth Fox Memorial Endowment Fund; and for her many other significant contributions demonstrating her wisdom generosity and her respect for people suffering from addiction.

Awards presented during the luncheon were:

  • ASAM President’s Award, Louis E. Baxter, Sr., M.D., FASAM, John P. McGovern, M.D. Lecture/Award, A. Thomas McLellan, Ph.D, “To recognize and honor an individual who has made highly meritorious contributions to public policy, treatment, research or prevention, which has increased our understanding of the relationship of addiction and society.”
  • ASAM Media Award, Dirk Wales – writer, producer, and director of Wearing Masks, a DVD Series
  • ASAM Annual Award #1, Kevin Kunz, M.D., M.P.H., FASAM, “For outstanding  contributions to the growth and vitality of our Society, for thoughtful leadership in the field, and for deep understanding of the art and science of addiction medicine.”
  • ASAM Annual Award #2, Marc Galanter, M.D., FASAM, “For expanding the frontiers of the field of addiction medicine and broadening our understanding of the addictive process through research and innovation.”
  • Young Investigator Award, Randall Brown, M.D., Ph.D., “For the best abstract submitted by an author who is within five years of receipt of a doctoral degree.”
  • Medical-Scientific Committee Program Committee Award, Hannu Alho, M.D., Ph.D. “For author of the submitted abstract receiving the highest rating for its scientific merit.”
  • Outgoing Chair Award, C. Chapman Sledge, M.D., FASAM, Chair, Credentialing Committee from March 2000 to January 2010
  • Outgoing Board Members: R. Jeffrey Goldsmith, M.D.; Margaret A.E. Jarvis, M.D., FASAM; Michael M. Miller, M.D., FASAM, FAPA; Marvin D. Seppala, M.D.; C. Chapman Sledge, M.D., FASAM; Scott Smolar, D.O.; Penelope P. Ziegler, M.D., FASAM
  • Pain and Addiction Common Threads Course Directors, Herbert Malinoff, M.D., FACP, FASAM, and Edwin A. Salsitz, M.D., FASAM
  • Ruth Fox Course for Physicians Course Directors Margaret A. E. Jarvis, M.D., FASAM, and John C. Tanner, D.O., FASAM
  • Medical-Scientific Conference, Gavin Bart, M.D., Med-Sci Conference Director

Technology Coming to Alcohol Treatment

New software, websites and Web applications exist — including an interactive video patient interview simulation — to aid doctors in diagnosing and treating alcohol-related disorders, and to allow people with drinking problems to get help.

That was the message of Saturday’s symposium, “Emerging Technologies: Translating Interventions Across a Spectrum of Risk for Alcohol Use Disorders.” The new technologies were funded by the National Institute on Alcohol Abuse and Alcoholism (NIAAA).

Robert Huebner, Ph.D., Acting Director, Division of Treatment and Recovery Research, NIAAA, introduced the session, saying, “We believe there are a spectrum of alcohol problems and we need to match treatments (to them). We have a good foundation of treatments. Where do we go from here? How can technology supplement and complement our evidence-based treatment options?”

One answer is a video avatar named Christy Johnson. She’s the patient in the lifelike, interactive video simulation demonstrated by Paul Grossberg, M.D., Clinical Professor Emeritus, University of Wisconsin-Madison, School of Medicine and Public Health, and Dale Olsen, Ph.D., President of SIMmersion LLC.

They presented their training software, “Alcohol Screening & Brief Intervention,” which features video of an actress who plays “Christy Johnson,” a patient on a follow-up visit after having headaches (now resolved) after a car accident.

One-third of the screen shows video of Christy; part of the screen features question prompts for the physician trainee to ask; another part includes video of an attending, who gives thumbs-up or thumbs-down reactions to the trainee’s questions.

Dr. Grossberg ran through several sets of questions with Christy, asking her aloud about her drinking. Christy responded very much like a real patient, even getting defensive at one point: “I never need to have a drink, in the morning or any other time.”

“This simulation is different every time,” said Dr. Grossberg. “The computer chooses whether Christy is low-risk, at-risk, or severely dependent.” The “dependent” Christy can be cooperative, resistant, or ambivalent, and each version answers questions differently. The program contains hundreds, if not thousands, of video responses from Christy.

“For everything you say, there are three to 40 things the character could respond. It gives you a rich variety — you never know what Christy is going to say.”

After you finish, the program asks which Christy you just interviewed, then gives you a Brief Intervention Score and shows you what you did and didn’t do, and what you should be asking.

Reid K. Hester, Ph.D., Director, Research Division, Behavior Therapy Associates, LLP, gave the second presentation of the morning, “Computer Delivered Interventions: A Stepped Care Approach for Problem Drinkers.”

“When people are involved in addiction treatment, we’re often seeing people at the extreme end of the spectrum,” Dr. Hester said.

He said the Stages of Change model — which identifies stages from pre-contemplation, contemplation, preparation, action, maintenance, exit, and relapse — is useful for “thinking about how and where you intervene with people.”

“The first thing they ask is, ‘Should I change my drinking? How bad is this?'”said Dr. Hester. “We developed two programs for this state of change.”

The two programs are online at DrinkersCheckUp.com and CollegeDrinkersCheckUp.com. In a randomized clinical trial of the Drinker’s Check Up program, he found moderate drinking outcomes were more common than abstinence.

ASAM Praised for Addiction Efforts

David K. Mineta: "The relationship and partnership between ONDCP and ASAM is of critical importance to the field and the millions of people we are able to serve."

David K. Mineta: “The relationship and partnership between ONDCP and ASAM is of critical importance to the field and the millions of people we are able to serve.”

The American Society of Addiction Medicine’s efforts are “invaluable” in moving President Obama’s 2011 strategy of addressing substance abuse disorders, said David K. Mineta, M.S.W., Deputy Director of Demand Reduction, White House Office of National Drug Control Policy (ONDCP). He made his remarks during Saturday’s Policy Plenary “Health Reform and Parity Implications for Addiction Medicine.”

“The relationship and partnership between ONDCP and ASAM is of critical importance to the field and the millions of people we are able to serve,” Mineta said. “Our office relies on continued coordinated effort with ASAM to ensure that doctors and other health care providers receive ongoing communication in addiction medicine.”

The Obama administration’s 2011 strategy calls for educating doctors on addiction, promoting the appropriate role of physicians in the care of patients with drug addiction, establishing addiction medicine as a specialty recognized by professional organizations, government, physicians, purchasers, and consumers of health care services and the general public, and supporting addiction research and prevention.

In terms of action toward those aims, Mineta commended addiction medicine for efforts to expand medical education in substance abuse disorders. Specifically, he drew attention to the American Board of Addiction Medicine (ABAM) for accrediting 10 training programs, the nation’s first postgraduate addiction medicine residencies for physicians, and for releasing national guidelines for addiction medicine residencies.

“Today, a shortage of health care professionals knowledgeable about addiction does not allow the health care field to efficiently identify addicts early enough to provide them with much needed services that could stem the tide of addiction,” Mineta said. “While the consequences of substance abuse (accidents, violence, and chronic illnesses) often require involvement with the health care system, sadly most health care providers are not well trained to adequately respond.”

He lamented that most health care professionals outside addiction medicine have minimal training in recognizing substance abuse in their patients. He called this “not only tragic for these patients, but also because undetected substance abuse complicates other illness and exponentially increases health care costs, affecting local economies.”

The deputy director also encouraged ASAM and its members to continue close collaboration with ONDCP.

“If we meet the opportunity that presents itself right now, we will be able to look back on this period right now as game changing,” Mineta said. “I want to thank all of you for everything you do in the field to make that happen.”

Also addressing the Policy Plenary was Mark I. Kraus, M.D., FASAM, Co-Chair of the Public Policy Committee, who commended ASAM members for the largest participation ever in ASAM Legislative Day this week. He encouraged them to continue advocacy, specifically in workforce issues.

“Mental health parity has passed, but this bill is useless unless we put teeth into it,” he said. “If we don’t have people come into the workforce, the number of patients that could be knocking on our door will be overwhelming.”

Though addiction medicine fellowships have been introduced at 10 universities, that won’t make a dent in the addiction medicine workforce. Dr. Kraus encouraged ASAM members to work with their Congressional representatives to gain their understanding about the addiction workforce need.

Immediate Past President Louis E. Baxter Sr., M.D., FASAM, concurred about the workforce shortage. “If we graduated 200 addiction physicians a year for the next 10 years, we will still not have enough addiction physicians,” he said. “The strategic plan has to do with our training of primary care physicians and allied health professionals in addiction issues, and the model for doing that is through the Federally Qualified Health Centers.”

A. Kenison Roy III, M.D., FASAM, Co-Chair of the Legislative Advocacy Committee, also encouraged continued communication with federal legislators because these efforts do ensure a warm reception of addiction medicine advocates on Capitol Hill.

He also emphasized the need to continue moving addiction medicine inside the mainstream of medicine.

“Parity legislation implies that addiction is a disease and that it should be treated as any other disease,” he said. “What this means is that treatment will be tightly managed and will be provided individually to individual patients using the many different treatment components and modalities.”

The Policy Plenary closed with fielding questions from the audience led by Petros Levounis, M.D., FASAM, Co-Chair of the Legislative Advocacy Committee.