Two Researchers Honored for Their Work

Two researchers will be honored during today’s ASAM Awards Luncheon for their work on projects that examined the number of babies diagnosed with neonatal abstinence syndrome and the amount of overlap between medical toxicology training and addiction medicine training.

The luncheon will be from noon to 2 pm in the Grand Ballroom on the second floor of the Hilton Chicago. Kay Roussos-Ross, MD, is the recipient of the Young Investigator Award and Timothy Wiegand, MD, FACMT, will receive the Medical-Scientific Program Committee Award.

Dr. Roussos-Ross is an Assistant Professor in OB-GYN and Psychiatry at the University of Florida Shands Hospital, Gainesville. Her paper, “Increasing Trends in Neo-Natal Abstinence Syndrome, What Is the Cost?” studied the number of babies diagnosed with neonatal abstinence syndrome (NAS) at the hospital after she noticed the number of patients using opiates during her OB-GYN residency.

“I became interested after noticing an increasing epidemic of opiate use in Florida, including among pregnant women,” she said. “We were seeing more and more neonates diagnosed with NAS in the NICU. I was interested in investigating the trend of NAS in our newborns, to determine if it was in line with the increasing epidemic of opiate use. I was also interested in examining the length of hospital stay of the affected neonates.”

The study also looked at the costs of keeping babies who were exposed to opiates during pregnancy and ended up having a diagnosis of NAS after delivery, Dr. Roussos-Ross said.

“We also wanted to look at the costs associated with caring for affected neonates, to show that perhaps spending money preemptively to provide treatment in substance programs for affected pregnant women might curtail costs of caring for affected neonates in the current, or in future, pregnancies,” she said.

Dr. Roussos-Ross noted that the OBGYN department at the University of Florida initiated protocols in 2011 for its clinics regarding opiate use in pregnancy.

“We are interested to see, with protocols in place, whether there is a difference in our incidence of NAS or if it continues to increase,” Dr. Roussos-Ross said. “We will continue to study this.”

Dr. Wiegand is Director of the Toxicology and Toxicology Consult Service and Associate Clinical Professor of Emergency Medicine at the University of Rochester Medical Center. “Addiction Training During Medical Toxicology Fellowship” received the highest rating for its scientific merit among abstracts submitted for presentation at the conference.

Dr. Wiegand worked with Joel Moore, MD, a University of Rochester Medical Center emergency medicine resident to survey fellowship directors at the 27 medical toxicology programs in the United States.

“We were interested in the extent of overlap medical toxicology fellowship training had with addiction medicine training and in looking at specific opportunities that medical toxicologists had to focus on content in addiction medicine. In particular we wanted to look at the overall hours and clinical experience with regard to whether the fellowship training in and of itself would allow them to be eligible to sit for ABAM credentialing,” he said in discussing the objectives of the survey.

The toxicology fellowship directors were asked about the content of their core curricula and opportunities to earn hours to become certified in addiction medicine, Dr. Wiegand said. Sixty-six percent of the directors responded.

“We found that toxicology fellowship training allows for a significant and diverse experience in addictions training with exposure to many patients with drug overdose and withdrawal syndromes,” he said. “Most fellowships allowed for opportunities involving research, surveillance, and prevention in addiction-related areas.

“The training seemed to have overlap with addiction medicine core components, but the directors had difficulty defining specifically where they spend their hours in addiction training. They said the fellows were exposed to addiction medicine training on a daily basis. We realized there are a lot of opportunities, but there is much better opportunity to define these opportunities.”

There are about 500 board-certified medical toxicologists in the United States. The American College of Medical Toxicology (ACMT) has defined six practice pathways in toxicology for development in terms of preparing models and opportunities for careers and practice, and addiction medicine is one of the pathways.

“We need to define the core curriculum in addiction medicine a little better because there clearly are opportunities,” Dr. Wiegand said. “ACMT is working on developing the training material and infrastructure in terms of exposure to addictions training during fellowship as well as in continuing education to better define the addiction medicine practice pathway in medical toxicology with the goal of creating a robust practice pathway model.”