American Society of Addiciton Medicine

Board of Directors

Leadership

Board of Directors

Holly Geyer, MD, FASAM

Candidate for Director At Large


Prior to entering medicine, I worked for a large, inpatient residential substance abuse treatment program for 6 years serving various non-clinical capacities. My interests drew me into the medical field where I pursued residency in Internal Medicine through Mayo Clinic, and ultimately obtained my Addiction Medicine subspecialty in 2018. I function as a Hospital Internal Medicine physician at Mayo Clinic, Arizona and oversee the Mayo Clinic Arizona Opioid Stewardship Program. I am also the Medical Director of Occupational Health, and Research Coordinator for Hospital Internal Medicine on our campus.

My career focus is on opioid stewardship and prevention and management of opioid-related consequences. I have served on a number of Arizona Department of Health Services (AZDHS) committees addressing the opioid epidemic and assisted with state legislation and AZDHS rules related to opioids and pain management. I have furthermore assisted with drafting the American Hospital Association Stem the Tide resource on opioid stewardship and continue to partner with them contributing podcasts and blogs on the topic. I have served as a board member of a large, national non-profit drug treatment program and maintain a robust lecture circuit speaking nationally on the neurobiology of addiction, safe prescribing practices and the importance of early substance abuse diagnosis and referrals.

I have authored more than 70 peer-reviewed publications and book chapters, many of which are related to safe opioid prescribing in cancer populations and the impact of pain treatment strategies on cancer-related quality of life. I have just finished authoring the Mayo Clinic Book, ‘Ending the Crisis: Mayo Clinic’s Guide to Opioid Addiction and Safe Opioid Use’ (release Q1 2023) which serves as an informative, patient-centered overview of how to stay safe opioids and navigate the complexities of OUD treatment.

 

Candidate Questionnaire Responses

1. What have been your greatest contributions to ASAM or to the field of addiction medicine over the last 10 years?

Prevention is worth a pound of cure. The opioid epidemic has highlighted the profound societal influence clinicians hold in the form of pen and prescription pad. For the past 6 years, I have dedicated my career to reducing the risks and consequences associated with legally prescribed controlled substances. These are best reflected in the following efforts:

  1. Education
    Ongoing education on opioid-related topics remains the top tier of my career trajectory. In addition to hosting numerous Grand Round topics on opioids internal and external to Mayo Clinic, I also lecture nationally at conferences and other events on opioid stewardship, the neurobiology of addiction, management of Opioid Use Disorder (OUD) and establishing opioid stewardship programs. I was the primary author of the Mayo Clinic opioid podcast series for CME which remains our most downloaded external and internal educational podcast for the organization. In addition, I have created mandatory opioid training material disseminated across the enterprise for all providers, nurses, and pharmacists. For patients, I have contributed to the development of a number of patient educational handouts, videos and instructional on pain and opioid-related safety. I have just completed a Mayo Clinic book on Opioids (title pending) which has been accepted by the Mayo Clinic Press for release in 2023. This reference is an easy-to-understand overview of the opioid epidemic, safe opioid use, opioid-alternatives, management of opioid-related complications, family interventions for OUD and how to identify treatment programs. I have partnered with the American Hospital Association (AHA) to author a robust podcast and blog series for 2022-2023 on topics related to the opioid epidemic.
  2. Legislation
    My almost 10 year experience serving as a member of the Arizona State Medical Association Legislative Committee offered me unique experience and perspective to assist with legislation related to management of the pandemic. In addition to serving on multiple AZ Department of Health Services (AZDHS) committees helping develop curriculum and guidelines related to safe opioid management, I also assisted with editing state legislation and AZDHS rules on this topic.
  3. Standardization of Workflows/Protocols that promote safe pain management
    One of my primary focuses has been ensuring Mayo Clinic manages opioids within a culture of safety. Accomplishing this has required our organization to develop 100’s of workflows, protocols, and guidelines on opioid and pain-related topics. Serving on the enterprise Opioid Stewardship Program (OSP) Executive Counsel offered me the opportunity to oversee many of these initiatives. In addition, I have been closely involved with development and integration of the Opioid Stewardship metrics dashboard which is monitored under the Department of Quality. I lecture regularly on the topic of establishing and maintaining an OSP and have assisted outside organizations with set-up. I have also contributed to OSP-related content for AHA and was the primary author for guidelines related to safe-opioid use in hematological malignancy patients (Blood, 2020).

2. How would your election to the ASAM Board of Directors benefit ASAM and the field of addiction medicine?

ASAM has emerged as the authoritative source for management of Opioid Use Disorder. Significant investment has been made by the organization to educate and advocate on OUD related topics. Our growing understanding of OUD’s impact on life expectancy, overall physical, mental and spiritual health, society and finances reinforce the incredible importance of managing this disorder proactively. Few would disagree that prevention offers us the greatest return on investment. Yet one primary barrier to this approach persists for OUD: No singular society or organization owns the topic.

Recognizing this, incredible opportunity exists within ASAM to grow in its addiction-prevention related content. This is particularly relevant for the healthcare sector on content related to opioid-stewardship, best practices for safe opioid management, appropriate referral mechanisms for OUD, differentiation of OUD vs. chronic pain and a host of other topics that remain a barrier to offering opioids in a reliably safe format. In addition, state laws across the nation have adapted elements of the 2019 CDC Guidelines for Prescribing Opioids for Chronic Pain. Many of these guidelines have lacked sufficient scientific evidence to support endorsement for acute prescribing, and studies have shown that some negatively impact patient outcomes. ASAM-sponsored content on evidence-based legislative interventions to prevent and manage opioid complications could be a welcomed resource. Similarly, an ASAM sponsored series focused on best practices for establishing opioid stewardship programs would be particularly useful given that the only national training alternative has been sponsored by AHA and lacks granular content. The development of educational guides for difficult patient conversations on opioid related topics, example-controlled substance agreements and other documents would help many institutions improve their care delivery to stigmatized populations.

As a proud ASAM member and outspoken advocate for our service line, I believe we have every opportunity to emerge as the leader in OUD prevention. My experience on this topic is extensive and I would love the opportunity to advocate for its importance and assist with operationalizing at a national level. Given these objectives, I humbly request consideration for a Director-At-Large position within the ASAM Board of Directors.