American Society of Addiciton Medicine

Board of Directors

Leadership

Board of Directors

Lori D. Karan, MD, FACP, DFASAM

Director At Large


Dr. Karan is Professor of Internal Medicine and Preventive Medicine and at the Loma Linda University School of Medicine and the VA Loma Linda Healthcare System. Six months after arriving at Loma Linda University, Dr. Karan authored an ACGME application for an Addiction Medicine Fellowship, building upon work of Dr. Mickey Ask. The Loma Linda Fellowship now hires, trains, and graduates 6 Fellows each year. Together, we are developing addiction services, faculty, and a community of skilled, empathic physicians to care for Southern California’s underserved.

Dr. Karan is certified by the American Board of Internal Medicine and by the American Board of Preventive Medicine in Addiction Medicine. She is Fellow of the American College of Physicians and a Distinguished Fellow of the American Society of Addiction Medicine (ASAM). Dr. Karan served as Treasurer and Publications Chair of ASAM from 2011-2015.

Dr. Karan has had a varied career which began in 12-step treatment programs and has spanned to methadone maintenance and private practice addiction medicine. She obtained a Career Scientist Development Award from NIDA and spent 10 years on the UCSF faculty performing mechanistic and drug development research. She co-chaired annual Nicotine Research Roundtables 1991-1999, which spawned the Society of Research on Nicotine and Tobacco (SRNT). Prior to her current work at Loma Linda University, Dr. Karan was a primary care physician for the California Department of Corrections and Rehabilitation (CDCR) 2009-2012, and Medical Director of Hawaii’s Prisons and Jails, 2012-2015.

Dr. Karan is passionate not only about furthering the evidence-based practice of addiction medicine, but about keeping our current leaders engaged in ASAM, promoting a healthier workplace, and developing the next generation of trailblazers in addiction medicine.

 

Candidate Questionnaire Responses

1. What have been your greatest contributions to ASAM or to the field of addiction medicine over the last 10 years?
I was Chair of the Publications Council from 2011 to 2015. During my tenure, with the support of ASAM staff and an excellent committee including Bill Haning, MD (who later succeeded me as Chair) we developed a mission statement, criteria and a procedure to evaluate new publications. We advanced the strategic direction and growth of ASAM’s publications from 3 fledgling products to a portfolio that included: The Principles of Addiction Medicine, Essentials of Addiction Medicine, Pain and Addiction Medicine, The Handbook of Addiction Medicine, The ASAM Criteria, The Journal of Addiction Medicine, and the ASAM Weekly. I helped select and evaluate the Editors and nurtured each product.

I pioneered the treatment of nicotine addiction within chemical dependency treatment and collected the experiences of similarly innovative programs around the country in a seminal issue of the Journal of Substance Abuse Treatment, “Towards a Broader View of Recovery.” I designed and co-chaired the nine consecutive Nicotine Research Roundtable Discussions (1991-1999) that set the stage for the formation of the Society for Research on Nicotine and Tobacco.

With Susan Blank, I authored the Nicotine and Tobacco Chapter of The ASAM Criteria. We advocated for insurance reimbursement for multidimensional nicotine dependence assessments. The next step is to develop a range of intensities for quitting tobacco from the low intensity outpatient services that we now have, to also include intensive outpatient, residential and inpatient treatment. We can achieve this by driving reimbursement through the ASAM Criteria and Continuum. In addition, the different intensities of treatment for tobacco/nicotine use disorders need be incorporated into primary and specialty care, obstetrics, psychiatric and other substance use disorders treatment.

I also wrote a chapter on nicotine and tobacco use for the ASAM Handbook on Pain and Addiction. During the prescription opioid and COVID pandemics, I remain concerned that we are ignoring the effects of nicotine and tobacco despite the known impediments to oxygenation, bone remodeling and healing caused by these substances and their combustion products.

I authored and updated the Pharmacologic Principles chapter for the last five editions of both Principles of Addiction Medicine and Essentials, and twice I wrote sections on the ‘Treatment of Substance Use Disorders During Incarceration.’ I am ASAM’s past Treasurer, and I currently serve on our Membership Council.

Building on the work of Mickey Ask, MD, I developed an ACGME accredited Addiction Medicine Fellowship at Loma Linda University, which now trains 6 Fellows each year.

While I tout these achievements, it is only because a group of us stand on the shoulders of giants, and together we enable such feats. Over the years, it is ASAM’s camaraderie and triumphs that are most meaningful to me, and keep me energized

2. How would your election to the ASAM Board of Directors benefit ASAM and the field of addiction medicine?
During the past 5 years, I’ve focused my energies on creating an ACGME accredited Addiction Medicine Fellowship at Loma Linda University. The 6 Fellows that we train each year provide me energy, hope, and inspiration. I want my mentees to go out into the world as compassionate, skilled practitioners, critical thinkers, and change agents.

ASAM and its state chapters are providing important opportunities for those who are new to addiction medicine to make important contributions to our field. It is an important time. Addiction is no longer a step-child but recognized as increasingly relevant to the practice of effective and successful medicine.

However, we can do a much better job of supporting each other throughout our careers, and as we age. If elected Director-at-Large, I will advocate that ASAM:

  1. Empower physicians with best practices, data, and mutual support so we can advocate for system-changes for healthier workplaces
  2. Encourage engagement with other physicians in supportive, self-care programs to vitalize and revitalize our careers
  3. Develop flexible roles and new activities for physicians who want to work less than full-time
  4. Value mid and late career physicians' lifelong commitment to medicine. ASAM can facilitate career transitions which keep us connected and honor our deep repository of wisdom and experience

Mid and later career physicians often have more time, less financial constraints, and desire activities with purpose and connection. ASAM can benefit from our physicians’ heart and wisdom. We can participate in advocacy, teaching, and helping the underserved in the US and abroad. I am already working with Valerie Evans, CAE, Vice President Governance & Membership, to form a new ASAM interest group with these objectives in mind.

ASAM, our professional home, is poised to play a pivotal role to improve both career and post-career venues. Moreover, group support, and the processes of change and transformation, resilience, and recovery are core to our discipline. As Director-at-Large, I will focus on the broader goals of mentorship, self-care, changes to the workplace, and the support and resilience of ASAM members throughout our careers.