Quality & Science

Fighting Disparity through Addiction Medicine

by | October 21, 2021

While in his second year at Eastern Virginia Medical School, Daniel Ageze, MD, returned home to Addis Ababa, Ethiopia, which he had left as a teenager, to provide medical care for underprivileged Ethiopians who lived in the country’s rural areas.

In entering medicine, Dr. Ageze knew he wanted to specifically help the poor and marginalized. The disparities he witnessed among the poorer patients who traveled from far away to the nation’s capital, where he had grown up, disturbed him.

“I remember specifically one man who begged for more than two months just to get enough money to get the bus fare to come to the capital,” Dr. Ageze recalled.

At the time, the medical team Dr. Ageze served with wasn’t equipped to help the elderly man, whom Dr. Ageze believes had a brain tumor. When Dr. Ageze told the patient this, the man grew discouraged. He shared that he would have to beg for another two months just to get the bus fare “to go home and die” in his village.

“The amount of money that he needed, I would spend on dinner,” Dr. Ageze said, putting the man’s needs in perspective. “Then you come back to the States, and you see people complaining, even when they have an entire patient room to themselves with all the resources.”

Upon his return to the United States, Dr. Ageze grew uncomfortable with the fact that such a disparity could exist anywhere in the world, let alone his home country. What he witnessed forced him to question his purpose in life, his medical career, and even his cherished Christian faith.

Soon, however, as Dr. Ageze was on his spiritual quest to find the truth, he had an encounter that confirmed his understanding that the problem started with us. “We humans were addicted to the world, fame, power, and to ourselves. Even when the world had enough resources, we didn’t love one another enough to share,” he said. Dr. Ageze realized that, if the suffering in the world was to be lessened, he would have to be part of the solution. During his residency, he heard a lecture from an addiction medicine specialist. Dr. Ageze was moved so much that he asked if he could shadow the visiting physician at his clinic.

            As the physician mentored him and he met patients with substance use disorders (SUDs) and learned about the field of addiction medicine, Dr. Ageze realized people battling addiction are struggling with their own disparities. His new purpose became clear – to care for those affected by such a debilitating chronic disease and are to some degree the “outcast” of the community.

            “I wanted to be with patients who were facing such disparities,” Dr. Ageze said. “From that point, and through daily encounters with these patients, the concept of addiction recovery helped guide me back to Christianity.” It required humbling oneself, letting go of the self-centered approach to life even when it was not easy, embracing communities and more importantly our higher power, and lastly, “to be less of a talker and more a person of true action.”

            From May 2020 to May 2021, Dr. Ageze worked as an addiction medicine specialist at Master Center for Addiction Medicine in Virginia. After working with patients with SUDs for a year, Dr. Ageze was surprised by how much the patients actually helped him.

            “It literally expanded my knowledge of what it means to be a human,” he said. “It helped me grow in my faith and caring for these patients made me more connected in a way I could not have imagined. It helped me a lot.”

Dr. Ageze is now pursuing a master’s degree in Public Health, focusing on health promotion and behavioral science, at San Diego State University. He is also doing a preventative medicine residency at UC San Diego, with an addiction medicine track. “I want to address systemic problems that my patients face daily. My eventual goal is to open sober-living homes, God willing,” he said.

Dr. Ageze initially entered family medicine to work with patients of all ages. His goal was to build relationships with his patients and provide a continuity of care for them. During his residency, he learned that, on average, he would see most patients only one to two times a year, making it difficult to build those relationships.

For him, addiction medicine has proven to be life-altering.

“In addiction medicine, you’re seeing patients every week and there’s a lot more to each visit,” he said. “You’re involved in their lives. You know their fears and the struggles they have. Because addiction is so stigmatized, a lot of patients don’t tell people about their true struggles, but when they find someone who understands addiction, they can open up and that’s big. You build these bonds and you’re really helping people regain and rebuild their lives, their marriage, etc.”

When patients relapse, Dr. Ageze said he’s grateful for the opportunity to provide them grace when they’re expecting a punitive or stigmatized response.

“I feel like I'm just passing out graces, you know,” he said. “It’s saying, ‘OK, you can do it again,’ and getting people to not beat up themselves and actually lifting them up and helping them work through how they can do it differently next time. It’s an awesome feeling to be able to do that.”

Dr. Ageze said ASAM has helped him grow as an addiction medicine specialist. He learned about ASAM through his mentor, Dr. James Thompson, who told him about the Virginia ASAM chapter. Today, Dr. Ageze serves as chair of the local Virginia chapter’s Membership Committee. He also serves on ASAM’s Membership Council.

He said ASAM’s conferences, review courses, and journals have helped him expand his knowledge. Above all, he enjoys meeting his colleagues in addiction medicine through ASAM.

“It’s great to see everyone’s passion for what they do,” he said.

When asked why he would encourage physicians outside of addiction medicine to consider entering the field, Dr. Ageze said physicians should first understand what addiction medicine actually is. There are numerous misconceptions about addiction medicine and chronic pain that are important to uncover.

He said he thinks many physicians would find the relatively new medical specialty to be the perfect fit for them.

“It’s a holistic type of care,” he said. “They will find joy in that. And those who love the continuity of care will definitely get it. It has a great mix of medical and non-medical interactions with patients as well. People who enjoy that would definitely love it. You’re really making a difference in people's lives. You are helping them find themselves, their true calling in life, while also saving their lives.”

            Looking back, Dr. Ageze is grateful that he made the switch himself.

“I couldn't have planned it,” he said. “I feel like it's my true calling in life, God sent. It's not just my job. I wake up every day happy and really want to be there, helping my patients and seeing where it takes me.” He added, “There is more coming. Stay tuned!”