About Us

Timothy Wiegand, MD, FACMT, FAACT, DFASAM

Candidate for Vice-President

Biography and Statement

Timothy Wiegand, MD, FACMT, FAACT, DFASAM

1. What are your greatest contributions to ASAM and the field of addiction medicine?

I am Board Certified in Medical Toxicology and Addiction Medicine. My professional work includes patient care and other activities including education, advocacy, mentoring and research that lie at the intersection of addiction medicine and medical toxicology. Over the years one of my primary professional goals has been to create awareness of and expand addiction medicine as a practice pathway for medical toxicologists and to introduce addiction medicine, and ASAM as a professional group, to the medical toxicology community. Some examples that this has been successful, not just from my efforts, but also many others that have seen the overlap and natural synergy between the two specialties, are that nearly 10 % of all currently board certified medical toxicologists have fulfilled practice pathway criteria and become dual-boarded in addiction medicine. Several have also completed formal addiction medicine fellowship training and obtained dual certification. Just this past year the American Board of Emergency Medicine (ABEM) and the American Board of Preventative Medicine (ABPM) announced a dual-certification pathway for qualifying programs over 2 and ½ years (instead of the standard 3 if done separately) for qualified dual Medical Toxicology/Addiction Medicine Fellowship training programs in recognition of the overlap in content, expertise and growing interest in the dual certification. ASAM now has a medical toxicology work group/committee and there are numerous cross-disciplinary presentations at a variety of both toxicology and addiction medicine conferences and events occurring annually.

Medical Toxicologists typically practice in the Emergency Department and hospital setting and often at academic centers. They are usually involved in a mixture of clinical and academic work, often participating in clerkships for medical students and in residency or fellowship training. Enhancing standard medical toxicology training with more addiction medicine content adds value for physicians and the hospitals and systems that employ them, as well as for the medical trainees that they impact, and the lives and outcomes for patients and their families impacted by substance use disorders and addiction. In recent years many of my colleagues have developed toxicology/addiction consultation service hybrids, much like the service I Direct at the University of Rochester, extending services beyond the treatment of intoxication, overdose and withdrawal to initiating pharmacotherapies for craving and dependence (e.g. buprenorphine, naltrexone, acamprosate and other pharmacotherapies) in the Emergency Department and hospital setting. This clinical work often occurs through a team effort, in the overall care for toxicology and addiction cases, such as supporting the treatment of acute pain and perioperative management in a trauma patient maintained on buprenorphine or for patients on specialty units such as in the ICU or related to the treatment of IVDU-related infective endocarditis.

Over the past several years I have been particularly pleased to participate in various collaborations both between the two specialty groups or their chapters (ASAM or NYSAM and ACMT) and with members of each (many of my toxicology colleagues belong to both ACMT and ASAM). I was the founding member and Chair of the ACMT Addiction Medicine Committee and have developed curriculum for national meetings and other activities for ACMT, NYSAM and ASAM including presenting the Toxicology, Pharmacology and Drug Testing presentation lecture at the annual ASAM Board Review Course for many years. NYSAM has included a ‘toxicology panel’ in the annual conference since 2014 which I moderate and develop the content for. I have also developed content for medical toxicology meetings (including chairing a satellite conference "ACMT Addiction Academy" and coordinated or participated in numerous medical toxicology symposia workshop and other presentations at the annual ASAM conference, including one at this past year’s virtual conference on fentanyl which we presented live on day 2. I have also presented extensively on withdrawal and intoxication management, and on the use and interpretation of urine buprenorphine metabolite levels at many different addiction and toxicology conferences including at both NYSAM and ASAM annual events. I am involved in ongoing mentorship and education activities supporting residents, fellows, early career physicians and many others in a variety of capacities including as mentor, through the ECHO platform (as facilitator in Rochester NY for a "pain and addiction" ECHO) and in other areas in particular related to toxicology/addiction practice management. In fact, many of the practicing dual-certified medical/toxicology physicians spent time shadowing me in Rochester on the addiction/toxicology CL service and in clinic, or I have worked with them in other areas of practice development such as related to billing and coding for toxicology and addiction clinical work. I also helped co-found and currently serve as Associate Program Director for the UR Medicine Combined Addiction Medicine Fellowship Program (TAMF-credentialed in process of pursuing ACGME certification) which includes substantial toxicology focus in the curriculum.

Most recently, as the COVID19 pandemic radically changed access to the treatment of substance use disorder and addiction I have been involved locally, at the state level and nationally related to changes in treatment and practice support. I have provided lectures and guidance for NYSAM and ACMT and through our regional ECHO on pain and addiction related to telemedicine during the COVID19 emergency and on the implementation of ambulatory detoxification for alcohol and regarding updates in policy, treatment and practice in the treatment of substance use disorder and addiction related to COVID19.

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

As I prepare my application for Vice-President of ASAM I am struck by how quickly medicine and the delivery of care can change as it is impacted by unexpected emergencies. Healthcare, not just addiction medicine, has been dramatically changed by the COVID19 pandemic. We face a public health crisis not just related to the virus and its disease morbidity and mortality, but also a financial crisis caused by mandates required to limit the spread of COVID19. This has impacted not only access to and delivery of care but also physician well-being, ability to provide medical education, professional society administration and function, as well as physician practice livelihood and reimbursement. In addition to the COVID19 emergency we face crisis and division across society caused by years of racial inequality and disparity. This afternoon at 1:00 PM I knelt, with many of my colleagues, in front of the University of Rochester’s Strong Memorial Hospital entrance, kneeling for 9 minutes wearing, “white coats for black lives matter.” I wore a white coat along with mask, set six feet apart from my colleagues not only in recognition of George Floyd’s life and the reprehensible way he died, but in recognition of inequality and disparity that minorities face in general. It was also an opportunity to reflect on how my actions and life can make a difference across my professional and personal life. While I felt sadness and anger I also focused on opportunity; that crisis and emergency are the basis for new direction and opportunity. The COVID19 pandemic caused increased isolation and financial stress which has already caused an increase in morbidity and mortality related to substance use and addiction. Overdose deaths from opioids, just starting to fall, are increasing again in many areas. Alcohol consumption is at unprecedented levels. ASAM is fortunate to have outstanding leadership, administrative and technical support teams across all of our platforms from advocacy to education and program management. The Executive Council and Board will be able to rely on outstanding experience and wisdom but will need to offer adept and innovative thinking to best position ASAM as it moves forward.

The COVID19 pandemic has radically altered the ways that professional organizations can communicate and provide content to their members. The annual conference and meeting, important not only for content but for networking and camaraderie, will likely be replaced, at least for the near future, by virtual conferences and events. This has important implications not just related to presentation but financially, as ASAM will need to find different ways for working with exhibitors and sponsors and to create a virtual experience that can ‘mimic’ the camaraderie of the in-person events. This is of particular interest and importance for me as I have participated in many ASAM conference events and presentations I want to maintain the quality and interaction of the in-person experience. I am also committed to working with ASAM in advocating for financial support for fellowship training and other types of training in addiction medicine. As the new ACGME-accredited fellowships increase in number and graduate newly trained fellows I would like to also look for opportunities for ‘asynchronous’ fellowship or non ACGME related credentialing that mimics a practice pathway for those that come to addiction medicine later in their professional life and for whom a traditional fellowship model is impractical. Providing this while maintaining high standards in curriculum and learning and ongoing maintenance of any certification is critical. I also will help in the development Practice Guidelines and with other ongoing content as regulation and policy change related to how we provide treatment for substance use disorder and addiction as regulations and policies change in response to COVID19 and other social factors. I anticipate that telemedicine and other novel ways of reaching patients will remain available but having parity in payment for these services as well as ensuring they not be taken advantage of critical. As I have stated previously, one of my professional goals is to continue to increase the exposure and opportunity for practice in addiction medicine for medical toxicologists. I will continue to work on this also expanding to other specialties. When different specialties collaborate critically important areas of addiction medicine are often better supported. Emergency Department and hospital care of individuals with opioid use disorder and other addictive disorders has evolved since I submitted my application for At-Large Director in 2019. It is critically important to continue and expand efforts in these areas given the importance that hospitals and EDs have within the public health infrastructure. Unfortunately this is an area that is often ill-equipped to support patients with addictions. Working on advocacy efforts and parity will be critical to these activities as well.

I have a diverse prior experience serving on Boards as well as professional experience of well over a decade of providing clinical care, education and mentorship related to the treatment of substance use disorders and addiction. I am compassionate, collegial, innovative and particularly interested in practice development and support. I am well-suited to serve ASAM in the position of Vice President and pledge to do so to the utmost of my ability should I be elected.

Biographical Sketch

Timothy J. Wiegand, MD, FACMT, FAACT, DFASAM specializes in Medical Toxicology and Addiction Medicine. He is an Associate Professor of Emergency Medicine and Public Health Sciences and the Director of Toxicology at Strong Memorial Hospital and for UR Medicine. Dr. Wiegand is also the Medical Director of Huther Doyle, a New York OASAS-certified addiction services provider in Rochester, New York, where he works in a collaborative model providing a variety of services for patients with substance use disorders and serves as facilitator for their Project ECHO program on pain, opioid prescribing and addiction. In addition to ED, hospital and clinic work treating drug exposure, intoxication and withdrawal Dr. Wiegand is involved with medical education and research in toxicology and addiction. He is the Associate Program Director for the UR Medicine Combined Addiction Medicine Fellowship and he is core faculty for the Emergency Medicine residency at Strong Memorial Hospital. He lectures locally, regionally, nationally, and internationally on topics in addiction medicine and medical toxicology and serves on the Board of Directors for several state and national organizations including as an At-Large Director for the American Society of Addiction Medicine, a 2nd term (completing 2022) for the American College of Medical Toxicology, the Medical Toxicology Foundation and he is currently President of the New York Society of Addiction Medicine. Dr. Wiegand is particularly interested in education in addiction medicine and the integration and collaboration between addiction medicine and medical toxicology. To this end he has Chaired and served on the Addiction Medicine Committee for the American College of Medical Toxicology and coordinated several presentations from toxicologists at the annual scientific meeting for ASAM as well as for his state chapter, NYSAM. He has been awarded the ASAM Millennium Labs Late Breaking Abstract Research Award twice with submissions on A.) Addiction medicine training in medical toxicology fellowship programs and B.) The interpretation of buprenorphine metabolite levels in urine drug testing, and he recently mentored (and was co-author) for Dr. Jade Malcho, the recipient of the 2020 ASAM Young Investigator Award for Best Poster: Buprenorphine Micro induction During Continuous Fentanyl Infusion.

Outside of his professional work Dr. Wiegand is fortunate to have the love and support of his wife, Bonnie, and 3 children, Eli, Sera and Charlie. He particularly enjoys canoe camping and fishing with them in the Adirondacks and he and his wife are actively involved with their children’s respective sports and after school activities.