ASAM Leadership Profile: Dr. John Tanner

ASAM interviewed John Tanner, DO, FASAM, ABAM Diplomate, CCFC, MRO, an at large member of the Board of Directors, as part of an ASAM Magazine series on leadership.  Dr. Tanner has been a member of ASAM since 1986 when it was called the American Medical Society on Alcoholism and Other Drug Dependencies (AMSAODD) and was certified that same year.  He has also been instrumental in helping to bring new associate member into ASAM.

ASAM Magazine: What or who influenced you to become an ASAM member?

John Tanner: When I was in my late teens and through my twenties, someone close in my life had serious problems with addiction that I was incapable of comprehending.  In my early thirties, back in about late 1984, a highly respected physician in my community who was treating addictions asked me to help him at an addiction treatment center.  Because of the issues that I had dealt with earlier, I became very interested in addictions and the recovery process and became very involved with the field.

In 1986 I received a mailing from the American Medical Society on Alcoholism and Other Drug Dependencies or AMSAODD (which understandably later changed the name to the American Society of Addiction Medicine) offering membership and a certification process.   I joined, became certified in 1986, and I have greatly benefited from being involved as a member ever since.

ASAM Magazine:  What does membership in ASAM mean to you?

John Tanner:  Helping those who suffer from addiction has been extremely rewarding and my membership in ASAM has been integral in helping me along this career path.   I quickly learned that my most grateful patients were those who learned to embrace recovery.  I find nothing more rewarding than helping someone who has lost their way in life due to addiction get back on track.

My involvement with ASAM has helped to provide much of the critical education I needed.  The ASAM publications have proven to be a valuable resource over the years.  Collaborating with fellow colleagues at ASAM’s conferences has been invaluable in providing awareness that they faced virtually all of the same issues that I was dealing with.

I have been extremely pleased to see what ASAM has been able to accomplish over almost 3 decades in regard to influencing government policy and third-party payers as well as increasing awareness that addiction truly is a brain disease.  The growth of our state chapters has also proven beneficial in providing more resources locally and influencing our state politicians.  I am proud that the ASAM Criteria has been so influential to guide appropriate placement, continued stay, transfer, and discharge of patients with addiction and co-occurring conditions.

ASAM Magazine:  What has been the most rewarding part of being a member of ASAM?

John Tanner:  The collaboration with our fellow members, some of whom have mentored me, has been the most rewarding aspect of my membership in ASAM.  I very much look forward to attending the conferences and meeting up with my colleagues.  I have had the good fortune to be able to give back by helping to mentor others.   I have found that our members are full of passion and empathy to a degree that I have seen in no other medical society.

ASAM Magazine:You have been an important part in promoting Associate Membership. Why do you feel so passionately about incorporating non-physicians into ASAM and the field of addiction medicine?

John Tanner:  Clearly the research, clinical treatment and teaching of addictive disorders does not rest solely with physicians.   In order for our patients to achieve success we need a team effort with individuals who have specific skills that go beyond the realm which most addiction physicians can provide.  By working together with our associates in this field we will all benefit, especially our patients.

With the new offering of Associate Membership, we now have an opportunity to learn more about what our fellow treatment providers, teachers and researchers offer for our patients and how we may guide our patients to the most appropriate therapies.  The roles of doctoral trained scientists, nursing professions (i.e. CARN, NP, DNP, RN and Psych-CNS), Psychologists (PhD and PsyD), Social Workers, licensed mental health counselors, Physician Assistants, Doctor of Pharmacy (PharmD), and masters level or higher counseling and clinical professionals are vital for helping our patients.  There are a wealth of resources among our associates trained in these affiliated professions.  I am excited that we can now learn from them and they can learn from us and together we can provide a more holistic approach to help our patients.

ASAM Magazine:What role can non-physicians play in the treatment of addiction?

John Tanner:  As physicians, we tend to focus on the more medicalized aspects of addiction such as medications including buprenorphine, naltrexone, naloxone, methadone or varenicline.   We also focus on identification and treatment of the complications of addictions such as HIV, HCV, neurotoxic effects of drugs and toxic liver effects.   Addiction adversely affects many facets of a person's life and more often than not, failure to address those facets may result in failure to attain recovery. Unfortunately, it is all too easy to overlook the vast array of valuable resources offered by our non-physician associates who are trained in very specific ways to help our patients with addiction.

We work hand-in-hand with other medical providers such as nurses, nurse practitioners, physician assistants and pharmacists to help with many of these addiction related medical issues.  By utilizing these health professionals’ skills we can extend our services to help more people.  Most physicians do not get involved with early drug development or high-level neuroscience research of addiction.  It is critical that we have highly skilled and trained scientists who are pursuing this type of research so that we continue to make valuable contributions to the progress in this field.  Our collaboration with these scientists is critical.

As addiction treating physicians, we need to become aware of all there is to offer our patients in the realm of psychosocial treatments that are offered by our fellow behavioral treatment providers including; psychologists, mental health counselors and social workers.  They frequently have very specific skills and tools to treat underlying issues that contribute to addiction that we may lack.  These associates are trained to more effectively treat various types of trauma, address some comorbid psychiatric disorders, help development of healthier coping skills, reduce anxiety and otherwise address a variety of other behavioral issues.   Many of these associates may be educators in the field of addiction who will be a resource for our society.

ASAM Magazine:  Where do you see ASAM going in the next 5 years?

John Tanner:  I see continued growth of our membership, especially our Associate Membership.  We will need to bolster our support for the American Board of Addiction Medicine by providing the high quality educational resources needed for ABAM certification and generate more interest among physicians to become fellowship trained and pursue certification through the American Board of Addiction Medicine.  We need to entice more young physicians and women to join ASAM and mentor them to become engaged in our society’s leadership roles.  We will likely be offering new and more innovative forms of Continuing Medical Education which will be more interactive and CME will become increasingly available on the Internet via our e-Live Learning Center.  I see us beginning to offer Continuing Education that may meet the needs of more of our Associate Members.

There is a great need to fulfill the gap in early education by providing guidelines and resources for addiction education to all medical students, residents and fellows in all medical disciplines.  I also see ASAM working more closely with criminal justice and governmental agencies to assure that people who suffer from addiction are offered the most effective and helpful resources, based not on stigma or punitive actions, but on scientific research and outcomes data.  There is a need for increased awareness of our Advocacy Toolkits that make efforts to advocate for these changes easier.   Hopefully within five years the problems with implementation of parity will be past history.

ASAM Magazine: What issues do you think need to be addressed by ASAM now or in the future?  What are some of the challenges that the field faces now or in the future?

John Tanner:  I believe that the challenges and issues that need to be addressed include a continuing need to educate healthcare providers, the criminal justice system, and the general public to help them overcome their stigma associated approach to this horribly destructive disease.   Those suffering from addiction must have access to proper identification and treatment and not be addressed with punitive measures that lead to recidivism.  Another major challenge that must be addressed in coming years is full implementation of parity so that our patients have equal treatment access for addictive disorders as for other medical conditions.

Too many people continue to die unnecessarily from prescription opioid analgesic and heroin overdose, which is in part due to the lack of availability of buprenorphine products in many areas throughout the country.  A well thought out resolution plan needs to be implemented in regard to the current 30/100 imposed limit upon physicians that contributes to this problem.  Another challenge is that many less trained buprenorphine prescribing physicians focus on the medication as the ultimate answer when in reality it is only one of many tools that help with recovery from addiction.  There is a great need to educate more physicians who offer medication assisted treatment about the importance of all aspects of recovery, including the available psychosocial treatments, spiritual components that offer benefit to many patients, and the value of mutual support group involvement.

Many treatment providers would likely benefit from enhanced skills in motivational interviewing techniques to help guide patients to make better decisions in their lives and develop a comfort level to regularly perform screening, brief intervention and referral to treatment (SBIRT).  Our challenge is to engage more physicians and Associate Members to avail themselves with the ASAM educational offerings that teach these skills.

We face a huge challenge in regard to the public’s misunderstandings about recreational marijuana and so-called "medical marijuana" that is likely to pose an increasing addiction related public health problem.  There needs to be more education of governmental officials and the public in regard to this.  There also needs to be encouragement for research into potential medical benefits of true medicalization of cannabinoids.  If such benefits, targeting specific disease states are identified and approved through the FDA, then these cannabinoids could be accurately quantitated, prescribed and administered through appropriate enteral or parenteral routes rather than being smoked.

ASAM Magazine: What recommendations would you give to someone who is new to the field of addiction medicine?

John Tanner:  You have chosen to enter one of, if not the most, challenging yet rewarding fields in medicine.  If you take this seriously, you will have immense career satisfaction.  Avail yourself of the many resources that ASAM has to offer as these will help you to grow in this amazing field and benefit your patients.   Collaborate with associates and receive the available mentoring that will help guide you.  Take advantage of the many different educational opportunities and the tools offered through this society.  Become involved with the society by serving on committees and helping mentor those in need and this will provide additional rewards for you.  If you focus on having empathy and helping your patients while maintaining good boundaries with your patients, you will be very successful.  Most of all, enjoy your new career!    :-)