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Go Micro! TNSAM President Celebrates Involvement in ASAM’s State Chapters
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Jason Kirby, DO, MBA, FASAM, has found numerous meaningful ways to advance the field of addiction medicine at the macro and micro levels since joining ASAM in 2017.
Dr. Kirby, a board-certified addiction medicine specialist who entered the field eight years ago, has served on several ASAM committees, including -- most recently -- the Finance, Steering, Legislative, and Conference Planning committees. He was a co-author for the fourth edition of the ASAM Criteria®, set to be published this fall, and he has previously sat on ASAM’s Levels of Care and the Withdrawal Management committees.
Currently, Dr. Kirby is focused on advancing addiction medicine at the micro level – that is, the state level -- which he also sees as critical to making lasting, effective change.
“There are 50 states with 50 different agendas,” said Dr. Kirby, who joined the Tennessee Society of Addiction Medicine (TNSAM) in 2021 and became its president in April. “Every region is going to be different in their politics. Every state is going to have different nuances in their laws. While I have found engagement with ASAM at the national level important, if you really want to transform how a state treats folks with compulsive behaviors, it only makes sense to be involved with the state chapter.”
Changing Tennessee
In the Volunteer State, the biggest challenge addiction medicine faces is the political climate, Dr. Kirby said.
“There’s a fair amount of stigma,” he added. “We have many differing political persuasions and opinions in Tennessee. Depending on where you are, whether you're in Knoxville and East Tennessee, or you're in Memphis or Nashville, the political spectrum is different everywhere. It's been challenging to pass addiction-friendly, non-stigmatizing laws in the state or amend existing laws for best practices and standards of care. There’s a lot of politics in medicine and that's not a good thing.”
To tackle these challenges, TNSAM created a legislative subcommittee about three months ago. Members of the subcommittee travel to Nashville twice a month to meet with politicians and discuss the addiction-related issues the state is facing.
“We talk about the specific legislation proposed and whether we agree or disagree with it, and why,”’ Dr. Kirby said. “We'll also discuss upcoming federal bills.”
To help grow the field of addiction medicine in Tennessee, TNSAM is working to recruit more young academic physicians, through efforts such as a new scholarship program, which launched in April.
The state chapter offers three addiction medicine fellowships and one addiction psychiatry fellowship. Each recipient receives a $1,000 scholarship and half off their registration to the 2024 ASAM Annual Conference, which will take place from April 4-7 in Dallas, Texas.
Each recipient will also present on a topic of their choice during TNSAM’s monthly meeting and during the 2023 Mid-South Addiction Conference in October at Vanderbilt University.
“I'm happy to report that all four of our scholarship recipients are now active members of TNSAM,” Dr. Kirby said. “We're developing enthusiasm in TNSAM and trying to grow membership, especially with our younger physicians. I think that it’s catching on.”
Dr. Kirby also is working to build a collaborative network of physicians across Tennessee and to raise awareness about the importance of addiction medicine in the acute care setting.
“When I last ran the numbers back in the spring, I found that over half of hospital systems in the state of Tennessee didn't have addiction medicine specialists on medical staff in hospitals,” he said. “They didn't have an addiction medicine consult service or an addiction psychiatry consult service established.
“A big part of my agenda during the rest of my term as president is to try to work with hospitals, especially rural hospitals in the state, to entice them to recruit fellowship-trained addictionologists to be on medical staff so we can create addiction medicine consult services. The evidence shows that having these types of services in the acute setting improves follow-up to lower levels of care and the quality of care for in-patients.”
Go ‘Micro’
Dr. Kirby said his involvement in TNSAM has influenced his career in multiple ways since he moved to Tennessee from New York.
“I came from a state that was a little bit more progressive when it comes to addiction medicine,” he said. “In general, being involved in TNSAM opened my eyes to the fact that the work is not done and that there's still a large segment of the country that is not using evidence-based, outcome-oriented care. This reality encourages me to pursue leadership positions so I can contribute to the solution.”
Dr. Kirby is enjoying meeting with other addiction medicine specialists in Tennessee and other states. “There’s not a whole lot of us out there,” he said. “The more that we can just talk to each other about the successes and the struggles that we have in each of our own communities and states, and what we’re doing to address those, the more we can piggyback on a lot of good ideas from other states, and maybe we don't have to reinvent the wheel each and every time. For me, the comradery with other addictionologists has been the most impactful so far.”
Dr. Kirby said he encourages ASAM members to become more engaged in their state chapters. “To be honest, if any physician is genuinely interested in fundamental change at the grassroots level, they should get involved in their own community,” he said. “ASAM national is wonderful and I love sitting on ASAM committees. I love being a part of the leadership in ASAM, but that's the macro movement. The micro-movements are what's happening in Nashville or what's happening in Memphis or Chattanooga or Knoxville and Sparta, Tennessee – population of 2,000 people.
To have an effect on the policies and protocols in that community, you have to be informed. You have to get involved in your state chapter because, and I say this to everybody I've ever trained: addiction medicine is not golf. This is a team sport, and we need each other because this is hard work. We need each other for that support.”
If more ASAM members joined their state chapters, he said, it would dramatically improve the field of addiction medicine and the quality of care those struggling with addiction receive.
“You not only network with like-minded individuals who do this work throughout the state,” he said, “you get a chance to see what issues are affecting each region of every state. We need to have people in the same room as these politicians when they talk about passing these bills. If we're not representing the field, then nobody else will.”