The ASAMW Survey - foreword (9.18.2018)

This past week has been a reminder of our frailty, individual and collective, in the face of powerful external forces. It is, unsurprisingly, also a time when internal forces may rage in response. The susceptibility of our patients to relapse can be expected to rise, but probably the single greatest predictor of return to use will be isolation. Certainly flooding and the fear it engenders makes that sense of isolation almost unbearable for many, both in the eastern United States and on the island of Luzon.  Of those in Hawaii whose families originated in the Philippines, most are from Ilocos Norte, the province most severely stricken by super-typhoon Ompong.  Loss of communications to rural areas becomes isolative for all parties in these extended families.  Frustrated wishes to help can be painful to endure.

Just as the sense of isolation increases risk for major depression and suicide, so it is central to active addiction.  Again unsurprisingly, it is that experience of isolation which recovery groups, whether twelve-step or other, seek to overcome in re-developing connectedness.  It is also in our communion as treatment providers, whether through shared participation in organizations, acts such as reading or contributing to this publication, or in individual phone calls seeking consultation that we find ourselves better able to care for our patients.

The Survey (sic):  As the ASAM Weekly participation goes well past 50,000, it has become increasingly important to know what your expectations amount to.  ASAM staff inclusive of Luke Waldron and Jasmine Rennie both initiated and pursued a survey in which over 1400 of you participated. Astoundingly, over 500 of you chose to append narrative comments, as well.  Nick and I are sorting through those comments, even as Luke essays an analysis of the readership demography. When completed, we will publish results here, likely in the next few weeks. More importantly, we need to take several actions in response to the many requests for increased inclusivity of the readers. These will include but not be limited to guest editorials and new format elements. I would say that it is all daunting, but that would be whimpering and you deserve better. Certainly, while our patients and our neighbors are struggling, faced with assaults from within and without, it’s not daunting.

- W. Haning, MD