American Society of Addiciton Medicine

Editorial Comment 12/22/2020: Bill, Unmuted

Dear Readers;

We hope you, your loved ones, and everyone you know is safe and healthy this holiday season. 2020 has been a difficult year for so many and unfortunately a tragic year for too many. Hopefully, 2021 will bring some much needed joy into peoples’ lives. For now, we’d like to offer you this small tradition of joy with an end-of the-year editorial review in honor of the selfless work Bill has done over the years at the ASAM Weekly.

This year brought new and pounding headlines almost daily, covering subjects such as social justice, economic devastation and of course a public health crisis.  Bill’s editorials were ready from the beginning. The top three pieces are from January and almost forewarn the importance of the messenger and the message. The life of Dr. Ashton (Management of Benzodiazepine (BZ) Use Disorder) was celebrated not only for her contribution to the clinical management of benzodiazepines but for the importance of integrity and determination to speak up about an institution that is harming those it is meant to help. In Allies, Bill celebrated the life of a friend who demonstrated humility and dedication in his work facilitating the organizational necessities of addiction treatment, while humorously acknowledging that others would receive the celebratory recognition. Finally, in Dreams Realized, Dreams Slain we are invited into the matrimonial celebration of two colleagues whose marriage is emblematic of social progress but we are reminded to worry about a simmering public health crisis so perfectly messaged as “deaths of despair”. 

          Shortly after, we would all come to worry about COVID-19. From the beginning experts warned about the harm social distancing would bring to addiction recovery, but Isolation is more about the diseases of relationship and recovery is the recognition of repairing these relationships to heal the disease; both affective and addiction. In A Different Meaning of Recovery, patience is needed because recovery from addiction (or a natural disaster, or a pandemic) should not be expected (nor demanded) during the acute crisis phase. One of Bill’s mentors named Fred from a Very Large Army Hospital (A Story Regarding Projection and Expectations) teaches us that we are so often treating more than the individual patient and, as Bill has frequently written, we are treating each other. Such is the case in Recovering Healthcare Professionals with Addiction which visualizes a Venn diagram of the unique and varied humans of this collective recovery, in an effort to bring cohesion to a cause with such breadth. But more directly, when doctors need the help of each other (Doctors helping other doctors) an editorial can be a megaphone.

          So as we wrap up this year and this end-of-the-year review, keep in mind that hope is always a part of Bill’s editorials.  Moral Posture in Addiction Treatment unwraps for us the tenets of motivational interviewing as a step toward bridging political divides. Interestingly, the immune response can be a guide to a more compassionate model of surveillance and intervention when helping healthcare workers with addiction (OUD Among Healthcare Workers – Another Sort of Immune Response), and an appropriate understanding of the data is a must during any crisis (AA-derived Treatment Efficacy). Finally, I encourage our readers to re-read Masks and Twelve Steps. It is a timely (and timeless) piece about unconscious defense mechanisms, maturational processes, and masks. Sometimes our only defense is altruism.

From all of us at ASAM Weekly (Bill, Karen, Deedee, Bob, and myself) thank you for reading. Stay safe.

- Nicholas Athanasiou, MD, MBA, FASAM, Senior Editor, ASAM Weekly