EDITORIAL COMMENT:  Midyear transitions

July 1 has a democratizing effect for all program directors of residency training, in all specialties. For one brief week, we are equally humbled. All must pay homage to their minor deities, those institutional ones of scheduling and funding and quality assurance; and to the superordinate deities, the respective specialty boards, and the American College of Graduate Medical Education.  All have many masters, and all of the masters will at different times lay claim to being the One True Training Deity. 

This in mind, here are two additional items:

1. https://store.samhsa.gov/sites/default/files/SAMHSA_Digital_Download/PEP20-06-01-001_508.pdf  -  The SAMHSA Guidelines on Treatment of Stimulant Use Disorders is well-reasoned, brief (43 pages), reflects current knowledge and avoids speculation on unconfirmed pharmacologic approaches.
2. We are now entering the 40^th year of an epidemic first identified in the MMWR (Morbidity and Mortality Weekly Report) of the Centers for Disease Control.  The initial report of a cohort who would later be identified as suffering from AIDS appeared in this issue: https://www.cdc.gov/mmwr/preview/mmwrhtml/june_5.htm  In the interval since then, 32-35 million worldwide have died. As we conclude Pride Month, celebrating the presence  and attainments of the LGBTQ communities, the population most disproportionately affected by that epidemic, it seems right to acknowledge the endemics and epidemics in the background of the current concern with COVID-19.  Tuberculosis, malaria, gun violence, and of course substance use disorders continue to equally demonstrate our medical and our political limitations.

- W. Haning, MD, DFASAM, DFAPA