Aug 9, 2021, 13:40 by admin admin

In response to our invitation for guest editorials, Dr. Timmen Cermak, past President of the California Society of Addiction Medicine, submitted the following essay on the symbolic and real confinements experienced by a child in an alcoholic family, employing parallels with the current pandemic public health confinements.

Aug 9, 2021, 13:40 by admin admin

Substance use disorders appear unique. Alone among the illnesses that dwell in the house of medicine, those relating to addiction are characterized phenomenologically, behaviorally; and yet are the outcome of toxic exposure. They do not, unlike lead poisoning or the dementia that develops from diabetes, induce sympathy in the observer.

Aug 9, 2021, 13:40 by admin admin

In Hawaii, we had a teaching party this past week. Okay, in truth, we have one each year, about this time (April-June); which we choose to call, unsurprisingly, the Hawai`i Addiction Conference, or HAC. This has been an annual event in Honolulu from the inception of the University of Hawai`i addiction psychiatry and addiction medicine fellowships in 1998, the first such fellowships west of the Mississippi. Very far west of the Mississippi.

Aug 9, 2021, 13:40 by admin admin

Baumann and Lee’s article in Bloomberg Law leads, with a discussion of the exacerbating impact of the COVID-19 pandemic on those with substance use disorders (SUDs). Regardless of the substance or the pattern of addiction experienced, inaccessibility to treatment and support from risk of contagion is universal. For a month and longer, mutual support groups have been first discouraged, then formally prohibited from meeting in person. Residential and even outpatient treatment facilities have been trammeled. The central organizing theme of recovery has always been affiliation and the over-coming of isolation; social approaches now risk acute illness, disability, and death.

Aug 9, 2021, 13:40 by admin admin

The past week – past month, truly – has been filled with abrupt, unfamiliar, seemingly overwhelming tasks. In that space, ASAM chose to bring about an annual conference that customarily occupies 2-1/2 days plus two, day-long added courses, in a medium in which it has had some practice; but never with such ambition. Courses were re-formatted, re-scheduled, re-organized to meet the academic commitments of the original in-person event. Speakers were trained to use unfamiliar media, under curtain-raising and deadline demands rarely experienced in the luxury of the big-tent conferences. It was Chautauqua and Graduate School and prime-time TV, all gemischt. Registrations needed modifying or refunding, venue commitments required re-negotiating, insurance providers engaged, disappointed and angry and just unhappy folks needed solace and aid. That’s not half of it. …It is a course still accessible for three years with attendant CME.

Aug 9, 2021, 13:40 by admin admin

Brevity in access to courses and presentations, for this week : April 3-4 introduces the distance independent “ASAM Virtual 2020.” A heroic accomplishment by staff and faculty to provide content equal in quality and breadth to that in the annual scientific meetings, it is April 3-4; and because of its electronic facilitation, both real-time and recorded, registration is available to and through the sessions. Additional sessions will be provided throughout the month of April.

Aug 9, 2021, 13:40 by admin admin

Guidance for our practice of medicine: The ASAM National Practice Guidelines for Opioid Treating Opioid Use Disorder is linked below with introductory comments. The 95-page text, an ASAM Journal of Addiction Medicine Supplement, may be downloaded at no charge. This is a comprehensive update to the original 2015 Guideline, including both major revisions and new material. The ASAM Guideline on Alcohol Withdrawal Management was approved by the ASAM Board on 23 January, and we have re-linked it here for convenience. A final copy without watermark is pending.

Aug 9, 2021, 13:40 by admin admin

Readers are encouraged to proceed directly to the lead abstract and its link below, a Cochrane Review examination of the relative efficacies of available psychosocial treatments when compared with facilitated and un-facilitated Alcoholics Anonymous (AA) participation, in the management of alcohol use disorder (AUD).

Aug 9, 2021, 13:40 by admin admin

Periodically we re-state an enduring question: have any of the readers a wish to submit a commentary or a review on a topic in addiction medicine? While subject to peer review by the editorial panel, and thus risking re-writing or even rejection, your words will be treated gently and received gratefully.

Aug 9, 2021, 13:40 by admin admin

On 06 February, ASAM posted “Public Policy Statement on Physicians and Other Healthcare Professionals with Addiction”, acknowledged in the ASAM Advocate and by the Federation of State Physician Health Programs . While it addresses the practice and recovery environments for healthcare professionals as of 2020, the policy invites a review of the role of recovering physicians in developing the very specialties that many of them come to practice, Addiction Medicine and Addiction Psychiatry.

Aug 9, 2021, 13:40 by admin admin

Transitions (specific): Dr. Chuck Stevens (D.O.), addiction specialist and Methodist Minister, was a familiar figure and voice to many of us. His 27 years of recovery contributed to the survival of, and the fulfillment of ambitions for countless others. His passing in January came at age 67, a number he had not expected to attain; his grace in enduring more than one chronic, progressive illness both instructed and encouraged many who will see this. Transitions (general): Much of my past week was spent in the company of Western Doctors in Recovery, in San Diego, a more compact and regional organization than International Doctors in Alcoholics Anonymous (IDAA), but which shares many of the same aims.

Aug 9, 2021, 13:40 by admin admin

All efforts to describe addiction as an illness - comparable to those others suffered blamelessly, from misadventure, or from neglect - invariably fall back on models or analogies. The models are useful from a public health standpoint, in devising populational interventions. Heuristically analogies can be examined for flaws, as well, in order to come to a clearer notion of how the disease does not resemble another condition or process; and so prevent investigators from going down blind alleys. They can also clarify descriptive language.

Aug 9, 2021, 13:40 by admin admin

I’m a great one for castigating politicians. For dishonesty. For perfidy. And for that most corrosive of flaws, hypocrisy. I can put my burner on high blue flame, when some stridently vocal Defender of the Faith gets caught in flagrante delicto with some poor hotel staffer. So I can only assume there is something particularly distorted in the mirror of my behavior when I contradict what seem to be my own values.

Aug 9, 2021, 13:40 by admin admin

This week’s submissions reflect a strong bias to basic science, unapologetically. There are times when the brain is a three-pound grey pudding with obscure eponyms assigned to slightly darker streaks and patches, waiting to lose a contest between its inebriated owner and a delivery van.

Aug 9, 2021, 13:40 by admin admin

This past month a friend died. He did so quietly, drawing no attention to himself, despite having known for a number of years that this was impending; and certainly imminent within the past few months. I only knew of it because of a kind of long-term, episodic, two-student mini-seminar that we held for each other, on the topic of life’s end. The cause of his death was what will likely occur for many of us who are older - although he was not so very far into middle-age himself - if we are not infected by a Chinese chicken, stricken by a smartphone-distracted Mercedes-Benz driver, or overcome by gravity while a passenger in a helicopter. Nor was it from a substance use disorder, with all its attendant risks of infection and trauma. It was a cancer, for which the merits of 21st-century medicine shone, in that his life’s length and quality were clearly improved by treatment

Aug 9, 2021, 13:40 by admin admin

Some days ago, I was witness to an extraordinary event. That’s not quite right; I was an invited participant, in consequence of the way the event was handled. Two friends married, for whom such a marriage would have resulted in imprisonment, or just as likely, the deaths of either or both spouses, just within this past century. Wonderfully choreographed, with many hundreds of family and friends attending from homes thousands of miles afar, the marriage was between two exceptionally caring healthcare professionals who had been imaginatively, patiently planning toward this point for over eight years.

Aug 9, 2021, 13:40 by admin admin

The New York Times (NYT) Science section of 03 January carried this eulogy, by Knvul Sheikh*: “Dr. Heather Ashton, 90, Dies; Helped People Quit Anxiety Drugs” An excerpt from this review of Dr. Ashton’s professional life underscores how it is not merely opioids which have led to our dereliction of better judgment, in the prescribing of addiction-activating drugs: “Heather was a remarkable person,” Nicol Ferrier, an emeritus professor of psychiatry at Newcastle University who worked closely with Dr. Ashton, said in an interview. “She was very upset by this problem of benzodiazepine dependence that was essentially caused by doctors overprescribing the medications, and she took it upon herself to help patients struggling to withdraw from them.”

Aug 9, 2021, 13:40 by admin admin

It is with great pleasure we get to finish off the year with our annual tribute to Bill’s editorials. This is not just some 80’s sit-com ploy to keep our readers’ attention by re-running clips of the most watched episodes- it is a moment to show thanks for all that Bill shares by pouring out his thoughts 51 weeks a year…So let’s take a look back at 2019, make some sense out of it, and get ready for the twenties of the 21st century.

Aug 9, 2021, 13:40 by admin admin

In this holiday season, "gift giving" has become a trope, investing it with a spiritual value that makes the endless and fervent buying-and-giving-and-receiving-and-exchanging seem somehow a little sacred. But that misses the point. The gifts in such seasons are not those by us to spiritual entities, but from them to us. We give thanks to you, the readers for guiding our shared patients to a place of sustained relief.

Aug 9, 2021, 13:40 by admin admin

A December 11 article by Coffin et al. in JAMA Psychiatry suggests efficacy for the use of mirtazapine in management of methamphetamine use disorder, as well as some positive effect upon high-risk sexual behavior. The article particularly stirred up interest among one large group of addiction specialists, stimulating a high baud-rate exchange both pro/con.