Aug 9, 2021, 13:40 by admin admin

Those who are familiar with the superb program by Shankar Vedantam, on National Public Radio, "The Hidden Brain," a weekly interview and analysis of issues in neuroscience and behavior, may also be as accustomed as I in discovering how much I do not know [https://www.npr.org/podcasts/510308/hidden-brain ].

Aug 9, 2021, 13:40 by admin admin

In Stephanie Brown’s “Treating the Alcoholic” there is a section entitled “a psychological view of the 12 steps.” While paralleling the process of recovery - employing a 12-step model - with psychotherapy, she and George Vaillant have made the case for it being a maturational process.

Aug 9, 2021, 13:40 by admin admin

Owing in part to absence, I regret that this week’s commentary is abbreviated, limited to a short quotation. My choice of material reflects this week’s U.S. Presidential decision, which diverted clinical data needed for successful management of the COVID-19 pandemic away from the Centers for Disease Control and Prevention (CDC).

Aug 9, 2021, 13:40 by admin admin

The account of important events can be difficult enough in real time. A national pastime is watching the news and making fun of the various heads that are speaking. At the same time, we generally reserve a certain amount of sympathy for the difficulty of their vocation, and not merely for their performance anxiety.

Aug 9, 2021, 13:40 by admin admin

There is a common and grievous tendency to refer to the holiday just passed as “The Fourth of July,” when it is, in fact, “Independence Day”: a celebration specifically of the signing of the Declaration of Independence (plus or minus two days depending on whose account of the date you choose). Benjamin Rush, M.D., senior attending physician in the University of Pennsylvania and Surgeon General of the Continental Army, was very relevantly a signer of the Declaration of Independence of the nascent United States.

Aug 9, 2021, 13:40 by admin admin

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.

Aug 9, 2021, 13:40 by admin admin

ACAAM, the association of program directors in addiction medicine, thoughtfully provided certificates of acknowledgment to all of the recent fellowship graduates on June 4th. The acknowledgments included photographs of those about to graduate, and while this is a pretty mundane observation, I was seized by how youthful at least half of the faces appeared to be.

Aug 9, 2021, 13:40 by admin admin

In April, an ASAM task force was set up, chaired by Doctors Yngvild Olsen and Kelly Clark. The website that was constructed is conveniently arrayed, comprehensive, and exceptionally practical.

Aug 9, 2021, 13:40 by admin admin

For some years, Dr. Athanasiou, and before him, Dr. Miotto and I have tried to find a means by which to hold a journal club in addiction medicine that would span the continent. With over 50 fellowships in addiction medicine and a like number of addiction psychiatry fellowships, the call to share resources is less an opportunity than an obligation. The springboard for a universal journal club would in fact be this very weekly e-journal. It has the merit of conveying an overview of the literature in a condensed structure.

Aug 9, 2021, 13:40 by admin admin

In almost three millennia of historical record-keeping, humanity continues to vacillate between two poles: claims of special entitlements for one group over another; and imprecations to treat one another with equal regard. We seem to be an uncommonly stupid species, who cannot in all that time come to understand how central to universal happiness is the principle of universal respect.

Aug 9, 2021, 13:40 by admin admin

My custom of observing Memorial Day has been shared by fewer among my university and medical school colleagues as those with past military service age out of life, most of them more quietly than could the honorees. Memorial Day itself historically represented a tribute to those making the most obvious and most necessary contribution to defending a nation, dying in combat.

Aug 9, 2021, 13:40 by admin admin

The ASAM Webinair listed below (The ASAM National Practice Guideline 2020 Focused Update Webinar: Fundamentals), as well as this year’s ASAM Virtual Conference, oblige attention to the evolution in how we teach.

Aug 9, 2021, 13:40 by admin admin

It’s not so true that the COVID-19 pandemic confinement orders create more free time, as that they oblige even more time than usual, in front of a computer. So it has been that I find myself off on tangents of exploration, seeking the trails of topics and people, night after night.

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.