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.

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.