NEWSLETTER OF THE AMERICAN SOCIETY OF ADDICTION MEDICINE

INSIDE Dr. Banhwell Assumes ASAM Presidency ndrea G. Barthwell, cASAM health and human service, ASAM AT WORK M.D., FASAM, was S f private not-for-profit orga- FOR YOU: Ainstalled as ASAM's n ociety 0 nization. She also serves as President during the senior advisor on women's Report from the EVP: Society's recent Medical- health to the National Support Fairness in Treatment ...... 2 Scientific Conference in Women's Resource Center Los Angeles. Dr. Barthwell and is active as a consultant From the succeeds outgoing Presi- and lecturer. She describes President's Desk: dent Marc Galanter, M.D., herself as a "generalist in Looking to the Future .... 4 FASAM. Also assuming Addiction Medicine with Letters: Drug courts; office were Lawrence S. training in many moda- Pain and addiction ...... 4 Brown, Jr., M.D., M.P.H., lities and settings." She In Memoriam: FASAM, President-Elect; ASAM EVP James F. Callahan, D.P.A., congratulates new officers has experience in treating Emanuel M. Steindler .... 5 Michael M Miller MD installedduringASAM~recentMedicai-ScienrificConferenceln diverse populations, such · ' · ·' Los Angeles. From the left: Dr. Callahan; Secretary Michael M. Chapter Update: FASAM, Secretary; and Miller, M.D., FASAM; 7feasurerEiizabeth F. Howell, M.D., FASAM; as incarcerated persons, Arkansas, Michigan, Elizabeth F. Howell, M.D., President Andrea G. Barthwe/1, M.D., FASAM; Immediate Past pregnant or parenting ISAM ...... 8 FASAM, Treasurer. President Marc Galanter, M.D., FASAM; and President-Elect women, adolescents, and Newly elected mem- Lawrence 5. Brown, Jr., M.D., M.PH., FASAM. ethnic minorities. People in the News: bers of the Board of Directors installed at the meet- Dr. Barthwell's professional activities encompass Dr. Chen See ...... 10 ing are Regional Directors Louis E. Baxter, Sr., M.D., service as a. board member at large and immediate past Ruth Fox Memorial FASAM; Paul H. Earley, M.D., FASAM; Lloyd J. Gor- president of the Illinois Society of Addiction Medicine, Endowment Fund ...... 22 don Ill, M.D., FASAM; Thomas L. Haynes, M.D., past board member of the Chicago Area AIDS Task My Practice: FASAM; Lori D. Karan, M.D., FACP, FASAM; Peter A. Force and the AIDS Pastoral Care Network, co-chair- Linda Ferry, M.D., Mansky, M.D.; Peter E. Mezciems, M.D., FASAM; person of the Illinois AIDS Advisory Council and chair M.P.H ...... 23 Ronald F. Pike, M.D., FASAM; A. Kennison Roy Ill, of its medical subcommittee, member of the National Conference Calendar ... 24 M.D., FASAM; and Berton E. Toews, M.D., FASAM. Advisory Board of the federal Center for Substance The new officers' terms extend to April 2003, while Abuse Treatment and the National Institute on Drug SPECIAL Directors serve four-year terms. Abuse, and past member of the Drug Abuse Advisory REPORT: Dr. Barthwell is Executive Vice President, Human Committee of the U.S. Food and Drug Administration. Resources Development Institute, Inc., a multifaceted ~ DR. BARTHWELL continued on page 4 ASAM Med-Sci Report: Friends, Fellows, Awards ...... 16 ASAM Publishes New Patient Placement Criteria ALSO SEE: SAM has published a major revision of its care organizations, state Addiction widely used patient placement criteria. The alcohol and drug agency Medicine News: ASAM Patient Placement Criteria for the directors, addiction research­ Medical marijuana; A drug testing; more ...... 3 Treatment of Substance-Related Disorders, Second ers and educators, and Edition-Revised (ASAM PPC-2R) was released during public policymakers. From the Institutes: ASAM's Medical-Scientific Conference in April. Devel­ Through this process, A quiet revolution ...... 7 opment of the new edition was spearheaded by the criteria have been News from the AMA ..... 9 David Mee-Lee, M.D. and co-editors Gerald R. completely revised to bet­ Agency Reports: Shulman, M.A., FACATA, Marc Fishman, M.D., David ter respond to the needs ONDCP. CSAT, HRSA, R. Gastfriend, M.D., and Julia Harris Griffith, M.A. of public and private treat­ NIDA, SAMHSA ...... 12 The new edition is the product of an exhaustive ment programs. Unique features of the ASAM PPC- Funding consensus-building process involving all areas of 2R are new criteria for patients with co-occurring Opportunities: addictions and mental health expertise, including mental and substance-related disorders ("dual diag­ RWJF; more ...... 15 clinical staff and administrators of public and private nosis"); refined criteria for adolescents; development treatment programs, third-party payers and managed ~ PATIENT CRITERIA continued on page22 REPORT FROM THE EXECUTIVE VICE PRESIDENT Support the Fairness in Treatment Act James F. Callahan, D.P.A.

enator Paul Wellstone untreated addiction costs the nation six times (D-MN) and Congress­ more than heart disease, six times more than American Society Sman Jim Ramstad (R­ diabetes and four times more than cancer. of MN) once again have intro­ A recent Congressional hearing convened by Addiction Medicine duced federal legislation to achieve parity in Senator Orrin Hatch (R-UT) resolved unanimously 4601 North Park Ave., Suite 101 insurance benefits for addiction treatment. The to make addiction treatment one of the primary Chevy Chase, MD 2081 Fairness in Treatment: Drug and Alcohol Addiction focuses of U.S. drug policy. And President Bush has 5 Recovery Act of 2001 (S.595/H.R.1194) would promised unprecedented attention to addiction ASA~ ~s a specialty society of require that addiction treatment benefits be treatment. phys1c1ans concerned about alcoholism and other addictions offered in the same manner as all other medical While these are hopeful signs, we must con­ and who care for persons and surgical conditions. tinue to fight for parity. Senator Wellstone and affected by these Illnesses. Of the 70% of Americans insured by private Congressman Ramstad are doing their part. Please do Officers health plans, few receive benefits for treatment your part by writing, phoning, faxing ore-mailing President on a par with other diseases because their health your Senators and member of Congress to tell Andrea G. Barthwell, M.D. . FASAM plans employ a number of discriminatory prac­ them that you support the Fairness in Treatment: President-Elect tices. These include: Drug and Alcohol Addiction Recovery Act of 2001. Lawrence W. Brown, M.D• . FASAM Immediate Past President I Annual and lifetime caps that are more restric­ Five Steps Marc Galanter, M.D., FASAM tive than those imposed on other diseases; Here are five specific steps you can take to help Secretary I More stringent limits on days of inpatient care Michael M. Miller, M.D., FASAM enact the Fairness in Treatment Act: Treasurer and number of outpatient visits than are 1. Download the constituent letter, issue brief and Elizabeth F. Howell, M.D., FASAM imposed on other diseases; fact sheet from www.partnershipforrecovery.org. Executive Vice President/CEO I Higher co-pays and deductibles for employees (If you've not written to your Congressional James F. Callahan, D.P.A. and their families who seek treatment for delegation, click on the Capitol icon to send a ASAM News addiction; and letter, and encourage your friends and col­ is an official publication of the American Society of Addiction I Arbitrary and often undisclosed criteria used leagues to send one too!) Medicine. It is published six times by insurers and employers to determine 2. Call your Congress member's local office . Tell a year. Please direct all inquiries to whether treatment services are "medically the Editor at 703/538-2285, or the contact person you are interested in a 5- Email [email protected]. necessary." to 10-minute meeting with the Senator or Chair, Publications Committee Congressman/Congresswoman to discuss leg­ Elizabeth F. Howell, M.D . The Fairness in Treatment Act islation introduced in Washington that would Newsletter Review Board end discrimination in private health plans for LeClair Bissell, M.D. would remove these restrictions addiction treatment. If the member is not avail­ Sheila B. Blume, M.D., FASAM Max A. Schneider, M.D., FASAM and bring coverage of able, ask to meet with the staff person who handles health issues. Founding Editor, 7985-7 995 addictive disorders into parity Lucy Barry Robe 3. Arrive early for the meeting and stay only for Editor with other medical problems. the agreed upon amount of time. Tell the Con­ Bonnie B. Wilford gress member or staff person that you are Subscriptions asking for support of the Fairness in Treatment Free to ASAM members; $50 a The Fairness in Treatment Act would remove Act (S.595/H.R.1194). Talk about your personal year (6 issues) to non-members. these restrictions and bring coverage of addictive Order from the ASAM office experiences as a physician and an advocate for disorders into parity with other medical problems. at 301/656-3920, treatment. Let him or her know how important or fax 301/656-3815. While the act would not require that addiction this legislation is to saving lives, reducing dollars treatment benefits be covered by a health plan, Advertising and helping the families of his or her district. Advertising rates and schedules it would prohibit discrimination by plans that do are available on request. offer such benefits. 4. Wrap up by thanking him or her for the meeting Please direct inquiries to the Editor The Act comes at an opportune time, as and leaving a copy of your constituent letter. at 703/538-2285, or Email [email protected] policymakers debate more effective ways to You also may wish to leave a copy of a Fairness address the nation's problems with alcohol and in Treatment Act fact sheet and issue brief Website that can be downloaded from the Web site For members visiting ASAM's other drug addiction. A recent study by the Web Site (www.asam.org), Robert Wood Johnson Foundation documents (www.partnershipforrecovery.org). entrance to the on-line that addiction is the number one health problem 5. Follow up the meeting with a thank-you Membership Directory in America today. No disease costs society more. requires the Username "asam" letter, encouraging the Congress member or and the password "asam" The Physician Leadership on National Drug Policy staff person to support the Fairness in Treat­ (in lower case letters). (PLNDP) at Brown University points out that ment Act. •

2 ASAM NEWS ·.-·~·-··· ADDICTION MEDICINE NEWS marijuana would be defined as potentially intervention and prevention programs, imple­ Hi~h court Strik~s oown addictive, but with potential medicinal mentation of smoking bans, and grassroots Marijuana 1n1tiat1ve value. efforts to reduce drug use. The report can be In a unanimous decision, the U.S. Supreme Source: Associated Press and Reuters accessed through the foundation's Web site court has ruled that marijuana cannot b~ News Service, May 14, 2001 . at www.rwjf.org. distributed for medical ~urposes b:cause It Source: Reuters News Service, March 9, has been classified as having no medical value President Orders Study of 2001. under federal law. The court noted that by Treatment Capacity placing marijuana in Schedule I of the federal Calling for an "all out effort" to reduce Supreme Court Bans DruJl Controll ed Substances Act. the Congr_ess demand for illegal drugs, President George TestinJl of PreJlnant Women determined that marijuana has no med1cal W. Bush has ordered the Department of Public hospitals cannot test pregnant women use, undermining a cannabis buyers' clu_b's Health and Human Services to conduct a for drugs without consent, the Supreme attempt to seek protection from prosecution state-by-state study of treatment needs Court said in a ruling that buttressed the by arguing a medical-necessity defense. and capacity. The President also promised Constitution's protection against unreason­ "In the case of the Controlled Substances $1.6 billion in federal funding for treatment able searches . The 6-3 ruling was made in a Act the statute reflects a determination that programs over the next five years. case brought against the Medical University ma;ijuana has no medical b e nefi~ worthy "As of today, the federal government is of South Carolina, which operates a public of an exception outside the conf1nes of a waging an all-out effort to reduce illegal hospital in Charleston. The justices found that government-approved research project, " drug use," the President said . "The most testing without patients' consent violates Justice Clarence Thomas wrote for t he court. "It is clear from the text of the act effective way to reduce the supply of drugs the Constitution, even though its goal may that Congress has made a determination in America is to reduce the demand for be to prevent women from harming their that marijuana has no medical benefits wor­ drugs in America. This administration will fetuses by using crack cocaine. Several thy of an exception," he added. "Unwilling focus unprecedented attention on the women who tested positive for cocaine have to view this omission as an accident, and demand side of this problem . We recognize been arrested for violating the state's child­ unable in any event to override a legislative that the most important work to reduce endangerment law. determination manifest in a statute, we drug use is done in America's living rooms During oral arguments in the case, several reject the cooperative's argument." and classrooms, in churches and syna­ justices expressed concern that the program The case reached the court after the fed­ gogues and mosques, in the workplace effectively makes physicians "agents of the eral government sought an injunction in and in our neighborhoods ." police" and results in "the co-option of the 1998 against the Oakland Cannabis Buyers President Bush also ordered a govern­ medical community." They also questioned Cooperative and five other marijuana ment-wide review of anti-drug programs, whether the program actually risks harm to distributors in California. The ruling means including a White House review of faith­ the fetus by discouraging women from seek­ the Oakland Cooperative may not resume based programs. He also called on the ing prenatal care. distributing marijuana to patients. Lawyers Justice Department to develop a plan that In its decision, the court said that the for the club said they would pursue other would make federal prisons drug-free. program is unlawful because it violates the arguments. For example, the Court's ruling Source: Reuters News Service, May 10, Constitution's Fourth Amendment protection did not address whether states have the 2001. against unreasonable searches . In order for right to pass their own laws pertaining to drug testing to be conducted, the justices medical marijuana. Addiction Tops u.s. Health said, a search warrant or consent is required. California voters approved a 1996 ballot Problems, Foundation Says "While the ultimate goal of the program may initiative that allowed seriously ill patients to In a newly released report, the Robert well have been to get the women in question use marijuana for pain relief with a physician's Wood Johnson Foundation calls alcohol into substance abuse treatment and off of recommendation. Voters subsequently have and other drug use and addiction "the drugs, the immediate objective of the searches approved similar ballot initiatives in Arizona, leading health problem in the United was to generate evidence for law enforce­ Alaska, Colorado, Hawaii, Maine, Nevada, States." ment purposes in order to reach that goal," Oregon, and Washington State. According to the report, released in Justice John Paul Stevens wrote for the court. "I can see how on the issue of medical March, illegal drug use is the cause of nearly "It's a very, very important decision in necessity they might have come down as they 16,000 deaths annually, alcohol use leads protecting the right to privacy of all Ameri­ did, but I was surprised that the Supreme to 100,000 deaths, and tobacco use is the cans," said Priscilla Smith, lawyer for the Court chose completely to sidestep the cause of 430,700 deaths. The report com­ Center for Reproductive Law and Policy, which other issues we raised," said Robert Raich, piles data from hundreds of studies on represented the South Carolina women." It an Oakland attorney who worked on the addiction conducted over the past 30 years. reaffirms that pregnant women have that case. "The next step is to go back to the On the positive side, the report showed same right to a confidential relationship with lower courts and address fully these impor­ that there has been an overall decline in their doctors." tant constitutional questions." drug use in the U.S. since the late 1970s, South Carolina Attorney General Charles Medical marijuana advocates also are a drop in smoking rates starting in the mid- Condon, who as a local prosecutor in expected to focus on amassing the medical 1960s, and a drop in alcohol consumption Charleston began the testing program, issued research necessary to convince federal officials since the early 1980s. The declines are a statement saying that the program can that marijuana should be re-categorized as a attributed to growing awareness of the risks continue if police get a search warrant or the Schedule II drug. Under such a classification, of addiction, an increase in government ~ ADDIGION continued on page 6 ... : _'oil MAY·JUNE 2001 3 .---- - . FROM THE PRESIDENT'S DESK LETTERS OxyContin® and Pain Lookinl! to To the Editor: To ba lance the reports of diversion and abuse of Oxyco r the Future March-April ASAM News}, it is important to unders ta n~ 1 ~ [see the are 50 to 70 million patients in the U.S. whose pain is Und at there Andrea G. Barthwe/1, or not treated at all. In fact, pain is the most common pre :rtr~a tect M.D., FASAM complaint in doctors' offices. The use of oral long-acting 0 e~~lng . adjunctive analgesics is the regimen of choice for t reatme~ 10~ds Wtth 0 SAM has done very well for moderate to severe pain syndromes. ch ronic a young organ1zat1on - It is imperative for any physician who treats chronic pain 1 Aa collection of compo­ the patient, Evaluate the patient and, if indicated, Treat the p~ · B elleve nents, really, trying to become a nationally recognized body with opioids (BET). Once the physician determines that opioid~ent with active, effective local chapters. In a relatively short time, indicated, the patient should agree (either verbally or in writing) a;e abide by all the rules established by the physician. 0 our Society has achieved tremendous credibility as an orga­ nization . We are an incredible array of credible experts. Both Morphine Sulfate Cantin and OxyContin are indicated for th of severe pain. If the has or hepatic e ASAM-certified physicians are seen as the experts in this field . ~eat~en t c~ronic p~t ~ent r~nal 1m~a1rme nt, ~xyContln should be _the op101d of cho1ce because it has We have structured the cl inical work of the field with our 0 tox1c metabolites, whereas morphine has a build-up of toxic metabolit; products such as ASAM 's Patient Placement Criteria and the These toxic metabolites are morphine-3-g/ucuronide (M3G), which cans. Principles of Addiction Medicine. cause myoclonus. tremors and seizures, and morphine-6-glucuronide Now we are ready to define our strategic vision for the (M6G), which is associated with opioid side effects such as sedation and future . At the 2000 Medical-Scientific conference, ASAM respiratory depression. M6G is a more potent analgesic than morphine. members clearly conveyed that they want our activities to The current controversy surrounding OxyContin (a long-acting focus on a number of central concern s: oxycodone formula) with regard to abuse, diversion and trafficking ~ The disease of addiction should be recognized as a treat­ should not cause the health professions to deny va lid treatment of able medical disorder; pain, consistent with state and federal regulations, using medications appreved by the FDA. The aberrant behavior of a very few people ~ All persons who need treatment should be able to access it; should n0t prevent the 0verwhelming majority of our patients in pain ~ Such treatment should conform to scientifically validated, from receiving the care they deserve. Morphine Sulfate Contfn and clinically informed practice guidelines; OxyContin, prescribed and taken appropriately, are safe medications ~ Appropriate treatment should be widely available and in the treatment of moderate to severe pain . covered by health insurance; and Howard A. Heit, M.D., FACP, FASAM Fairfax, VA ~ All physicians, at every level of their development, should have the knowledge they need to identify, treat and Rural Druf! Courts appropriately refer patients with addictive disorders. To the Editor: The membership also clearly wants ASAM to engage in This letter is prompted by the discussion of Arizona Drug Courts on public advocacy to achieve these goals. page 12 {of the January-February] ASAM News. In response, the Society's leadership has reviewed our I am sorry the Yum·a County Drug Court was not referred to since, previous choices in important areas. We have evaluated our in the Yuma County Superior Court jurisdiction, the drug court has successes, our failures, our satisfactions and disappointments. proven extremely effective with helping to deal with chemical We have spent time reworking our previous long-range plan dependency in a rural setting. (Maricopa County is dominated by in the context of old aspirations and wishes. We have seen Phoenix· and Pirna County is dominated by Tucson, neither rural!) our limitations, fixed roles, finiteness of opportunities and Drug courts work extremely well in rural and in semi-rural settings, time, and had an opportunity to develop our identit y. At as demonstrated by Judge Tom Cole's drug court in Yuma County. times, we have been overwhelmed by too many obligations Those of us who live and work in rural counties need as much help and duties, pulled back and pushed for ward, but we also have and support as we can get! experienced satisfactions from most of what we have done . WilliamS. Masland, M.D. We are sufficiently established to have a wide array of Yuma, Arizona relationships. We intend to use our membership and strategic links to change the way this country thinks about treatment. ~ DR. BARTHWELL continued from page 1 We know that treatment works when it is done right. The science and the art of addiction medicine are available. We Within ASAM, Dr. Barthwell has served as Secretary and member can fix this broken system . We are developing or have devel­ of the Board of Directors. She has chaired Review Courses and State of oped the tools for diagnosis, for treatment planning and for the Art Courses in Addiction Medicine, and ASAM Nicotine Confer­ removing artificial barriers that keep people from getting well. ences. In addition to chairing the Clinical Issues Section, Dr. Barthwell Over the next two years, I will work with a core of com­ was the organizing Chairperson of the Cross Cultural Concerns Com­ mitted members to move our Society and the field forward . mittee and chair of the Resources and Development Com mittee. ~he We want to partner with like-minded organizations to create also has been active in the Methadone, Membership, and Rev1 ew opportunities for ASAM to have the kind of impact no other Course committees and on the Strategic Plan Task Force. Dr. Barthwell group could be expected to have. I was certified in Addiction Medicine in 1986. •

4 A 5 A M N E W 5 ·.. ·:,\f.! -~ on Drug Abuse (now units of the National Institutes of ecutive Director Em~ nuel M. Health) to spur scientific research into the prevention eured ASAM ~red at his home in Ch1cago on and treatment of alcohol and drug addiction. s eu.,dler. 76. cerebral hemorrhage., . In 1978, he led the AMA to become the first RMay ~9. 20~A~~ ai n 1985 as the Societ~s f1r~ national health organization to call public attention to Manny JOined t from which he ret1red 1n the problem of Fetal Alcohol Syndrome (FAS) and E ecu IVe Drrec tor, a pot ears ASAM Past President 89. Recalling those ear YY M ' 'd that "as our first to urge women to abstain from alcohol use during 19 'd MD FASA , sa l . . ax Schner er, . · ·' ·rector Manny - in hts quiet, pregnancy. 0 ulf-ume Executrve I d the •Societ y and helpe d gu1' de During the Carter Administration, Manny served as e tJCienl way - res~u~s a diplomat, knowledgeable, . the AMA's liaison to the White House, assisting in rt rnto a new erbal.. · ·H: was a gentleman. kind and considerate, and reforms of the mental health system spearheaded by First Lady -,.j 1ndefatrga e. .. Rosalynn Carter. In another collaborative effort, he aligned the AMA a'"" m le He was a true mentor. ugh} by e~ n~y ~as instrumental in the creation of ASAM . In ~he with the American Psychiatric Association in a joint initiative to In a~~ / anized a series of "unity meetln.gs" ~h ~o~gh wh1ch assure better care of the chronically mentally ill. 19S~s~ 0o~ps in New York Georgia and California JOined forces In 1983, he crafted the AM.A:s policy calling for a .08% blood physb •oan egrllle American Medical Society 011 Alcoholism (later the alcohol concentration as the standard for drunk driving . While the to ecom . . dl · ) A h · · h policy was controversial at a time when few states had adopted even American Society of Add 1ct1on fl:'1e. one . . p ys1c_1an II! o ~s pre ent in those meetings, Dr. Jok~ch1 Takam1ne of Ca!1forn1a, ha1led a .1 0% BAC level, Manny amassed scientific data on alcohol-related Manny's personal integrity ~n~ diplomacy as essent1al to success­ impairment to support the AM.A:s position, which subsequently was ful completion of the negot1at1ons. ASAM Past Pres1dent Anthony adopted by most states and recently was embodied in federal a. Radcliffe. M.D., FASAM, who also was present, noted ~hat legislation enacted by the Congress and signed by President Bill "Manny could clearly articulate an argument so that both stdes Clinton . Bonnie Wilford, who succeeded Manny as director of the co uld see a path neither had seen before. He had a patience that department of substance abuse at the AMA, recalled that "he was amazed me and a sense of vision that few have, ... and he was enormously creative in understanding what the reputation of the always work1ng to be sure the vision became rea lity." AMA and the resources of the AMA could accomplish." Gail Jara, recently ret ired Executive Director of the California Manny is survived by his wife of 55 years, Maureen, as well as Society of Addiction Medicine, agreed that Manny helped develop by two sons, Arthur and Wallace, a daughter, Kathryn, and three ASAM into a strong national presence. "Manny guided ASAM to grandchildren : Nathan, Corynne, and Ellen . His passing also is membership in the American Medical Association [House of mourned by professional colleagues and friends around the coun­ De legates) and then guided us within the AMA. He helped us try. "Humanity will have a hole in it with the passing of this man," become a rea l voice within that important organization." Dr. Takamine said . "We will all miss his wisdom, his humor and his Jim Callahan, who followed him as director of ASAM. remarked loving kind ness, " Ms. Jara added. on Manny's "se lflessness, humility and, of course, his sense of A memorial service is planned for September in Chicago. To ensure humor." Jim recalled that Manny, even after his retirement, "was that Manny's work continues, his family has asked that memorials be always available to help move ASAM's mission forward . I consulted directed to ASAM's Ruth Fox Memorial Endowment Fund. • with him often and called on him to work with us at the AMA and in our endeavors to achieve specialty status. 1 will miss him person­ ally and professionally ASAM has suffered a great loss. " SAN FRANCISCO . ~anny knew the AMA well. He served on the staff of that orga­ n~zatlon for 24 years, first at JAMA and then, for many years, as Department of Veterans Affairs Medical Center drrector of the AMA5 departments of mental health and substance Full-Time Position abuse. Through his eHorts, the AMA assumed a leadership role in The Mental Health Service at the SFVAMC is seeking a board-certified the destigmatization of addictive and mental heatth disorders and or eligible psychiatrist for a full-time position on the 12-bed Psychi­ in advocating for appropriate medical care for persons so afflicted. atric Intensive Care Unit (PICU). The position will emphasize multi­ He campaigned tirelessly for the recognition of alcoholism and disciplinary team assessment, treatment and dispositional planning in m~nta l illness as medical disorders, urging that physicians treat them addition to psychopharmacologic therapies. With the same skill and compassion they brought to other health This position also incl udes admil1 istrative leader hip of the PICU and P!Oblems. A gifted writer and graduate of the Northwestern Univer­ the Acme Psychiatry er ices (APS). The APS includes the PICU, a sity School of Journalism, he authored "The AMA Manual on Partial Hospital Program and a Transitional Community Cnre program. There are opportunities to teach and receive. a O inical Faculty appoint­ Alco holism," published in 1979 as one of the first treatises on melll al the University of California School of Medicine, San Francisco. alcoholism for primary care p,hysicians. "Manny conceptualized Co mpetitive alary is negotiable, depending on qu11 lifications; excel­ addiction medicine before most of us knew what lt was and cajoled len t benefits and retirement package. The Depanme.nt of Veterans many skeptical physicians to believe that treatment did work," Dr. Affairs is an Equal Opponunity'Employe.r. U.S. citizen hip is required. Radcliffe recalled. He also was instrumental in developing medical The seleuted applicant may b subjectLo random pre-employrntnt dntg society programs to identify and rehabilitate physicians who them­ screenillg. Submit CVand three references by june 15, 2001, to: selves suHered from alcohol or drug problems. John Straznickas, M.D., at VA Medical Center (116N) In the 1970s, Manny worked with Senator Harold Hughes of 4150 Clement Street, San Francisco, CA 94121 Iowa and other members of the Congress to create the National or call415/221-4810 x2074 for further information. Institute on Alcohol Abuse and Alcoholism and the National Institute

~~.. MAY·JUNE 2001 5 ·- • I .... ADDIGION continued from page 3 Bates said that the U.S. should withdraw California Treat patient's consent. "There is no right of a from the negotiations rather than forcing Lack Funds to Hrnent Proq mother to jeopardize the health and safety other countries to weaken the treaty to a point that it could not be ratified . With Cal ifornia's Pro e l ~ . New ~~~rtl of an unborn child through her own drug to go into effect in JufOSitlo.n 36 ~C en abuse," Condon said. U.S . negotiators denied Bates' accusa­ tions. "The adm inistration feels strongly programs in the state y, add•ction lre ' Source: Associated Press, March 2 7, to treat the expectemday lack focused on publ ic health -especially pre­ the r::.,.... ~ 2007 . p · · 1n fl - ""'Ur vention in kids and stopping smuggling," ropo ~1t1on 36 sends f irst- ux of Pat, non -violent drug off and seco'""" n s said U.S. delegation chief Tom Novotny. But . . enders t ·ov· "' Alcohol Industry Plans TV Ads th th Vince Willmore of the U.S.-based Campaign ra __er an to pnson. The Ia o trea rn · The Distilled Spirits Co uncil of the U.S., a m1 llion annually to be sh w allocated for Tobacco Free Kids sided with Bates, s12 0 trade group for beverage alcohol manufac­ agencies, probation ofted by treatrne saying that the U.S. delegation has tried to turers, announced that it will end a volun­ will determine how and Otherll weaken several treaty provisions, including wh~ ~~~rs tary ban on television advertising of distilled ser v1 ces, enforcement and Pand tre ' a ban on "low-tar," "light," and "mild" alcohol products by launching a campaign Many of the labeling claims; an end to duty-free sales; co rnmun~~~ervis i on to encourage local stations to accept adver­ ment_pro grams in the state's _trea • and a ban on smoking in public places. ~ bas e d tisements for hard liquor. womed that they may not 8bcoun t.es ar Jim Rogers, owner of Sunbelt Commu­ Source: Associated Press, May 4, 200 7 financially for the flood of new e prepare nications in Las Vegas, NV, appears in the the most wonderful thing to mt~tlen ts . ~ I ·~ promotional advertisement aimed at con­ ~buse _ a priority," said Barbara Farr!~bstance vincing local television stations to accept tlve d1rector of Ohloff Treatme t ( execu. liquor commercials to help their business. "But you have to be careful whant enters. "For the past year and a half, I've chosen to f Wh · you WISh or. ere are we gomg to put all 0 f h run distilled-spirits ads just like these on my people?" t ese eight stations," said Rogers, who controls The urgency to implement plans befo seven NBC -affiliated stations and one Fox the July deadline has f?rced some trea t me~~ affiliate. "The ads are legal, tasteful and centers to come up w1th creative solul 0 responsible and they are a great source of For ~xampl e , son;e of those u nable ~ revenue." obta1n zomng perm1ts for new facilities have The beverage alcohol industry is hoping arranged to use space at nearby hospitals. that Rogers' testimonial will change some Political Contributions Hinder In addition to funding, treatment lead­ minds, especially since advertising revenue Tobacco Regulation Efforts ers say they need local government's help at local broadcast stations is expected to to obtain zoning permits to expand their Political contributions by tobacco makers are drop 11% in the coming year. In the past, facilities. " People may vote for treatment. hampering efforts to regulate tobacco, most local television stations refused to but not in their neighborhood. They want it according to leading anti-smoking groups. A , accept liquor commercials because they in the next county over," notes Susan new report by the American Heart Associa­ feared harsh criticism from the public. But Blacksher, executive director of the California tion, the American Lung Association, the Mr. Rogers claims that he has had no com­ Association of Addiction Recovery Resources, Campaign for Tobacco-Free Kids, and Com­ plaints during the 18 months he has aired which is composed of 150 nonprofit groups. the commercials . mon Cause says that cigarette makers have Source: The Chronicle of Philanthropy, "If ever there were a time when local contributed $32 million to state and federal May 3, 2001 . stations would consider revising their rules, candidates and political parties since 1995. this would be it," said Jack Myers, chief media The report asserts that there is a "strong correlation" between political contributions Appeals court Dismisses economist at Myers Reports in New York . Tobacco Lawsuits Source: The Wall Street Journal, May 7, to lawmakers from Philip Morris, R.J. The U.S. tobacco industry won victories in 2007. Reynolds Tobacco and other tobacco inter­ ests, and how those lawmakers vote on three cases as a U.S. appeals court dis­ u.s. Criticized for Stance on tobacco-related issues. For example, the missed two separate lawsuits brought by International Tobacco Treaty report claims that recipients of tobacco foreign governments and one by several The U.S. government has come under fire donations acted to block leg islation union health funds . for hindering progress towards an interna­ opposed by the tobacco industry. One such The lawsuits by Guatemala and Nicara­ tional tobacco control treaty. bill would have given the U.S. Food and gua and the Ukraine accused the tobacco "The U.S. contribution has been entirely Drug Administration authority to restrict the industry of fraud and racketeering violations. negative- weakening , delaying and delet­ sale of tobacco products to minors and to The suit brought by the union health fund s ing anything that might have substance," limit advertising and marketing by tobacco sought reimbursement for smoking -related said Clive Bates, director of the British group companies . health-care costs. . Action on Smoking and Health (ASH). Bates "This is all about purchasing the desired In issuing the U.S. Court of Appeals' unani­ made the comments as negotiations over degree of inaction from a compliant Con­ mous ruling, Judge Judith Rogers wrote the treaty drew to a close in Geneva, Swit­ gress. Sadly, the evidence indicates that thei r for the three-judge panel in the Distnct of zerland. The treaty, sponsored by the World money was well spent," said Common Columbia that the claims were "too remote, Health Organization (WHO), is aimed at Cause President Scott Harshbarger. contingent, derivative, and indirect." curbing the increase in tobacco-related Source: Reuters News Service, March 74, Source: Reuters News Service, May 22, deaths worldwide . 2007 . 2007 . •

6 A 5 AM NEW 5 . ··;r . ~, OM THE INSTITUTES REPOR T FR A Q~iet Revolution is Under Way. . . . . d researchers will find it New ant1-add1Ct1on med1cat1ons l1ke competeI Iy ma Ppe · d b · quiet revolut i ~n . t d velop medications that address na 1trexone, acamprosate, an uprop1on 0 is under way Jn eas1erh tice underpinnings of add1ct1on.· · attempt to f'1g ht cravrng· f or d rugs by regu- the addiction t e gene lating brain chemistry. The federal COMBINE researchA commu~ i ty, study is expected to provide valuable infor­ over turning a v a r~ e ty Unlike other drugs ... alcohol mation about how well these drugs perform of long-held bel1efs works on many chemical receptor in combination with addiction counseling, ranging from h_ow the which Dr. Gordis said is absolutely critical to disease is def1ned to sites in the brain, not just one, success. As with treatment outcomes, n treatment is measured._ making medication development however, research findings can be skewed v succ~IS M.D., director of the Nat1onal especially challenging. if the bar for success is set artificially high. EoocJ'I AI ' hoi Abuse and Alcoholism For example, Dr. Gordis noted that some •tute on ~oaf these changes during an naltrexone studies of alcoholics yield far ( IA::.~;:sored symposi um at ASAM 's The development of medications to help more impressive results if the occasional leal-Scientific Conference. . . "slip" is not counted as a treatment failure. way of example, or. Gord1s po1nted to fight addiction over the last decade has 8 Another trouble spot for addiction treat­ a '1_ ear study of 1 o.ooo veterans con­ been driven in large part by research show­ 30 ment is noncompliance; relapse . "Research ducted by Charles O'Brien, P~ . D . , ~ . D . , at ing how various drugs of abuse affect the the Umversity of Pennsylvama, wh1ch has chemical systems of the brain, Dr. Gordis shows that video cues activated the brains elped clarify the distinctions between said. Unlike other drugs, however, alcohol of former cocaine users in a way similar to alcohol and other drug use. abuse and works on many chemical receptor sites in sexual arousal in young men, only more so," addiction. Increasingly. addiction has come the brain, not just one, making medication he noted. "Drugs essentially hijack a part of the brain, so you can see that this is an 10 be equated with loss of control •.n?t neces­ development especially challenging . "We're sanly daily use. "Unfortunately, th1s lnforll_la­ working to find the sensitive sections incredibly enticing behavior." tion has not gotten out to the commun1ty, on receptors in order to fight alcoholism," Source: ASAM Medical-Scientific Confer- including physicians," Dr. Gordis said . he added. ence, April 20, 2001. • Using this definition of addiction, the O'Brien study concluded that tobacco is the most addic tive drug used by humans How are we developing one of the world's most beca use 31.9% of tobacco users become advanced health care environments?. addicted to nicot!ne. That is more than double the percentage of drinkers who It begins a•itb listening. become addicted to alcohol, and signifi­ ADDICTION MEDICINE PHYSICIAN cantly higher than the 23.1% of heroin users The Addiction Medicine Division of Advocate Medical Group (AMG) and the Addiction Treatment who become addicts, Dr. Gordis said. Program of Advocate Lutheran General Hospital (ALGH) are seeking a BC Psychiatrist. Internist or Family Physician who Is board certified In Addiction Psychiatry or certtfied by ASAM to work Similarly, Dr. Gordis cited the work of collaboratlvely within a multi·speclalty group practice. Both AMG and ALGH are part of Advocate researcher Tom Mclellan, Ph.D., of the Uni­ Health Care · a large, Integrated healthcare system In the Cl1 icago area and cited by Chicago Magazine as one of 25 "Best Places to Work". ALGH, previously known as Parkside Medical versity of Pennsylvania, who has helped to Services, has a proud history of offering a network of nationally and internationally recognized reshape the scie nce of outcomes measure­ addiction treatment programs. Today, ALGH continues to provide a continuum of addiction services for adults and adolescents which represent nearly all ASAM levels of care. Additionally, AMG ment. Rather than judging the success of administers the Illinois Professionals Health Program. the case management s·ervices sponsored addiction treatment programs solely on the by the Illinois State Medical Society, ISM IE, other professional societies and the Illinois Department of Professional Regulations. subsequent abstinence of those in treatment the McClellan study posits that a whole host This role Is responsible for providing medical care to patients in the hospital, structured outpatient programs and outpatients referred by tile medical gro ~ p and other providers. Other responsibilities of positive outcomes should be considered Include staffing and supervising the clinical staff, teac111ng medical students and residents, participating In research opportunities and promoting programs and services to the community. including improvements in mental health: Assisting In case management and medical review functions of the Professionals Health Program, legal problems, employment status, and is also involved. family relationships. "When we look at A thorough understanding of assessment, medical detoxification, patient placement according to treatment outcomes, we need to consider the ASAM·PPC and diagnosis and management of concurrent psychiatric and medical problems is these other factors," Dr. Gordis said. essential. Certification as a Medical Review Officer is preferred. Advances in biological and genetic If you would like to join a dynamic teem of professionals who provide care in Chicago's northwest suburbs and case management services across the State, please send CV or contact: Martin research and medications development also Doot, MD, Director of Medical Management, AMG, 701 Lee St., Ste. 220, Des Plaines, IL have the potential to change the fundamen­ 60016. Ph: 847·795-2875. E·mall: [email protected] · tal nature of addiction treatment, he said. "The human genome project probably will +.AdvocateHealth Care have a major impact on treatment," he '"Better Doctors Listen Better added, pointing out that 40% of human genes have proteins that affect the nervous system. With the human genome now . [ ~~· ' MAY-JUNE 2001 7 CHAPTER UPDATE

Arkansas New Directors Installed President: The following Regional Directors and Harley J. Harber, M.D., PA., FASAM November 2000, were installed as Alternate Direct Regional Director: Directors during the Medicai-Scientif~ernbers of ASAoMrs: elected. tc Confer s B 11'1 A. Kennison Roy, M.D., FASAM Re~ion I (New York) ence in Lo oard Of Members of tile Arkansas Society of Addiction Medicine have elected Regional Director: Peter A. Mansky, MD. s Angeles: Harley J. Harber, M.D., P.A., FASAM, new President of the chapter Alternate Director: Memll Scot Herman, M.D. and James E. Tutton, M.D., Vice President. Forrest "Bernie" Miller, Re~ion II (California) M.D., was elected Secretary. Regional Director: Lori D. Karan, MD., FACP, FASA Dr. Miller reports that the chapter plans to sponsor educational meet­ Alternate Director: Donald J. Kurth, M.D., FASAM M ings and dinners, and is working to establish a speaker's bureau . All Re~ion Ill (0', ME, MA, NH, Rl, VTl ASAM members in Arkansas are invited to become involved . Further Regional Director: Ronald F. Pike, M.D ., FASAM information is available from Dr. Miller at [email protected] . Alternate Director: Peter Rostenberg, M.D., FASAM Michil!an Re~ion IV (NJ, OH, PAl President: Michael L. Fox, D. 0. Regional Director: Louis E. Baxter, Sr., M.D., FASAM Regional Director: Thomas L. Haynes, M.D. Alternate Director: R. Jeffrey Goldsmith, M.D. Members of the Michigan Society of Addiction Medicine mourn the Re~ion V (DC, DE, GA, MD, NC, SC, VA, WV) passing of their chapter President, Stephen Alan Bendix, M.D ., who Regional Director: Paul H. Earley, M.D., FASAM died in March. Alternate Director: Timothy L. Fischer, D.O. Michael L. Fox, D.O., will serve as President for the remainder of Dr. Re~ion VI (IL, IN, KY, Ml, MN, NO, SO, TN, Wll Bendix' term, which extends through 2003. Regional Director: Thomas L. Haynes, M.D., FASAM Alternate Director: NormanS. Miller, M.D., FASAM ISAM: 2nd Annual Meetlnl! Scheduled The International Society of Addiction Medicine has scheduled its Re~ion VII (AR, lA, KS, LA, MO, NE, OK, TX) Regional Director: A. Kennison Roy Ill, M.D., FASAM 2001 Annual Meeting, "Addictions: Sharing International Respon­ sibilities in a Changing World," for September 12-14 in Trieste, Italy. Alternate Director. John P Epling, Jr., M.D., FASAM A satellite symposium is set for Saturday, September 15, in Ljubljana, Re~ion VIII (AK, AZ, CO, HI, ID, MT, NV, NM, OR, UT, WA, WY) Slovenia. Regional Director: Berton E. Toews, M.D., FASAM ASAM is a cooperating organization, as are the National institute on Alternate Director: Richard E. Tremblay, M.D., FASAM Drug Abuse and the National Institute on Alcohol Abuse and Re~ion IX (Canada and International) Alcoholism, the World Health Organization, the Pompidou Group, Regional Director: Peter E. Mezciems, M.D., FASAM and other prestigious scientific organizations. Alternate Director: Saul Alvarado, M.D. Detailed information about the meeting Is available on the !SAM Re~ion X (AL, FL, MS; PR, VII Web site (www3.sympatico.ca/pmdodiSAM) Regional Director: Lloyd J. Gordon Ill, M.D., FASAM or from the organizing committee (www. theoffice.iti/SAM). Alternate Director: C Chapman Sledge, M.D., FASAM •

Medical Director for Detoxification and Methadone Services SAN FRANCISCO HOLYOKE, MASSACHUSETIS Department of Veterans Affairs Medical Center We ole seeking a half·tima Mo~lcal Ol•acto1 to p10vide medical Half-Time Position aveiSight for the Providence Hospilol Detoxification, Methadone Mointononce Twotmcnt Programs, end the Inpatient Psychiat­ The Mental Health ervice at the SFVAMC is seeking a board-certified or ligibl licServices . Providence HospHol p10vldos the only methadone· psychiatrist ror a hair-time position on the 12-b d PsychiatTic Intensive ar ni t bo.>lld detoxification for opiate wlthd10 wol in Western Massachusetts on its 27-bed inpatient unit. (PlCU) . The position will emphasize multi-disciplinary team assessment, treat­ The Hospital also runs two Iorge outpatient Methadone T~eot­ ment and dispositional planning in addilion to psychopharmacologic therapie · mont Programs, one at the Hospital in Holyoke ond the other in Sp•ingfisld. You would provide StJpelvislan to the Physician There are opportunities to teach and receive a Clinical Faculty appointment at Assistants ond work wilh the dedicated multidrsdplinory staff. the University of California School of Medicine, San Francisco. In addition, you would provide medico! support to the psychi· ofric units ot Providence Hospital, including consultations ond Comperiti e salary is n gotiable, depending on qualification · excellent benefit supervision of PAs. and retirem Ill package. The Deparuue.nt of Veterans Affairs is an Equal Oppor­ We seek on internist or family practitioner with previous ttmity Employer. U . . citizenship is required. The s lected appUcant may b experience and expertise in Addiction Medicine. subject to mndom pre-employment drug screening. Submil CV and three rder­ Please contact: Jonathan Chasen, M.D., Medical Director ence by june 15, 2001 to: Providence Hospital 1233 Moin Street • Holyoke, Massachusetts, 01040 john Straznickas, M.D., at VA Medical Center (116N) Phone: (413) 539·2 405 • Fox: (413) 539·2992 4150 Clement Street, San Francisco, CA 94121 Email: [email protected] or call415/221-4810 x2074 for further information.

8 ASAM NEWS ~···: NEWS FROM THE AMA information's use for any other purpose, said ~ mmunication at Emerson Colle9e Health Co "There's a concern that they re David Kibbe, M.D., chair and cofounder of Canopy Systems Inc., a health care Internet 'I " in .sost~~se their identity and become a pa~t -~-uuns pon "'Providers company based in Chapel Hill, NC. Doctors called d Hphysician" or gorng mbly-line process in health care. ~~-se of the asse . also will have to make available a statement 1- 10 ...... r ,. deliberately . American Med1cal News, May 7. .. .. pro ,der 15 'ndustrY to source. of their privacy policy that says to patients, msurance 'nt relation­ 2001. "Here are your rights, and here's how we as ctan·paue P yil ns· role in l1ealth care Privacy Rule Called a practice are complying with those rights," .-...on11J~ ph)'SI"lcl'' from them- and Burdensome to Ph~sicians. Dr. Kibbe said . rnor vthOf Ytrac t tune. accord- A new federal rule governrn~ the_pnvac~ of But obtaining consent and authorization - s at con wed tor a recent forms represents only the "tip of the ice­ ~.... .ns mtefV'C: patients' medical information IS caustng berg," he said. Physicians also will need to ~ • ' • _11 • ·:ecJical News. . some apprehension among phys_1c1an . . • :'t /l)~~ oian that benefits tns u~ groups, according ~~the AMA. Pres1de~t be aware of confidential patient information · ''"" ' ' ·· · · " tclans say - a P1 a Bush's April 12 deos1on to release a medi­ that is available to their lawyers, accountants ! .. .., h;,~ pi~~~ - medical doctors • , · )~• n l r C rorn cal records privacy rule initially issued by the and others identified in the rule as "business . ... ' CN' . ' ~ : . ~ • ~ with lower-cost nurse ,. ... . ' 1•1C:'~r- t CH J., . Cl inton administration came as a surprise to associates." : • : · ....:.. .•: , :.~. 1 physician assistants. . many who had urged the new administration For now, the AMA and other medical f1ttc · i 1tible/ccrtified. The The State Medical Society of Wisconsin, AMA policy calls for getting informed practice encompas;es primary care and at 1ts March annual meeting, adopted a consent whenever possible before person­ addiction medicine. Live in a college policy calling for use of the word "physi­ ally identifiable health information is used con1m unitv close to the coast, moun­ Cian" when referring to an M.D. or D.O ., for any purpose. Under the rule, physicians tains and J~J.:es. Salary plus full benefits and "non physician clinician" when referring will be required to obtain patient consent and assistance with stuclen.t loans. Call to all other health care professionals. prior to using personal medical information or fax your CV to: Those outside the medical community for treatment, payment and performing have taken note of the shift from the word such health care operations as quality SUSAt\T EDSON "physician" to "provider." "The word itself assessments, training and case manage­ Telephone: 207/866-5680 is going to drive a wedge between doctors ment. Physicians must have patients sign Fax: 207/866-5696 and HMOs," said J. Gregory Payne, director those consent forms when they come into E-mail: [email protected] of the Center for Ethics in Political and the practice and will have to be aware of the "' tj.. MAY·JUNE 2001 9 PEOPLE IN THE NEWS NMTP Honors jasper G. Chen See, M.o. asper G. Chen See, M.D., is the recipi­ placement criteria h ent of the Nelson J. Bradley Lifetime and Utilized by a br~a~t Would be r JAchievement Award of the National treatment providers Thspectrurn of ....tJ.,.n .... __ • Association of Addiction Treatment Provid­ and accepta nce of th e continued ers (NAATP). Dr. Bradley pioneered what legacy of Mr. Ford's v~ :4SAM Cn na . "S I h SIOn and I r today is known as the Minnesota Model of . o t ank you for eadt!r

1 0 A 5 A M N E W 5 . ~. ~;1.~ .,. _:, ... t this disease which Please visit our ~eam!n9 rnor~ ablou nd their families. ' booth at this ;,,es ror i nd i VidU~~~on Foundation and the Board of the of the disease. On year's ASAM ()1'1 nts on the p a tholog~ Director Emeritus. meeting ~ Chert See was ~~:~va University and ?f • SO ~rd of Trustees ~:abli s h a degree program In ott re he helped 10 ~ and administration. C • w dcftctton counse 1 lng f the local chapter of the dn~ng board member o ed as Vice-chair of the a 'fon Alcoholism an1 s e~~ug Dependencies. He was . ...., .tlf'!,.l cou ; 00 AlcohOlism a n:d~:,,~~n Association of Pennsylv~- C Afcohohsm a~ d • Task Force of the Pennsylvama _ux:,.. ' an of the Prest de ~~~ hol Abuse. Dr. Chen See w~s ~he c Co ell on orug and A d of the Alcohol and Add1ctton rJP..If'lf1ifJI ' he 1984 Ke~s tone Awar 100 of Pennsylvanta. n honorary degree fro.m Villanova for his 1991. he rece tv ~~n~ as a national pioneer In the treatment 0f iSh s rv1ce to man u dependency. h red him with its Annual Award "For his In 1994. ASAM no~; the growth and vitality of the Society, for 00 andlng contnbut'? the field and for his deep understanding of ul leader.sh'P tn • d. . " '., nd fence of addiction me ICine . r a sc on Foundation nominated Dr. Chen See, I was asked ~':,~~e~t~r~~rs upport. 1would like to close my remarks by read- to you from my letter. Addiction is a oear Mr. Eaton: h b · •1 I3S plea ed to learn t11at Jasper G. Chen See. ~-D : , as e~n noml- nclted to be the recipient of the Nelson J. Bradley L1fet1me Ach1evem~nt Treatable Disease Awa rd. Dr. Chen See is the very embodfme~t of .the purpose f.or wh1ch he Award was established . I can say in all s1ncenty that there ts no one The American Academy of Addiction Psychiatry whom 1c ould recommend more highly for the Award than Dr. Chen See. " Dr. Chen See served as President of the American Society of The American Academy of Family Physicians Addiction Medicine from 1989 to 1991. It was under his presidency tha t the SoCiety set forth its first long-range plan for establishing The American Medical Association Add iction Medicine as a medical specialty, and for integrating prevention, trea\ment and research of alcoholism and other addictive The American Society of Addiction Medicine disorders into our nation's healthcare system . The National Institute on Alcohol "He had the vision to recommend to the ASAM Board that the Abuse & Alcoholism Society establlsh its national headquarters in Washington, D.C. in order to play a first-hand role in the establishment of our nation~s preven­ The National Institute on Drug Abuse tion, treatment and resea rch policies in addictive disorders. It was under Dr. Chen See's presidency that the American Medica l Association recognized Addiction Medicine as a medical specialty. It was under Dr. Chen See's presidency that the Society, at the invitation of .and with There are over 15 million Americans the full support and collaboration of the National Association of who suffer from alcohol and drug abuse. Addiction Treatment Providers, issued the ASAM Patient Placement Criteria, building on NAATP's work and that of the authors of the DrugAbuse Sciences is a pharmaceutical Cleveland Criteria. It was also under Dr. Chen See's presidency that, at his recommendation, the ASAM Board of Directors established the company exclusively dedicated to developing Ruth Fox Endowment to assure the Society's permanence and its lasting novel therapies for treating these diseases. influence in assuring treatment for addictive disorders. "Dr. Chen See's vision and his genius for administration and strategic planning are matched by the largeness of his love and sincerity, Medicine for treating the disease and by his total commitment to those who suffer from addictive disorders. He is a person of unique and genuine humility, who moves those who work with him to action. both by the persuasiveness of his insight and foresight, and by the genuineness of his personal commitment. DrugAbuse Sciences, Inc. "It is my fervent hope that you will choose to honor Dr. Chen See with the Nelson J. Bradley Award. In doing so. you will not only be 866-266-4086 honoring one of the giants of our field, but you will also be giving further witness of NAATP's enduring commitment to the values and purpose for which Addiction Medicine stands . www.drugabusesciences.com II And with that, Jasper, we present to you the Nelson J. Bradley DAS0900 10 Lifetime Achievement Award. II • ~!"... :. MAY-JUNE 2001 1 1 AGENCY REPORTS

CSAT: Methadone for more clinical judgement in treatment, The $1 million pro r ReQulations Issued helping mainstream the medical treatment by the Association l arn will be COnd The Center for Substance Abuse Treatment of opioid dependence, and continue a and Research in S u bs~ r Medical Educ~ (CSAT) has issued new regulations to improve federal role" through CSAT oversight. Program details can b n~e Abuse {Afv1ER~o the quality and oversight of treatment pro­ Details on the new regulations are avail­ Web site at www.a e ound on AMER sA~. grams that use methadone and other pharma­ able at the CSAT Web site (www.csat.gov). mersa.org. A's cotherapies for heroin and re lated addictions . In addition, CSAT is sponsoring a series of NIDA.: Reports Rei The regulations create a new accreditation eight training sessions around the country to Rx Abuse, Halluci~:sed on program that replaces a 30-year-old inspec­ help treatment programs that use metha­ The National Institute on ~ens tion program conducted by the U.S. Food done and LAAM understand how to meet released two reports of i t rug Abuse has and Drug Administration (FDA). They became the new accreditation standards. medicine specia lists. n erest to addiction effective May 18 as part of the Code of ONDCP: john Walters In a conference cosponsor Amencan Association of R t' ed by lhe Federal Regulations 42 Part 8, "Certification Named Director of Opioid Treatment Programs." the American Pharm aceutic~llred Pe!sons. Under the new regulations, treatment President Bush has named John P. Walters the Pha rmaceutical ResearchAss~ clation. to head the White House Office of National facturers of America the N t.an Manu- programs that dispense or administer metha­ .1 . • a 10nal Cou done or levo-alpha-acetylmethadol (LAAM) Drug Control Policy (ONDCP). c1 on Pat1ent Information and Ed n- The new director is well known to the the National Association of Ch ~ cation, will be accredited by private sector organi­ . a1n Drug field, having served previously at ONDCP as Stores, an d the Nat1onal Comm . zations, using standards established by · t A . Unity Phar­ CSAT. The standards emphasize factors deputy director for supply reduction under ~acl . s s ssoclatio.n, NIDA an nounced relevant to the quality of care, such as indi­ William Bennett in the administration of ;, at 1t has updated 1ts research report on vidualized treatment planning, increased former President George Bush. He also Presmpt1on Drugs: Misuse, Abu se d medical supervision, and assessment of co-authored, with Mr. Bennett and John Addiction." • an patient outcomes. DiJulio, Jr. (who now heads the White House A second research report, on "Halluo­ CSAT Director H. Westley Clark, M.D ., Office of Community and Faith-Based Initia­ nogens and Dissociative Drugs," examines J.D., M.P.H ., FASAM, explained that the tives) a book entitled Body Count: Moral abu se of drugs with street names like accreditation system will "set a higher stan­ Poverty and How to Win America's War "acid," "angel dust," and "Vitamin K" that dard of care for those receiving methadone Against Crime and Drugs. distort the way a user perceives time, motion, treatment. It should improve the quality of Mr. Walters long has opposed exemp­ colors, sounds, and self. The report notes treatment programs overall by allowing tions for the medical use of marijuana and has that such drugs can disrupt a person's abil­ stressed criminal penalties for drug users." ity to think and communicate rationally, or Our country has made great progress in the even to recogn ize reality, sometimes result­ past in reducing drug use, and we will do it ing in bizarre or dangerous behaviors. again," he told the press during a ceremony The full texts of both reports can be We are a statewide health care organJzation providing sub­ stance abuse treatment and primaty medical care services. to announce his nomination, which requires downloaded from NIDA's Web site at We have a great opportunity available in our Los Angeles Senate confirmation. He added that he www.nida.nih.gov. region for a physician to assume responsibility for the hopes to "shield our communities from the medical department and to perform medical services for SAMHSA: National Treatment patients. This includes authorizing and supervising dis­ terrible human toll taken by drug use." pensing of daily narcotic replacement therapy and other Directory Updated medications by medical staff and training all staff in Uni­ HRSA: Faculty TraininQ The Substance Abuse and Mental Health versal Precautions and emergency medical procedures. Initiative Launched Services Administration (SAMHSA) has The successful candidate will be licensed in good stand­ In an effort to educate those who teach released its updated National Directory ing to practice medicine in California and will have a current and valid DEA registration. The applicant must future physicians and other health care of Drug and Alcohol Abuse Treatment never have had an application for a DEA license denied, a professionals, the Health Resou rces and Programs, a guide conta ining information DEA registration revoked or denied, or have surrendered Services Administration (HRSA) and the Cen­ on thousands of local treatment programs. a DEA registration for cause. The ability to communicate with a diverse patient population is required, and at least ter for Substance Abuse Treatment (CSAT) are The new directory includes a nationwide one year of primary medical care and substance abuse collaborating to support the development of inventory of publicly funded drug and aleo~~~ treatment experience is strongly preferred. a training program to teach medical school treatment programs, as well as private fac.lh­ We offer a competitive salary and benefits package, which ties that are licensed certified or otherw1se includes incentive pay, fully paid medical leave and dental faculty about screening and referral of patients insurances, regular hours (generally 6:00 a. m. to 2:00 who exhibit signs of alcohol or drug addiction. approved by state agencies. The director~ !s p.m. Monday through Friday), a generous time-off policy, The Interdisciplinary Faculty Develop­ organized on a state-by-state basis to facili­ a 401(k) plan and a business casual work environment. ment Program to Improve Substance Abuse tate reference by health care profes~1o~als, BMRTICDP values diversity and is an equal opportunity employer. social workers, managed care organ1zat1ons Please send your resume and a cover letter Education will provide educators with the with your salary history and requirements to: background and resources to teach students and the general public. - . BAART/CDP, Attn: Human Resources Manager, how to recognize addictive disorders, how Single copies of the directory are ~vall­ 1111 Market St., 4th Floor, San Francisco, CA 94103, able at no charge from SAM HS.A:s National or fax to 415/552-3455, to talk to their patients about alcohol and or e-mail your resume as an MS Word attachment to drug problems, and when to refer patients Clearinghouse for Alcohol and Drug l n ~or­ [email protected]. to addiction treatment. In addition to medi­ mation (NCADI), PO Box 2345, Rockville. For more information, please visit our Web site at cine, the effort will involve educators in 15 MD 20847, or can be ordered by phone : www.baartcdp.com. health professions. 1-aoon29-6686.

12 A 5 A M N E W 5 . "--.;. Help him conquer the moment with Antabuse®

N w for alcoholism, from Odyssey Pharmaceuticals­ A~t a buse , an Integral part of an integrated system of support for the patient with chronic alcoholism. When your patient with chronic alcoholism needs a behavioral modification tool to keep his commitment to sobriety, Antabuse can help. Unique and effective, but it won't work alone. Use Antabuse as part of an integrated program that includes professional counseling and family support, and it can help the committed quitter look the moment of truth in the eye - and win.

Disulfiram should never be administered to a patient who is in a state of alcohol intoxication or without their full knowledge. Relatives should be instructed accordingly.

Patients who have recently received metronidazole, paraldehyde, alcohol or alcohol-containing products should not receive Antabuse. Antabuse is contraindicated in severe myocardial disease or coronary occlusion, psychoses, and hypersensitivity to disulfiram. Antabuse should be used with caution in patients receiving phenytoin and its congeners. Please see complete prescribing information on next page for more information.

In alcoholism

The Newest Brand ~ ANTABUSE® Pharmaceutical From (Disulfiram, USP) ~y 250-mg tablets PHARMACEUTICALS. INC " Support for the committed quitter 72 DeForest Avenue East Hanover, NJ 07936 Visit our web site at www.OdysseyPharm.com. Tel : 1-877-427-9068 Odyssey Pharmaceuticals is a wholly owned subsidiary of Sidmak Laboratories, Inc. © 2001, Odyssey Pharmaceuticals, Inc. PIOPA-404 Antabuse is a registered trademark of Odyssey Pharmaceuticals, Inc.

• · : MAY-JUNE 2001 1 3 - )• Antabuse"' (Disulfiram, USP) Tablets It may be net$sary to adj~ the dosage of oral anucoa IN ALCOHOLISM firam, since disulfiram may prolong PIOihtombln time. oulants upon beg nnlllQ Patlents taking lsuniazid when disulfiram Is given should or,topp llO d u nstead~ oail or marked changes In mental status, tha dl lfllle ob:rorvcd tor tho s1gns appear. stJ ram $houlu he disc 9Ptlt;)rance WARNING: 01 In rats, simultaneous ingestion of disulfiram and nitrite flu! OIIUOuecJ If Disulfiram should never be administered to a 1 Wtl! patient when he is in a state of alcohol Intoxi­ ed to cause tumors, and it has been sugge sted th at dlsulflra~n mo d.latlor 78 weeks IQs ach to form a n1trosam~ne, wh1ch IS tumorigeni c. OlsuUiram YTeact wth onrltes In ~" 11 ll011· cation, or without his full knowledge. 1 1 The physician should instruct relatives such tumors. The relevance of this finding to humans Is 1101 ~~~•In tho rat'a Ui&t did n ~:=om . Concomitant Conditions: Because of the posslbifity of a allh~t lime 0 d lo accordingly. 30 'ci tion, disulfiram should be used with extreme caution In patients ... ~h Uantol msulllram.otcohOI diabetes mellitus, hypothyroidi sm, epilepsy, ce rebral damage ;I:r ~~ny 01the folto1• no C:OM•t;~­ cirrhosis or insufficiency. ' 0 c Slld ac:uiA! nephritJs, he~ DESCRIPTION: CHEMICAL NAME: Usage in Pregnancy: The safe use of thi s drug In PI'Cllnancy has he 001 bis(diethylthiocarbamoyl) disulfide. disulfiram should be used during pregnancy only when , fn the IUdgeme been establish Cl Therttore STRUCTURAL FORMULA: able benefits outweigh the possible risks. 01 Olllu! PhYslclan, Ill! Pto~ PRECAUTIONS: Patients with a history of rubber contact dermauu hypersensitivity to thiuram derivatives before receiving dlsulllram ($ee co~~ld be ll'llluatecl lor It is suggested that every patient under treatment canry an ldontll/l:aflon INOICJ\TtOIIS), receiving disulfiram and describing the symptoms most likely to occur as C8td Slllltng that he 3 11 alcohol reaction. In addition, this card shou ld Indicate tbe physician or Ins~~~~ Ol tl)e di$utnrint· in an emergency. (Cards may be obtained from ODYSSEY PHARMACEUTICALS 011 10 be C:OnJ.aetnd Alcoholism may accompany or be followed by dcpenden<:a on naJcollcs , 0"'6Que.t l M.W. 296.55 0 sedat'tt and disulfiram have been admini stered co ncurrently l'll!hout ~ntnward olletts· lhe es;:~r bhu131 oa tiating a new abuse should be considered. ' PO t1 ly Of lot- Disulfiram occurs as a white to off-white, odorless. and almost tasteless powder, soluble in water Baseline and follow-up transaminase tests (10·t4 days) are suggested to detect an . to the extent of about 20 mg in 100 mL, and in alcohol to the extent of about 3.8 gin 100 mL. function that may result with disulfiram therapy. In addition, a complete blood count~ 1~epatlc diS· Each tablet for oral administration contains 250 mg di sulfiram, USP. Tablets also contain colloidal tial multiple analysis-12 (SMA·12) test should be made every six months. n 3 seq uen - silicon dioxide, anhydrous lactose, magnesium stearate, microcrystalline cellulose, sodium starch gly· Patients taking disulfiram tablets should not be exposed to ethylene dibromide or its vapo T . colate, and stearic acid. is based on preliminary re sults o.t resoaith currently in progre ss that CLINICAL PHARMACOLOGY: Disulfiram produces a sensitivity to alcohol which results in a preca~ tion a ni~sl s~~ges~': tox1c mteract100 between Inhaled ethylene drbromtde and Ingested disulfiram resulting in hi h highl y unpleasant reaction when the patient under treatment ingests even small amounts of alcohol 3 incidence of tumors and mortafily in rats. A conmlalion between this finding and humans, hm~e~' Disulfiram blocks the oxid ation of alcohol at the acetaldehyde stage , Dunng alcohol metabolism fol· er, has not been demonstrated. lowing disulfiram intake, the concentration of acetaldehyde occurring in the blood may be 5 to 10 ADVERSE REACTIONS: (See CONTRAINDICATIONS, WARNINGS , and PRECAUTIONS.) times higher than that found during metabolism of the same amount of alcohol alone. OPTIC NEURITIS, PERIPHERAL NEURITIS, POLYN EURITI S, AND PERIPHERAL NEUROPATHY Accumulation of acetaldehyde in the blood produces a complex of highly unpleasant symptoms MAY OCCUR FOLLOWING ADMINISTRATION OF DISULFIRAM . referred to hereinafter as the disulfiram-alcohol reactio n, This reaction, which is proportional to the Multiple cases of hepatitis, includi ng both cholestatic and fulminant hepatitis, have been reporle~ do sage of both disulfiram and alcohol, will persist as long as alcohol is being metabolized. to be associated with administration of disulfiram. Disulfiram does not appear to influence the rate of alcohol elimination from the body. Occasional skin eruptions are, as a rule, readily controlle d by concomitant administration ol an Di sulfiram is abso rbed slowly from the gastrointestinal tract and is eliminated slowly from th e anti histaminic drug. body, One (or even two) weeks after a patient has taken his last dose of disulfiram, ingestion of alco· In a small number of patients, a tran sie nt mild drowsiness, fatigability, impoten ce , headache, hoi may produce unpleasant symptoms. . . acneform eruptions, allergic dermatitis, or a metallic or garlic-like aftertaste may be experienced Prolonged administration of disulfiram does not produce tolerance; the longer a pat1ent rema1ns during the first two weeks of therapy. These complaints usually disappear spontaneou sly l'lith the on therapy, the more exquisitely sensitive he becomes to alcohol. continuation of therapy, or with reduced dosage , INDICATIONS: Disulfiram is an aid in the management of se lected chronic alcohol patients who Psychotic reactions have been noted, attributable in most cases to high dosage, combined toxici ty to remain in a state of enforced sobriety so that supportive and psychotherapeutic treatment want (with metronidazole or isoniazid), or to the unmasking of underlying psychoses in patients stressed may be applied to best advantage. by the withdrawal of alcohol, Di sulfiram Is not a cure for alcoholism. When used alone, without proper motivation and su p­ DOSAGE AND ADMINISTRATION: Disulfiram should never be administered until the patient portive therapy, it is unlikely that it will have any su bstantive effect on the drinking pattern of the has abstained from alcohol for at leas t t 2 hours. chro nic alcoholic Initial Dosage Schedule: In the first phase of treatment, a maximum of 500 mg daily is given CONTRAINDICATION$: Patients who are rece iving or have recently received metronidazole, in a single dose tor one to two weeks. Although usually taken in the morning , disulfiram may be paraldehyde, alcohol, or alcohol-containing preparalions, e,g., cough syrups, tonics and the like, taken on retiring by patients who experience a sedative effect. Alternatively, to minimize, or eliminate. should not be given disulfiram. the sedative effect, dosage may be adjusted downward. Disulfiram is contraindicated in the presence of severe myocardial disease or coronary occlusion, Maintenance Regimen: The average maintenance dose is 250 mg daily (range, 1251o 500 mg). psychoses, and hypersensitivity to disulfiram or to other thluram derivatives used in pesticides and it shoul d not exceed 500 mg daily. rubber vulcanization. Note: Occasionally patients, while seemingly on adequate maintenance doses of disulfiram. report WARNINGS: that they are able to drink alcoholic beverages with impunity and without any symptomatology. All ~D-Is-u -lfir_a_m-sh-o-ul-d -ne-v-er_b_e-ad-:-m...,.in...,.ls..,.te-re-:d...,.to_a_p_a""tie-n71t appearances to the contrary, such patients must be presumed to be disposing of t11 e1r tablet s Ill when he is in a state of alcohol intoxication, or with­ some manner without actually taking them . Until such patients have been observed reli ably takmg out his full knowledge. their daily disulfiram tablets (preferably cru shed and well mixed with liquid), it cannot be co nclud· The physician should instruct relatives accordingly. ed that disulfiram is ineffective. . Duration of Therapy: The dally, uninterrupted administration of disulfiram must be con tinu ed until the patient is fully recovered socially and a basis for permanent self-control IS established The patient must be fully informed of the disulfiram-alcohol reaction . He must be strongly cau· Depending on the individual patient, maintenance therapy may be required for montl1 s or even years. lioned against surreptitious drinking while taking the drug, and he must be fully aware of the po ss i· Trial with Alcohol: During early experience with disulfiram, it was thought advisable for eac~ ble consequences . He should be warned to avoid alco hol in disguised forms, i.e., in sauces, vi ne· patient to have at least one supe rvised alcohol-drug reaction. More re ce nt ly, the test react1on 118a gars, cough mixtures, and even in aftershave lotions and back rubs. He should also be warned that been largely abandoned. Furthermore, such a test reaction should never be adm1mstered to be reactions may occur with alcohol up to 14 days after ingesting disulfiram. patient over 50 years of age , A clear, detailed and convincmg descnpllon of the reaction IS fell to The Disulfiram-Alcohol Reaction: Disulfiram plus alcohol, even small amounts, produce flush­ sufficient in most cases. s· ing, throbbing in head and neck, throbbing headache, respiralory difficulty, nausea: copious vomit· However where a test reaction is deemed necessary the suggested procedure is as foliO\'/ · ing, swea ting, thirst, chest pain, palpitation, dyspnea, hypervenlilation, tachycardm, hypotension, After the 'first one to two weeks' therapy with 500 mg' daily, a drink of 15 mL (1/2 oz) of 100 proo 1 syncope, marked uneasiness, weakness , ve rtig o, blurred vision, and confus1on , In sevem react1ons wh'lskey or equivalent is taken slowly. This test dose of alcoholic beverage may be repeated once there may be respiratory depression, cardiovascular co llapse, arrhythmms, myocardial mfarct1on, only, so that· the lotal dose· does not exceed 30 mL (1 oz) of whiskey. Once a reaction· deve lops. ·nosno moreita I· acute co ngestive heart failure, unconsciousness, convulsions, and death. alcohol should be consumed . Such tests should be carried out only when the pallent IS P The intens ity of the reaction varies with each individual, but is generally proportional to the ized, or comparable supervision and facilities, including OxytJen. are available. sed by an amounts of disulfiram and alcohol ingested. Mild reactions may occur in the sensitive individual Management of Disulfiram-Alcohol Reaction: In severe reactions, wt1other cao asores when the blood alcohol concentration is increased to as little as 5 to 10 mg per 100 mL. Symptoms 10 excessive test dose or by the patient's unsupervised lngastlan of alcohol, supportlvo m~udo ' o'xy· are fully developed at 50 mg per 100 mL, and unconsciousness usually results when the blood alco· restore blood pressure and treat shock should be Instituted. Other rooammeodallons ~~~ da~s (I hoi level reaches 125 to 150 mg. gen. carbogen (95% oxygen and 5% carbon dioxide), vitamin C lnlravenousl)' In mass m levels The duration of the reaction varies from 30 to 60 minutes, to several hours in the more severe g) and ephedrine sulfate. Antihistamine s have otso beM used tntrovenously, Pot;!SS 1u ned . cases, or as long as there is alcohol in the blood. should be monitored, particularly in patients on diQitaJis, sine$ hypokalemia has been rcpo Drug Interactions: Disulfiram appears to de crease the rate at which ce rtain drugs are metabolized HOW SUPPLIED: Di sulfi ram Tablets, USP: and the refore may in crease the blood levels an d the possibility of clinical toxicity of drugs g1ven con· 250 mg ·White, round, unscored tablets in bottles of 100. comitantly. Debossed : OP 706 DISULFIRAM SHOULD BE USED WITH CAUTION IN THOSE PATIENTS RECEIVING PHENYTOIN Dispense in a tight. light-resistant container as defined in the USP. AND ITS CONGENERS, SINCE THE CONCOMITANT ADMINISTRATION OF THESE TWO DRUGS Store at controlled room temperature 15'·30'C (59'-86'F). CAN LEAD TO PHENYTOIN INTOXICATION. PRIOR TO ADMINISTERING DISULFIRAM TO A PATIENT ON PHENYTOIN THERAPY, A BASELINE PHENYTOIN SERUM LEVEL SHOULD BE OBTAINED. SUBSEQUENT TO INITIATION Of DISU LFIRAM THERAPY, SERUM LEVELS OF Distributed by Odyssey Pharmaceuticals, Inc .. East Hanover, New Jersey 07936 PHENYTOIN SHOULD BE DETERMINED ON DIFFERENT DAYS FOR EVIDENCE OF AN INCREASE Manufactured by Sidmak Laboratorie s, Inc., East Hanover, NJ 07936 OR FOR A CONTINUING RISE IN LEVELS . INCREASED PHENYTOIN LEVELS SHOULD BE TREAT· ED WITH APPROPRIATE DOSAGE ADJUSTMENT.

. ~>. 1 4 A 5 A M N E w 5 ·.... I. A f UNDING OPPORTUNITIES

reduction policies; office-based opiate agonist therapy; alternative oo Treatment in nicotine delivery systems; and alcohol and tobacco addiction . tO studY A . QS . . SAPRP funds research projects that seek policy-relevant infor­ ..,,.ds d care settl~ . treatment service delivery. In mation about ways to reduce the harm caused by substance abuse na4e llabfe to study addl~tl~ns p ecia l fu nding opportumty in the United States. Experts in public health, law, political science, f J a a e setttngs, throug tance Abuse Treatment (CSAT). medicine, sociology, criminal justice, economics, and other behav­ ged car the center for sub~e computerized decisionmaking ioral and policy sciences are encouraged to apply. Project awards need ~eiG studies to e valu~tients in selecting the best treat­ are funded up to $400,000 and may extend up to three years. cl9eoz, assist clinicians and Phether performance measures The deadline for receipt of letters of intent for this special solici­ sys ern~~tions and todasses~r;anizatio n s actually lead to better tation is August 20, 2001. For the full text of the call for propos­ men d by manage care loye f als visit the foundation's Web site (www.rwjf.org). Once at the rea ment outcomes. will be available to support up to 1ve 00 000 sit~, click on "Applying for a Grant," then "Calls for Proposals." APPro'<~mate ly $S $150,000 each for a peri~d no~ to excee? rds of sso.ooo t~ 1 cal governments (includ1ng tnbal org ~m- DruQ Abuse FundinQ Monitor hree years. Stat~ and noon profit organizations such as commumty­ Drug Abuse Funding Monitor is a monthly newsletter on federal zaU<>ns) and pu~lrc a~ 'tl -based organizations, universities, colleges L - ..A organ1za t1ons. a1 1 and private-sector funding and financial assistance for drug and 1 ~ . 15 re encouraged to app Y. , alcohol programs, law enforcement agencies and drug courts. The and hoSplta a d pilot study grants have been added to CSAT s Grants & Regulation Alert section highlights upcoming grant The m~nage t ~~~t Program. PA 99-050. Applications will be application deadlines for receiving financial and technical assistance Commumty Jrea one-time receipt date of September 10, 2001. from the federal government, foundations and corporations. The accept~d un b~u~ program issues should be directed to Sarah newsletter also includes a conference calendar and profiles of private Questlo~s a CSAT project officer, at 301/443-0092. Grants funding sources. Watte.n ergt, questions should be addressed to Pilar Carrillo at 301/ managemen . J f d. · For more information, contact Capitol City Publishers at 3030 43 _6284. Details about th1s and other CSA un 1ng opportunl- Clarendon Blvd ., Suite 219, Arlington, VA 22201; or phone 703/ 11es are posted on the SAMHSA Web site (www.samhsa.gov). 525-3080; or fax 703/525-3044. • Grants Fund Opiate Treatment in Rural Areas The Center for Substance Abuse Treatment (CSAD has announced MEDICAL DIRECTOR, CDRP a special funding opportunity to support de~elopm~nt . of treatme~t services in rural communities for persons w1th add1ct1on to herorn (Oakland) or prescription pain medications such as OxyContin ®. This targeted Responsible for providing direct grant opportunity is part of the ongoing CSAT Community Action medical care and supervising the Grants Program, which provides support for the adoption and clinical care of a multi-disciplinary implementation of best practices in addiction treatment. staff. Requires BE/BC in Adult The special funding opportunity will result in award of up to Psychiatry, ASAM Certification or five grants of $50,000 to $150,000 each. Grantees will be expected CAQ in Addiction Psychiatry, previ­ to implement best medication-assisted therapy practices, including ous CD experience and the ability to the use of opioid agonists such as methadone or LAAM, in provide leadership to a multi-disci­ rural communities where access to treatment services is limited or plinary team. nonexistent. Grants are available to state and local governments (including OUTSTANDING NEW SALARIES & tribal organizations) and public and nonprofit organizations such UNPARALLELED BENEFITS PACKAGE. as community-based organizations, faith-based organizations, Please contact: Andrew Carota, The universities, colleges and hospitals. Permanente Medical Group Inc, Applications for the grants will be accepted under a one-time 1814 Franklin St, 4th Floor, receipt date of September 10, 2001. Questions about the Opioid Oakland, CA 94612; Ph: (800) 777- Agonist Treatment Exemplary Practice Model grants should be 4912; Fax: (510) 873-5006; Email: directed to Mike Bacon, CSAT project officer, at 301/443-7749. [email protected]. Refer to Grants management questions should be addressed to Kathleen Job Code #: A77. www.kp.org/ca. Sample at 301/443-9667. Details about this and other CSAT EEO/AAIM/F/DN funding opportunities are posted on the SAMHSA Web site (www.samhsa.gov). RWJF Funds Available ~f~ The Robert Wood Johnson Foundation's Substance Abuse Policy Research Program (SAPRP) is requesting proposals on the follow­ KAISER PERMANENTE® ing research topics through a special solicitation : policies and systems surrounding the medicinal uses of marijuana; legalization/ decriminalization of marijuana and other drugs; illicit drug use harm

~ !~. \~. MAY·JUNE 2001 1 5 .. '"':" ... Friends Recruit New ASAM Members A group of enthusiastic ASAM members MED-sc were honored at the annual Medical­ Scientific Conference as "Friends of ASAM" for their success in recruiting new 2001 Medical-Scientific Conference Sets members for the Society. Each Friend received a special certificate and the Records for Attendance, Uuality of Sessions thanks of ASAM 's officers for their efforts to support the Society's continued growth ore than 1,000 physicians and other health care professionals atte d d and success. 32nd Annual Medical-Scientific Conference. April 19-22 in Los ~ne /•SAM's M conferees- ASAM members as well as nonmember physicians nurses 9 es. The Named Friends of ASAM were: gists, counselors, students and residents - also participated in the R~th Fox e:Psycholo­ Steven L. Batki, M.D. Physicians and an ASAM Forum on Pain and Addiction, and in the ground~urs~ _ for Daniel J. Blake, M.D., Ph.D. Buprenorphine trai~ing c?urse, which is des i~ne d ~o _qualify ~S~M members an~~t~ng Robert Stephen Brandram-Adams, M.B.B.S. physicians to prescrrbe th1s prom1s1ng new antJ-add1ct1on med1cat1on . er Lawrence S. Brown, Jr., M.D., M.P.H., FASAM Carl J. Brueggermann, M.D. Brady M. Burns, M.D. Alfredo Cerdan-Assad, M.D. George L. Chappell, M.D. Christina M. Delos-Reyes, M.D. Paul H. Earley, M.D., FASAM John Peter Femino, M.D ., FASAM The annual Business Meeting and Donald E. Fischer, Jr., M.D. Breakfast was gaveled to order by Stephen Neal Fisher, M.D. Immediate Past President Marc Gregory Fuller, D.O . Ga/anter, M.D., FASAM. Marc Galanter, M.D., FASAM David R. Gastfriend, M.D. Douglas Graham, M.D ., FASAM William Frees Haning, Ill, M.D., FASAM William B. Hawthorne, M.D. Thomas L. Haynes, M.D., FASAM Carlos Antonio Hernandez-Avila, M.D. Frederick Karaffa, M.D. Timothy J. Kelly, M.D. Robert A. Liebelt, M.D. Robert Mallin, M.D. Elinore F. McCance-Katz, M.D., Ph.D. Norman S. Miller, M.D., FASAM Shannon Corey Miller, M.D., CMRO Arturo E. Morales, M.D. Joel A. Nathan, M.D. Ronald J. Oehler, M.D. John Osei-Tutu, M.D . Ashwin A. Patkar, M.D. Christopher Douglas Prater, M.D. A highlight of the opening ceremony was Mark R. Publicker, M.D., FASAM the R. Brinkley Smithers Distinguished Thomas L. Purcell, M.D. Scientist Lecture, delivered by Charles P Anthony B. Radcliffe, M.D., FASAM O'Brien, M.D., Ph.D., Professor and Vice Virginia S. Roberts, M.D. Chair; Department of Psychiatry, the University of Pennsylvania, and Chief of Terry K. Schultz, M.D., FASAM Psychiatry at the Veterans Administration Gregory Seeger, M.D. Medical Center; Philadelphia . Dr. O'Brien Gregory Earl Skipper, M.D., FASAM spoke on "Science-Based Tr'eatment David E. Smith, M.D., FASAM of Addictions." Peter I.A. Szilagyi, M.D. Jokichi Takamine, M.D. G. Douglas Talbott, M.D., FACP, FACC, FASAM James W. Van Hook, M.D. Mark L. Willenbring, M.D. Jack R. Woodside, Jr., M.D.

16 A 5 A M N E W 5 '_:.'_:_Jt • £P ORT ____ _

Lecture inaugurated Tht Smirhers d program rich in ~ 1~'/!ce;//clinica/ presenta- sc,ef/11 ' ram chair Edward tion~ Prog FASAM and his Gort_lle!l. M.~- ~cco!ades for the rrllttee wv · com itmg selection of 5YfT!P0.51a, vvorkshops, mvlted exc;coo rses' . papers and poster sess1ons.

Immediate Past President Marc Galanter; M.D., FASAM (left), congratulates co-chairs Seddon Savage, M.D., FASAM and Howard Heit, M.D., FACP, FASAM, on the success of the second annual ASAM course on "Pain and Addiction: Common Threads," which preceded the Med-Sci conference.

SAN FRANCISCO Department of Veterans Affairs Medical Center Medical Director The SFVAMC is seeking a board-certified or eligible psychiatrist for a full-time position in clinical care in the Opioid Replacement Treat­ The well-attended exhibit area featured displays by groups ranging ment (ORT) Team in the Substance Abuse Section of the Mental from pharmaceutical manufacturers to federal agencies, and included Health Service. The position will emphasize clinical care of a dual­ treatment programs, publishers and service providers. diagnosis population whose presenting drugs of choice are opioids such as heroin and whose primary modality of care is the use of agonist medications (methadone, LAAM, buprenorphine). ODYSSEY This position also affords opportunities for participation in smoking cessation programs and other section activities. Research collaboration is available in existing and planned protocols. there are opportunities LO Leach UCSF p ychialr}' residents and ubstance Abuse Fellows and to receive a Clinical Faculty appointmem at the University of California at San Francisco (UCSF) School of Medicine. ASAM or AAAP certification in Addiction Medicine/Psychiatry is desirable. We have a competitive salary, depending on qualifications and experience, and an array of benefits. The Department of Veterans Affairs is an Equal Opportunity Employer. U.S. citizenship is required. The selected applicant may be subject to random pre­ employment drug screening. Submit CV and three references by june 15, 2001, to: Peter Banys, M.D., at VA Medical Center (116E) 4150 Clement Street, San Francisco, CA 94121 or call415/22l-4810 x2356 or [email protected] for further information .

• 1 ~ _ MAY-JUNE 2001 1 7 New ASAM Fellows Awards Dinner Honors Dr. Primm, Dr. Gordis Honored Dr. Radcliffe, New ASAM Fellows ' Kevin O'Brien, M.D., FASAM, Chair of the ASAM Fellows Subcommittee and Richard Tremblay, M.D., FASAM, Chair of the ASAM Membership Committee con­ gratulated 21 newly elected Fellows of the Society at ASAM's Annual Awards The _ASAM Awards Dinner on Saturday, Dinner in April. Apnf 21, featured presentati0n of the John P. McGovern Award on Addiction d These Fellows join a group of 148 ASAM Society to Beny J. Primm, M.D., Executi~; colleagues who have been elected Fel­ Director, Addiction Research & Treatment lows in recognition of their certification Corp., Brooklyn, NY. and former director in add iction medicine, their significant of the federal Center for Substance Abuse contributions to the field of addiction Treatment. The McGovern Award was medic ine, and their service to ASAM . ~~fished in 1997 to recognize and honor an mdrvidual who has made "highly meritorious The new Fellows are: contributions to public policy, treatment Terry L. Alley, M.D., FASAM research, or prevention which has incre~sed Blount Springs, AL our understanding of the relationship of Jacob Bobrowski, M.D., B.Sc., FASAM addiction and society. " The award is sponsored Toronto, Ontario, Canada by an endowment from the John P. McGovern Foundation. David W. Brook, M.D., FASAM New York, NY William G. Campbell, M.D., FASAM Calgary, Alberta, Canada Robert D. Daigle, M.D., FASAM An ASAM Annual Award San Jose, CA for "expanding the frontiers John P. Epling, M.D., FASAM of the field of Addiction Shreveport, LA Medicine and broadening Stanley J. Evans, M.D., FASAM our understanding of the Portland, ME addiction process, through Charles F. Gehrke, M.D., FASAM research and innovation" Saline, Ml was presented to ASAM member Enoch Gordis, William Glatt, M.D ., FASAM M.D., Director of the South San Francisco, CA National Institute on John Harsany, Jr., M.D., FASAM Alcohol Abuse and Hemet, CA Alcoholism of the National Henry E. lrby, M.D., FASAM Institutes of Health. Jackson, MS Gary A. Jaeger, M.D., FASAM Carson, CA Donald J. Kurth, M.D., FASAM Alta Lama, CA Thomas E. Lauer, M.D., FASAM High Point, NC Richard F. Limoges, M.D., FASAM Philadelphia, PA Lance P. Longo, M.D ., FASAM An ASAM Annual Award for "outstanding Whitefish Bay, WI contributions to the growth and vitality of our Robert J. Middleton, M.D. , FASAM Society, for thoughtful leadership in the field, Louisville, KY and for deep understanding of the art and Gary D. Olbrich, M.D., FASAM science of addiction medicine" was presented Nashville, TN to ASAM past President and Board member Jeffrey D. Roth, M.D., FASAM Anthony B. Radcliffe, M.D., FASAM. Chicago, IL Mark T. Schreiber, M.D., FASAM Virginia Beach, VA Will W. Ward, Jr., M.D., FACP, FASAM Louisville, KY For information on the Fellows program, contact ASAM Membership and Chapter Relations Manager at CK/[email protected] .

I. ' 1 8 A S A M N E W S :1' .-

__j Alcoholism is a chronic disease of the brain ... fn estigator Award went to Renee M. Cunningham­ ~'$ \t) ~b ~PE for the best abstract submitted by an author AlcohoiMD™ is here W1llfa!ns •.P.h : ffve y~rs of receipt of a doctoral degree. whO 1s wrt m to help.

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Archived Binge Drinking on Charles P. O'Brien, College Campuses MD, PhD

Archived Optimizing Naltrexone joseph R. Treatment Volpicelli, MD,PhD March Brain Imaging as an Aid Daniel G. Amen, to Patient Assessment MD May Physician Diversion G. Douglas Programs Talbott, MD November Avoid Slips and Relapses Terence T. Gorski During the Holidays Also recognized was Peter L. Selby, M. D. , Available for CME, live and archived. who received the first Medical-Scientific Program Committee Award as author of SEE YOU Visit the abstract judged best overall of those IN ATLANTA www.alcoholmd.com submitted for the conference. NEXT YEAR! There~ always something new!

,· ~\:, MAY-JUNE 2001 19 ASAM CERTIFICATION Certified in Michelle Ruth Moran Addiction Medicine 284 Physicians Certified Karen A. Moriah Geetha N. Aakalu Judith Morishima-Nelson Shashikala Abkari and Recertified in Robert Dennis Mullan Saleh M. AIShebil Mark E. Mullendore Husam K. Alathari Addiction Medicine Meenakshi Nayak Syed As if H. Ali Chapman M. Sledge, M.D., Chair of the ASAM Credentialing Lucila Nerenberg Theodore Elias Allen Richard Ng Committee, has announced that 213 physicians passed the ASAM Ammar Alrefai Robert G. Niven Segundo B. Amarga examination in November 2000 and thus won certification in Ravinder Kumar Ohri Mohammad Basil Amin addiction medicine. Certificates were presented to the successful Jorge A. Oldan Akwasi Amponsah candidates during the Annual Awards Dinner at the 2001 Medical­ Raquel L. Oldan Armin Ansari Scientific Conference. Ahmet Husamettin Ozturk Davar Aram Gopakumar P Panikkar Ralph H. Armstrong Vipul R. Patel Danette Arthur Chandrakant A. Patel Mark Robert Austein Vidya Patil Jaswant S. Bagga Jagannath J. Patil Hector D. Barreto Richard Tremblay, M.D., Steven Alexander Peligian Joseph Alton Barrett FASAM, Chairman of the Maria D. Perez Michelle Bauer ASAM Membership Commit­ David Paul Petrie James Edward Beckett tee, presented certificates to Dorota Katarzyna Poluha Clifford A. Bernstein newly certified physicians R. Paul Post Mahomed Suleman Bhana during the Annual Awards Rajeswar Rajagopalan Ralph Bharati Dinner. Jeri Lynn Rasch Bharat Shushan Nicholas Rathe James Blair Blankenship Elise K. Richman Steven C. Boles Carole Yvonne Rivers Roy Dewayne Book James S. Robbins Judith L. Boyer-Patrick Samuel H. Rosen Jonathan Cross Campbell, Ill Nicholas Z. Rosenlicht Thomas G. Carlton Mike Allan Royal Edgar Hugo Castellanos Valgerdur A. Runarsdottir Sanjay S. Chandragiri David Andrew Sack Rany Antony Cherian Patricia Denise Salvato Fernando Andres Cobos Gregory Lytton Sathananthan Stuart Allen Conrad Alberto Grinstein Ronald Joseph Lotesto William Dmitry Savanin Michael Richard Crosser Vishwanath S. Gundur Robert E. Lowenstein Mark H. Scheutzow Yolanda I. Dagnino George D. Hall Michael Howard Lowenstein John Schmitz Winthrop C. Dillaway, Ill William Lloyd Hay Shao-Hua Lu Michael E. Schorsch Santosh Doddamane Carlos Antonio Hernandez-Avila Stephen Douglas Lykins Leslie H. Schwartz Joselito Borja Domingo Sheldon Hershkop Monica K. MacDougall Mark G. Schwei Marisela Dominguez Richard Ray Hill Donna Marie Mackuse Mohammed S. Seedat Lawrence Michael Dowden Gray Hilsman Howard Samuel Mahler David Robert Semeyn Ricardo 0 . Dunner John Byron Hunt William Bernard Mahoney lntezar Hussain Shah Evelyn R. Edelmuth Adrian Francis Mary Hynes Nayyera Batool Malik Stephanie Shaner Robert C. Erwin, Jr. Thomas Glenn Ingram Timothy D. Malone Robert C. Sherrick Kenneth W. Faistl Joseph Richard Ippolito Thomas J. Markoski Kay Shiu Matthew Felgus Robin J. Iversen Mavis B. Marks Gowramma Shivashankar David A. Fiellin William Solomon Jacobs, Jr. Don Alfredo Marshall, Jr. Scott Brian Smolar Peter Kenneth Finelli Gary Phillip Jacobs Katherine Robinson Marshall Paul W. Sobey Kevin Anthony Fiscella Mark Getty Jameson Craig Mell Martin Jose M. Soto Enrique Jose Roberto Flechas Carmen Leah Johnson Lawrence D. Mass Ravindra P. Srivastava James L. Flowers Kimberly Toland Jones John J. McCarthy William D. Stanley William R. Ford Nenita Jusayan Gary Lynn McGrew James Johnston Stockard Joyce Foster-Hartsfield Mina C. Kalfas Rekha P. Mehta Raymond Lee Struck Tay G. Gaines Robert A. Karp Malini Mehta C. Lee Sturgeon, Jr. Devang H. Gandhi Soma Sekharam Kaza Matilda M. Mengis Eva Styrsky Carol V. Garner Sunil Dharamdas Khushalani Rosa Frances Merino Stephen Mark Taylor Daniel Ray Gaskin, Jr. Wang K. Kim Joseph Owen Merrill Peter L. Tenore Ralph Ervin Gauen Ebenezer Adekunle Kolade Manuel Meza Paul Aloysius Terpeluk Harbinder S. Ghulldu Puskoor Manmadh Kumar Medhat Migeed Laila Tewfik-Moussa George Carlton Gilbert Rajiv Kumra Robert Alan Miller Shanthi Thangam Sheldon Glass Joseph Peter Laurelli Jayshri M. Mody Gabriel Kazuo Tsuboyama Daniel Jay Glatt Ottis L. Layne Joseph Molea Craig Joel Uthe Scott Golden Anne E. Linton Eric T. Moolchan Daniel N. Valicenti Cristina Goldizen Fred Warde Llewellyn Edward A. Moore Edward R. Verde Marc N. Gourevitch Antony David Loebel Richard C. Moore Joseph Marc Verret Marilyn Granger Marcelo Enrique Lopez-Ciaros Carlos Mora Kenneth E. Warner

~ '.T~: 20 AS AM N E W S __ ·. ~~1 ; ASAM CERTIFICATION Monica K. MacDougall . rn E washington A special moment was Robert Douglas MacFarlane W1llia ..,..i"rram watrous shared by the Glatt family William Bernard Mahoney AOI)ert .).; I t Mark o. Mes Westreich when William Glatt, Nayyera Batool Malik urence · M.D ., FACP, FASAM Timothy D. Malone La d wetsman Howar h' (seated, left) was David Clarence Charles Marsh Gregory W lte recognized as a newly Katherine Robinson Marshall ; arn;~t seth Wiesen elected Fellow of the R~bh Wayne Wilkerson John J. McCarthy 1 Society on the same night Arnold Walter Mech M l \~n~h Leonie Will iamson his son Daniel Jay Glatt, Matilda M. Mengis ~J~a rd pa ul Woloszyn M.D., MPH., was Stephen I. Merlin oavld Joseph Zoeller awarded his certificate in Joseph Owen Merrill Recertified In addiction medicine. Medhat Migeed Addiction Medicine Congratulating father and Joseph Molea son on their achievement additional 71 physicians Edward A. Moore n are (standing) ASAM assed ·the examination for Richard C. Moore Immediate Past President ~ece rtiftcatlon In addiction Jud ith Morishima-Nelson Marc Galanter, M.D., Roy Haynes Morton medicine. FASAM, and President James T. Mulry Patricia Louise Ashley Andrea G. Barthwell, Lucila Nerenberg Ray Paul Baker M.D., FASAM. Robert G. Niven paul 'T. Bakule Jorge A. Oldan Roger Balogh J. Ahmet Husamettin Ozturk Lou Gene Bartram Jonathan Hugh Bevers Allan H. Rabin John Peter Femino Vipul R. Patel Ethan E. Bickelhaupt Jay Shireman Reese Kevin Anthony Fiscella Joseph Anthony Piszczor Milton M. Birnbaum James L. Reinglass James L. Flowers Dorota Katarzyna Poluha John Calvin Chattos Richard D. Roark William R. Ford Terry E. Ptacek Jerry Lee Clausen Barry M. Rosen David Hirsch Fram Jeri Lynn Rasch Dale C. Dallas Harold R. Rosenblatt J. Gilbert Freeman, Jr. Nicholas Rathe Timothy Edward Davis Neal B. Schofield Tay G. Gaines Elise K. Richman Philomena Jacintha Dias Michael Edward Scott Devang H. Gandhi Carole Yvonne Rivers Dora Dixie James E. Sellman Carol V. Garner Barry M. Rosen Christine Dian Ell is Edward C. Senay Daniel Ray Gaskin, Jr. Samuel H. Rosen John E. Emmel, II Danny R. Sessler Ralph Ervin Gauen Nicholas Z. Rosenlicht John P. Epling, Jr. Agha Shahid Harbinder S. Ghulldu David Andrew Sack John Peter Femino William M. Short Daniel Jay Glatt Gregory Lytton Sathananthan David Hirsch Fram George K. Shotick Scott Golden W(lliam Dmitry Savanin J. Gilbert Freeman, Jr. Gregory Earl Skipper Karen Mae Gosen Mark H. Scheutzow Lawrence D. Ginsberg George Peter Tardelli Marc N. Gourevitch Neal B. Schofield Richard N. Goldberg Matthew Bernard Teolis George D. Hall Michae l E. Schorsch Lester Sherwin Goldstein Donald D. VanDyken Gurdon H. Hamilton Mark G. Schwei Daniel P. Golightly, Jr. Charles Vincent Wadle William Frees Haning, Il l Michael Edward Scott Karen Mae Gosen Joseph S. Haraszti David Robert Semeyn Gurdon H. Hamilton MRO Certification William Lloyd Hay Edward C. Senay William Frees Haning, Ill The followln~ physicians passed Sheldon Hershkop Danny R. Sessler Joseph S. Haraszti the special subsection of the Richard Ray Hill Stephanie Shaner Kenneth Alexander Harris examination for Medical Review Gray Hilsman Saleh M. ai-Shebil Masoud S. Hejazi Officers. John Byron Hunt Robert C. Sherrick Eric J. Ittner Ammar Alrefai Adrian Francis Mary Hynes Kay Shiu George K. Shotick Gary A. Jaeger Davar Aram Eric J. Ittner William Solomon Jacobs, Jr. Gregory Earl Skipper Steven Manley Juergens Mark Robert Austein Gary A. Jaeger Scott Brian Smolar Bruce Jay Arthur Kerr Ray Paul Baker Steven Manley Juergens Paul W. Sabey Steven S. Kipnis Hector D. Barreto Carmen Leah Johnson William D. Stanley Thomas J. Kuettel Michelle Bauer Wolfgang F. Kuhn Mina C. Kalfas James Johnston Stockard James Edward Beckett Robert A. Karp Raymond Lee Struck George Louis Lagorio Clifford A. Bernstein Neil Stanton Levy Bruce Jay Arthur Kerr C. Lee Sturgeon, Jr. James Blair Blankenship Nicola Jane Langmuir Sunil Dharamdas Khushalani George Peter Tardelli Steven C. Boles Robert Douglas MacFarlane Steven S. Kipnis Peter L. Tenore Jonathan Cross Campbell, Ill Arnold Walter Mech Raj iv Kumra Donald D. VanDyken Thomas G. Carlton Rohinton K. Merchant Joseph Peter Laurelli Edward R. Verde John Calvin Chattos Stephen I. Merlin Ottis L. Layne Charles Vincent Wadle Michael Richard Crosser Roy Haynes Morton Michael David Lester Kenneth E. Warner Dale C. Dallas James T. Mulry Neil Stanton Levy Howard Wetsman Timothy Edward Davis Jagadeeswararao Musunuru Fred Warde Llewellyn Robert Seth Wiesen Dora Dixie Beatrice Alexandria Nelson Antony David Loebel Michael Wayne Wilkerson David Drew Pinsky John E. Emmel, II Nicola Jane Langmuir Edward Paul Woloszyn Joseph Anthony Piszczor John P. Epling, Jr. Ronald Joseph Lotesto Hunter E. Woodall Terry E. Ptacek Matthew Felgus Stephen Douglas Lykins David Joseph Zoeller

u ?· -~, MAY-JUNE 2001 21 .I ~ PATIENT CRITERIA continued from page 1 of a wider range of options for detoxification; and improved criteria for the management of long­ term recovery and opioid maintenance. Dear Colleague: The ASAM PPC-2R continues to offer separate The generosity of many donors was acknowledged during the annual guidelines for adults and adolescents, with five Ruth Fox Memorial Endowment Fund reception at ASAM's Medical­ broad levels of care defined for each population. Scientific Conference in Los Angeles, . As in past editions, the levels of care are : Level 0.5 (early intervention); Levell (outpatient treatment); The reception itself was underwritten by a generous gift from Joseph E. Level II (intensive outpatient treatment/partial Dorsey, M.D., FASAM, and Mrs. Dorsey. Their current gift is in addition to hospitalization); Level Ill (res idential/inpatient many previous gifts to the endowment fund by Dr. and Mrs. Dorsey, for treatment); and Level IV (medically managed which they have been named members of the fund's Distinguished intensive inpatient treatment). Within this broad Fellows' Circle. framework, the criteria define a range of specific Singled out for special recognition with a Gold Medallion were levels of care. The ASAM PPC-2R continues to Lawrence S. Brown, Jr., M.D., M.P.H., FASAM, John Alonzo Luker, M.D., "unbundle" clinical services from treatment Michael I. Michalek, M.D., and Jokichi Takamine, M.D. Silver Medallions setting, in recognition of the fact that clinical care went to Stanley J. Evans, M.D., FASAM, Barry M. Rosen, M.D., and John P. can be and often is provided separately from McGovern, M.D., FASAM. Bronze Medallions were awarded to Sandra Jo environmental supports. Counts, M.D., FASAM, Ronald J. Dougherty, M.D., Camilo A. Martin, M.D ., The diagnostic terminology used in the ASAM David Mactus, James M. Merritt, M.D ., John E. Milner, M.D., Teresa Reed, PPC-2R has been updated to conform to the M.D., and Thomas Stammers, M.D. language of the American Psychiatric Association's We especially wish to thank long-time member Conway W. Hunter, Diagnostic and Statistical Manual of Mental M.D., FASAM, for his very generous bequest in addition to his previous Disorders (DSM-11/) . The new edition also been contributions. It gives us great pleasure to add his name to the Benefactors' totally reformatted to facilitate comparisons across Circle . levels of care. For information about providing a life insurance policy or making a The ASAM Patient Placement Criteria for the deferred gift, pledge, contribution, bequest or memorial tribute, or to Treatment of Substance-Related Disorders is an discuss in confidence other types of gifts, please contact Claire Osman at essential tool for use in treatment planning and 1-800/257-6776 or 718/275-7766. Of course, financial decisions should be in working with public and private treatment discussed with your personal tax advisor. All contributions are completely providers, third-party payers and managed care tax deductible, as ASAM is a 501 (c)(3) organization under the Internal organizations. Revenue Code. The 400+ page book is available at a cost of $70 to ASAM members and $85 to nonmembers. Max A. Schneider, M.D., FASAM, Chair, Endowment Fund Quantity discounts are available. To place an order, Jasper G. Chen See, M.D., Chair Emeritus, Endowment Fund contact the ASAM Publications Distribution Cen­ Andrea G. Barthwe/1, M.D., FASAM, Chair, Resources & Development Committee ter at 1-800/844-8948. • Claire Osman, Director of Development As of May 10, 2001...Total Pledges: $3,220,966 TENNESSEE NEW DONORS, ADDITIONAL PLEDGES AND CONTRIBUTIONS: Benefactors' Circle ($50,000-$99,999) Donors' Circle (up to $2,999) MEDICAL DIRECTOR FOR Conway W. Hunter, M.D. Joyce F. Bailey, M.D. PHYSICIANS HEALTH Founders' Circle ($25,000-$49,999) E. Joan Barice, M.D. PROGRAM Lawrence S. Brown, Jr., M.D., M.P.H . Daniel M. Blake, M.D. Ronald H. Bradley, M.D. The Tennessee Medical Foundation has an imme­ John Alonzo Luker, M.D. Michael I. Michalek, M.D. Truett Bridges, M.D. diate opening for a licensed physician to serve Jokichi Takamine, M.D. Barbara H. Chaffee, M.D. as full-time Medical Director for its statewide Irving A. Cohen, M.D. President's Circle ($10,000-$24,999) Physicians Health Program. Responsibilities Martin Gleespen, M.D. Stanley J. Evans, M.D. include interventions on, referrals and aftercare Lynda M. Karig Hohmann, M.D. Barry M. Rosen, M.D. oversight of, physicians impaired by chemical Renee R. Lamm, M.D. John P. McGovern, M.D. dependence or mental/emotional illnesses, or John D. Lenton, M.D. both. Experience in addiction treatment required, Leadership Circle ($5,000-$9,999) Zenaida M. Mata, M.D and ASAM certification a plus. Sandra Jo Counts, M.D. George M. McNabb, M.D. John P. Epling, Jr. , M.D . Attractive salary and benefits package. Peter E. Mezciems, M.D. Donald J. Kurth, M.D. James M. Miner, M.D. Forward CVs, salary history, and references to David Mactus Stephen J. Ryzewicz, M.D . TMF Search Committee Thomas Stammers, M.D. Jud ith Sei xas P.O. Box 120909 *Nashville, TN 37212-0909 John J. Verdon, Jr., M.D . John C. Tanner, D.O. E-mail peggym@tma. medwire. org Circle of Friends ($3,000-4,999) Nina Thiessen, M.D. Fax 615/383-5918. Larry T. Brice, M.D. Norman Wetterau, M.D.

- . . 22 A 5 A M N E W 5 _ .. ~ MY PRACTICE . y busy academic physicians, Linda finds. "Once you tell them smoking is an ,keman H b" Hyder Ferry; M.D ., M.P. ., com ~nes addictive disorder, they are not thrilled atient care, research, and teach 1n g. Dr. Ferry Carves a about being involved, because addicts can LP of her colleagues in ASAM, she be difficult to treat. They relapse, they don't Like m~~~ "crusader" to her job description. Niche in Preventive tell you the truth. Doctors like treating a disease that they can examine, test, diag­ ofte;sa cl1ief of Preventlve Medi~ine at _ t~e Medicine nose, treat, and it goes away. Then they feel L Pettis Memorial Veterans Admlms- Jerry.. n· Medica l Center at Loma L"1n da good and their patients feel good. That is tra t 10 . F . " H pita! Loma L1nda, CA, Dr. ·e1 ry cares 10r ASAM News is proud to not the way addictions work." ~~ents 'with obesity, high cholesterol, poor showcase the many ways in which If every medical school had one cham­ ~~~trol of diabetes. and to?acco addiction. ASAM members contribute to pion of tobacco dependence education, Although today; Dr. Ferry_1s a_ sought-after the field of addiction medicine. says Dr. Ferry, medical students would learn that smoking is addictive but treatable. Dr. expert on smoking cessat1~n, 1n 1987, _on ly Jeanne Erdmann 5 o/o to 7% of her patients remamed Ferry, who teaches a course on smoking cigarette -free after one year - numbers so cessation at Lama Linda Medical School, discouraging that she wondered if the would like to see training extended to nurs­ program was worthwhile. ing schools, dental schools and pharmacy Not ready to give up, she asked her schools. She also has created FIND, the patients questions: What didn't we give you Foundation for Innovations in Nicotine that you needed? How should we change Dependence. The foundation's Web site what we do? Their answers changed the (www.findhelp.com) serves physicians course of her career and changed the lives and smokers alike by providing lists of of many smokers. The patients said that tips, articles, advice, resources and smoking brochures, and weekly sessions weren't cessation lectures. enough. Often divorced or widowed, they Help from other parts of the community were alone and lonely. When Dr. Ferry are needed in this effort. Dr. Ferry wants served as Medical Director of the VAs addic­ insurance plans to cover screening and tion treatment unit, she wondered why advice, counseling and medications. "If you patients who had overcome drug addiction can imagine someone in the health care and alcoholism had such difficulty stopping system saying 'no, we aren't going to treat smoking. Because, she learned, veterans your hypertension. That is not a benefit. If saw how alcohol, cocaine, or heroin was you want to be screened and treated for destroying their lives, but cigarettes were hypertension, you will pay for it on your with them in the battlefield when buddies own' -that' is just ludicrous," she says. were dying all around. "But that is what they do to the smoker." "It dawned on me that this is a much Dr. Ferry also would like to see employ­ more serious problem than I ever gave credit Funding her research proved difficult­ ers in large companies bargain for smoking for," says Dr. Ferry. "This was not like giving two grants were turned down and pharma­ cessation coverage when they negotiate up bananas on your oatmeal in the morn­ ceutical companies rejected her proposals as with health insurers, making the contract ing." If her patients wanted to quit smok­ well. In 1990, she scaled down the pilot contingent on coverage of smoking cessa­ ing, then she would work equally hard to study and Lama Linda University gave her tion and other addiction treatment. She help them find a way. $5,000 to fund it. A medical student and takes satisfaction in the June 2000 report of In 1987, the only medication for nicotine residents helped, and her mother, a retired the Agency for Healthcare Research and addiction was Nicorette® gum, which the nurse, administered the study. Quality that called for health plans to cover VA pharmacy would not approve, and which The trial lasted throughout 1991 and therapies for smoking cessation. The AHRQ Dr. Ferry believes can perpetuate addiction 1992. At the end of that perioid, all of the report called for reimbursement of physician by replacing one form of nicotine with placebo subjects had relapsed, but 55% of services as well. "Now why did they throw another. Searching the medical literature, the buproprion subjects had quit smoking. "I that last thing in?" asks Dr. Ferry. "Because she found that addicts in a trial of clonidine looked at that and thought I had done some­ physicians do not get paid. You get paid for for the symptoms of heroin withdrawal had thing wrong," recalls Dr. Ferry. "I thought, taking care of asthma and COPD caused by the worst outcome if they also had a previ­ 'no one is going to believe this. I am going smoking, and you get paid for treating their ous history of depression. She knew that to be the laughing stock of the smoking heart attack. But no one pays you one cent people used tobacco to self-medicate. Find­ research community'." But larger studies to help them quit smoking." ing a drug that treated depression and that supported her initial results and, in 1997, "If every physician got training on how worked like nicotine might help people stop the FDA approved bupropion (under the to deal with tobacco addiction and then got smoking, she reasoned. Conversations with trade name Zyban®) for smoking cessation. paid to do it," predicted Dr. Ferry, "we psychiatrists, pharmacologists and physiolo­ Much work remains to be done. Dr. Ferry would see things change in five years." • gists led her to bupropion, an antidepressant says physicians are reluctant to become that works on norepinephrine and dopam­ involved in smoking cessation. "Their skep­ Jeanne Erdmann is a St. Louis-based ine-two neurotransmitters responsible for ticism stems from the fact that doctors in medical writer who also writes for Science tobacco withdrawal symptoms. general don't like dealing with addicts," she and CBS Health Watch.

~ .-· MAY-JUNE 2001 23 .. ·-.. .· ~ cASAM CONFERENCE CALENDAR ASAM OTHER EVENTS OF NOTE june 1-3, 2001 june 16 September 7-11 Medical Review Officer (MRO) Training Course Addiction Symposium : An Update Addictions 2000+ 1: St. Louis, MO for the Primary Care Physician Challenges and Opportunities for a 20 Category 1 CME credits Toms River, NJ New Millennium [For information, phone 732/557-8991 September 13-16, 2001 Jerusalem, Israel or e-mail [email protected]] [For information, e-mail ASAM Conference on Tobacco Dependence jorge.gleser@moh .health. gov. in At lanta, GA july 19-20 15.5 Category 1 CME credits (plus 6 CME credits MDMA/Ecstasy Research : September 12-14 for preconference workshops) Advances, Challenges, Future Directions ISAM Annual Conference: November 1-3, 2001 (Sponsored by the National Addictions- Sharing International Conference on the State of the Art Institute on Drug Abuse) Responsibilities in a Changing World in Addiction Medicine Bethesda, MD Trieste, Italy Washington, DC [For information, visit the conference Web site [For information, e-mail 20 Category 1 CME credits at www.drugabuse.gov] [email protected]] November 29, 2001 july 19-21 September 26-29 Forensic Issues in Addiction Medicine 6th Annual Rocky Mountain Carolina Conference on Addiction Washington, DC Mental Health Symposium and Recovery 7 Category 1 CME credits Whitefish, MT Charlotte, NC 12 Category 1 CME Credits 22.5 Category 1 CME Credits November 30-December 2, 2001 [For information, phone 406/7 52 -177 5 [For information, phone 877-392-9973 Medical Review Officer (MRO) Training Course or e-mail [email protected]] or e-mail [email protected]] Washington, DC 20 Category 1 CME credits AU!!USt 9-10 October 18-21 April 25, 2002 2nd National Conference on Canadian Society of Addiction Medicine Pain & Addiction: Common Threads Ill Drug Abuse Prevention Research 13th Annual Scientific Meeting Atlanta, GA Washington, DC Rimrock Resort Hotel, Banff, Alberta 7.5 Category 1 CME credits (Sponsored by the National [For information, e-mail Institute on Drug Abuse) sweeney@ucalgary cal April 25, 2002 [For information, contact Mildred Prioleau Ruth Fox Course for Physicians at 301/46?-6008 x431] Atlanta, GA 8 Category 1 CME credits For additional information, visit the ASAM Web site at www.asam.org, or contact the ASAM April 26-28, 2002 Department of Meetings and Conferences at 4601 North Park Ave.; Suite 101 Upper Arcade, 33rd Annual Medical-Scientific Conference Atlanta, GA Chevy Chase, MD 20815-4520, or phone 301/656-3920, or fax 301/656-3815, or e-mail Up to 19 Category 1 CME credits [email protected]. Information on ASAM's Web site will be updated as meetings are scheduled.

baPoflua. 6ol1/ef-tfft-81Jff ASAM STAFF lrddittffJk aftd ((-8t1J~Pq [Except where noted below, ASAM staff can be reached by phone at 301/656-3920, or by fax at 301/656-3815] Presented by Pavilion International Treatment and Renewal Center James F. Callahan, D.P.A. Sherry Jones Claire Osman 5-tprelnl;-ef 26-2f, 2fJfJf Executive Vice Office Manager Director of Development PresidenVCEO [email protected] Phone: 1-800/257-6776 Renaissance Charlotte Suites Hotel JCALL@ASAM .ORG Cheryl Kim Fax: 718/275-7666 Charlotte, North Carolina [email protected] Nancy Brighindi Manager, Membership For more in[ormation Director of Membership and Chapter Relations Noushin Shariati see our Web page at & Chapter Development CKIM@ASAM. ORG Accounting Assistant www. carolinaconference. com [email protected] Katherine May [email protected] or e-mail Caprice Falwell Director of Meetings Christopher Weirs [email protected]; Meetings Assistant & Conferences Credentialing phone 877/392-9973 C FALW@ASAM . ORG KMAY@ASAM. ORG Project Manager CWEIR@ASAM .ORG or fax 828/625-8213 Joanne Gartenmann Peter Miller Exec. Assistant to the EVP Office of Finance Bonnie B. Wilford Our Mission: To provide education, JGART@ASAM .ORG [email protected] Editor, ASAM News inspiration, and training to help addiction professionals meet the needs of their clients in Lynda Jones Phone: 703/538-2285 ways that better serve individuals, families Director of Finance Fax: 703/536-6186 and communities. [email protected] [email protected]

24 A 5 A M N E W 5 . ··-~;~