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Substance-Exposed Newborn Reporting for the Addiction Medicine Provider: Guidelines and Critical Appraisal (1 CME)Contains 3 Component(s), Medical Credits Offered
The CAPTA (Child Abuse Prevention Treatment Act) Reauthorization of 2010 requires the reporting of substance-exposed newborns to CPS (Child Protective Services). Compliance with CAPTA is required for state block grant receipt of CPS funding which has led to a heterogeneity of state laws and much confusion at the provider level. Furthermore policies related to alcohol, cannabis, MAT, and illicit substances differ during pregnancy. This focus session will review the background to this legislation and the different state responses. The benefits of CPS in terms of access to services will be contrasted with examples of how CPS reporting of maternal drug use can become a barrier to prenatal care. Special attention will be placed on MAT and confusion from the legislation regarding the reporting of newborns who exhibit withdrawal from methadone or buprenorphine.
The CAPTA (Child Abuse Prevention Treatment Act) Reauthorization of 2010 requires the reporting of substance-exposed newborns to CPS (Child Protective Services). Compliance with CAPTA is required for state block grant receipt of CPS funding which has led to a heterogeneity of state laws and much confusion at the provider level. Furthermore policies related to alcohol, cannabis, MAT, and illicit substances differ during pregnancy. This focus session will review the background to this legislation and the different state responses. The benefits of CPS in terms of access to services will be contrasted with examples of how CPS reporting of maternal drug use can become a barrier to prenatal care. Special attention will be placed on MAT and confusion from the legislation regarding the reporting of newborns who exhibit withdrawal from methadone or buprenorphine. Presentations will include cases drawn from clinical experience as well as data from original research including both maternal perspectives on CPS and state-level data from Maryland Department of Social Services detailing the number of reported newborns, substances reported and outcomes.
MD, MPH, FACOG, FASAM
Mishka Terplan is a physician boarded in both obstetrics and gynecology and addiction medicine. His clinical, research and advocacy work focuses on the intersection of reproductive health and addictions. He is currently Medical Director of Behavioral Health System Baltimore, the local behavioral health authority, adjunct faculty at University of Maryland Department Epidemiology and Public Health, and staff physician at Planned Parenthood Maryland. He has represented both the American Congress of Obstetricians and Gynecologists (ACOG) and the American Society of Addiction Medicine (ASAM) on federal taskforces and in testimony including before the House Energy and Commerce Subcommittee regarding H.R. 1462, the “Protecting Our Infants Act".
Margaret S. Chisolm
Dr. Margaret S. Chisolm is an Associate Professor of Psychiatry and Associate Director of the Paul R. McHugh Program for Human Flourishing at the Johns Hopkins University School of Medicine. She is also Director of Education for the Department of Psychiatry at Johns Hopkins Bayview Medical Center. Dr. Chisolm is co-author of a textbook on psychiatric evaluation and has written more than 70 scientific and clinical articles about substance use and other psychiatric disorders, humanistic practice, and medical education. Dr. Chisolm is an ACNP and ABAM diplomate, a member of the Miller-Coulson Academy of Clinical Excellence, an Arnold P. Gold Foundation Humanism Scholar, and the recipient of the 2014 Johns Hopkins University Alumni Association Excellence in Teaching Award.
Sarah CM. Roberts
Sarah CM Roberts, DrPH, is an Assistant Professor at Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco, Department of Obstetrics, Gynecology, and Reproductive Sciences. Her research interests include policies that affect women's reproductive lives including both state-level abortion restrictions and state-level policies targeting alcohol and drug use during pregnancy. Dr. Roberts' current substance use-related research focuses on the relationship between alcohol and drug use and abortion as well as the effects of policies targeting alcohol use during pregnancy. Her previous substance use-related research focused on barriers to prenatal care for women using drugs and racial disparities in Child Protective Services reporting related to maternal drug use.
Alene Kennedy-Hendricks, PhD is an assistant scientist in the Department of Health Policy and Management at the Johns Hopkins Bloomberg School of Public Health and a core member of the School's Center for Mental Health and Addiction Policy Research. She conducts health policy analysis and communication research related to substance use and mental disorders. Much of her research has focused on public opinion and policy attitudes, social stigma, and news media coverage surrounding the issues of nonmedical use of prescription opioids and prescription opioid use disorder. In addition, Alene is interested in the implementation and impact of delivery system reforms that aim to integrate behavioral health and primary care for individuals with substance use disorders and mental health conditions.
Hashtags & Handles: How to Ethically Utilize Social Media for Alumni Networking (1 CME)Contains 3 Component(s), Medical Credits Offered
Earn a maximum of 1 AMA PRA Category 1 ™ credits while how, in recent years, social media has revolutionized the face of behavioral healthcare marketing. Now more than ever, alumni are turning to social networking sites such as Facebook, Twitter, and Instagram to share experiences, make meaningful connections, and access recovery tips and resources. But with so much potentially sensitive information abound, providers and marketing professionals must be cognizant of the many regulations and ethical complexities relating to social media before sharing and connecting with alumni online. In this interactive discussion, you will gain a clear understanding of social media marketing best practices, and learn how to grow a vibrant online community while maintaining an ethical digital presence and adhering to HIPAA rules and regulations.
Social media has revolutionized and expanded the way we communicate and interact with the world around us. A mere decade ago, it was little more than a budding trend. Now, with Facebook closing in on 1.5 billion active users monthly and 74% of the adult US population using at least one social networking site, it has become a global phenomenon. Utilizing social media platforms can be an asset for addiction treatment providers and program alumni alike, as social support and camaraderie is an important factor to the recovery process. However, providers must remain mindful of patient privacy rights when interacting on social media, as all content must comply with HIPAA, applicable facility policies, and state common law. Breaches in patient privacy and confidentiality on social media can have serious consequences for individual staff members and an organization, including loss of employment and/or state licensure; criminal investigations; fines and penalties; and lawsuits. As providers and marketers within the addiction space, how can we balance the complexities and boundaries of social media with the power of connectivity that these platforms bring? The purpose of this presentation is to demonstrate ethically sound ways to engage with and provide support to alumni via social media platforms. We will first cite ethical issues and case studies relating to engagement with alumni on social media. This includes an in-depth discussion on HIPAA regulations. We will then highlight best practices for engaging with alumni on social media for treatment providers. Finally, in an interactive section of the presentation, we will show examples of tweets, posts, and scenarios that an addiction treatment provider might come across and demonstrate how to best handle these situations.
Ruchi M. Sanghani
Ruchi M. Sanghani, MA holds the position of Director of Research at Recovery Brands LLC. Ms. Sanghani received a Master's degree in Bioethics from Case Western Reserve University, with a concentration in health care research ethics. Her previous works conducted include physician-industry transparency research at The Cleveland Clinic Department of Bioethics, and studies on improving the efficacy of conflict of interest reporting at the Edmond J. Safra Center for Ethics at Harvard University, where she served as a Research Ethics Fellow. Ms. Sanghani is an expert in quantitative methodologies with extensive experience in utilizing survey tools to develop products and programs to increase efficiency. At The Cleveland Clinic, Ms. Sanghani served on a committee to create and implement a reporting platform for physicians to efficiently monitor payments made to them by industry partners. Ms. Sanghani has authored several peer-reviewed publications, including a public call to action for the development of vital multi-metric outcomes measurements to improve the quality of care in the addiction industry. In her current capacity as Director of Research at Recovery Brands, Ms. Sanghani oversees the development and implementation of research investigations to synthesize meaningful and relevant analyses for public consumption to aid in the decision-making process of those seeking addiction treatment.
Content Marketing Manager
Ryan is the Content Marketing Manager at Recovery Brands LLC. In her role, she is responsible for leading the branding and strategy of Recovery Brands' social media channels, blogs, email campaigns, and viral marketing projects. With over six years of experience leading content strategy and implementation in agency and startup environments, she's helped brands amplify their online presence & community engagement. Ryan has been involved on social media and content marketing campaigns for Goodwill Industries, the National Disaster Search Dog Foundation, and the San Diego Union Tribune.
Lifelong Learning: Review of Articles for Addiction Medicine MOC Part 2 (1.5 CME)Contains 3 Component(s), Medical Credits Offered
Earn 1.5 AMA PRA Category 1 ™ credits while reviewing recent articles in addiction medicine this conference recording from the The ASAM 47th Annual Conference, 2016. The presenters will walk you through recent articles in addiction medicine selected for MOC Part 2 will be reviewed and critiqued to demonstrate the process and educate participants on the latest research findings in addiction medicine, including how this impacts patient care.
Maintenance of Certification (MOC) is a fundamental part of Addiction Medicine certification, and it can be important for patient care as well as professional development. MOC Part 2 (also known as lifelong learning and self-assessment) involves reading medical literature and answering questions based on articles, which is not always easy, especially for new addiction medicine certified physicians. This workshop will help meet MOC Part 2 requirements for attendees. In addition, attendees who are not certified in addiction medicine can learn about recent research from across the spectrum of the field of Addiction Medicine. This information will be discussed in terms of clinical relevance to patient care. Session description: Recent articles in addiction medicine selected for MOC Part 2 will be reviewed and critiqued to demonstrate the process and educate participants on the latest research findings in addiction medicine, including how this impacts patient care. Attendees will have a demonstration of the addiction medicine MOC web portal and be able to log on to review and participate in MOC self-assessment modules in real time during this workshop (laptop or tablet with wifi connection required for this—attendees will be informed to bring to the workshop if desired). Several articles from the Self-Assessment Modules (SAMs) will be described and discussed by experienced researcher-educators in Addiction Medicine from around the United States in an unbiased fashion, with attention paid to both strengths and limitations of each article. Each discussion will provide essential information to allow addiction medicine certified physicians to answer self-assessment questions for each article if they desire, and receive credit for participation in MOC Part 2, either during or after the workshop. Conclusions: Participants will gain an appreciation of the scope of recent research in addiction medicine and how it may impact patient care. In addition, participants will learn about new research that may potentially affect their practice. Addiction Medicine certified physicians who attend and are participating in MOC will be able to answer Part 2 Self-Assessment Module questions for MOC credit during this workshop.
Michael F. Weaver
Dr. Michael Weaver is Professor of Psychiatry and Medical Director of the Center for Neurobehavioral Research on Addiction at The University of Texas McGovern Medical School at Houston. He completed a Residency in Internal Medicine and a Clinical Research Fellowship in Addiction Medicine at Virginia Commonwealth University. He is involved in patient care, medical education, and research. Dr. Weaver has multiple publications in the field of addiction medicine. He treats patients at the Innovations Addiction Treatment Clinic at the Texas Medical Center in Houston, which provides medication-assisted treatment. He is the Sub-Board Chair for Addiction Medicine for the American Board of Preventive Medicine. He is a member of the ASAM Publications Council and on the Editorial Board for the Journal of Addiction Medicine.
Lia Bennett is an independent consultant serving as the Director of Maintenance of Certification for the American Board of Addiction. She was a quality improvement program coordinator for the American College of Physicians and brings to ABAM, over 10 years of experience developing and managing MOC compliant programs. She has worked in the field of internal medicine conducting continuing medical education research in the areas of adult immunization, cardiovascular risk and diabetes. Ms. Bennett received her Masters of Public Health with a graduate certificate in Integrative Health. She strives to provide superior guidance to ABAM Diplomates.
Dr. Michael Fingerhood is an Associate Professor of Medicine at the Johns Hopkins University. He is the Chief of the Division of Chemical Dependence and medical director of the Comprehensive Care Practice (CCP) at Johns Hopkins Bayview Medical Center. The CCP integrates substance abuse treatment with primary medical care, including care for HIV and hepatitis C.
Alexander Y. Walley
MD, MSc, FASAM
Alexander Y. Walley, M.D., M.Sc., is an Associate Professor of Medicine at Boston University School of Medicine, a general internist and addiction medicine specialist at Boston Medical Center. He is the director of the Addiction Medicine Fellowship program and founded the Inpatient Addiction Consult Service at Boston Medical Center. He does clinical and research-related work on the medical complications of substance use, specifically HIV and overdose. He provides primary care and office-based buprenorphine treatment for HIV patients and methadone maintenance treatment. He is the medical director for the Massachusetts Department of Public Health’s Opioid Overdose Prevention Pilot Program.
Population Health: The Promise, Perils, and Pitfalls of the Electronic Health Record (1 CME)Contains 3 Component(s), Medical Credits Offered
The mandate to adopt electronic health records (EHR) has created great promise and opportunity throughout medicine. The promise has been in efforts to meaningfully use the information contained in the EHR to improve patient safety and outcome. With this opportunity comes challenge. In this focus session, three principal investigators from the NIDA Clinical Trials Network will share their work covering the promise, perils, and pitfalls of the electronic health record as related to the identification, treatment, and privacy of patients who use alcohol, tobacco, and other drugs. Dr. Li-Tzy Wu will show a population health initiative that identifies comorbid mental health and substance use diagnoses in Type 2 diabetics. Dr. Katharine Bradley will address systems quality improvement through EHR initiatives on marijuana and alcohol screening in primary care settings. Dr. Gavin Bart will address the complexities of privacy protections in the era of the EHR and solicit audience feedback on how privacy protections are implemented within their EHR.
The mandate to adopt electronic health records (EHR) has created great promise and challenge throughout medicine. The promise has been in efforts to meaningfully use the information contained in the EHR to improve patient safety and outcome. With this opportunity comes challenge. In this focus session, three principal investigators from the NIDA Clinical Trials Network will share their work covering the promise, perils, and pitfalls of the EHR as related to the identification, treatment, and privacy of patients who use alcohol, tobacco, and other drugs. Dr. Li-Tzy Wu will share her experience in utilizing a large EHR data warehouse with data from more than 170,000 adults to identify comorbid substance use and mental health diagnoses in patients with type 2 diabetes mellitus (T2DM). Prevalent diagnoses among adults with T2DM were mood (21.22%), SUD (17.02%: tobacco 13.25%, alcohol 4.00%, drugs 4.22%), and anxiety diagnoses (13.98%). The data sets allow for identification of risk groups in general medical settings that can be used to inform the need and structure of collaborative care models and to identify utilization patterns. Dr. Katharine Bradley will describe collaboration with health system clinical and IT leaders to integrate marijuana and drug screening into the EHR. Working in a learning healthcare environment, these partnerships have allowed over 12,000 patients to be screened in the first 6-months. She will present rates of drug and marijuana screening, rates of standardized substance use disorders assessment for high risk patients, and rates of marijuana- and drug- related discussions documented in primary care progress notes. How this process allows for greater monitoring of practice performance and impact on HEDIS measures for initiation and engagement of patients with drug use disorders in care at the level of health system, practice, and practitioner will be discussed. Dr. Bradley will also discuss the challenges of obtaining meaningful data from the EHR progress note through automated natural language processing. Given the high prevalence of marijuana use and the focus of health plans nationwide on HEDIS measures, she will facilitate an audience discussion of perceptions of primary care “best practices" for addressing marijuana use and for improving HEDIS measures. Dr. Gavin Bart will address the complexities of patient privacy protections as specified in 42 CFR Part 2 in the age of the EHR. These protections enacted more than 40 years ago could not have predicted the adoption of the EHR and the integration of addiction and general medical care. Whether 42 CFR Part 2 hampers patient safety through the segregation of medical information in EHRs or threatens the ability to improve population health through the analysis of data in EHR and claims/utilization databases will be discussed. Because there is little understanding of the variability in how the rule is interpreted by health systems, the audience will be encouraged to share their experiences in how the rule has influenced their EHR roll out and ability to track patience centered outcomes and utilization.
MD, PhD, FACP, DFASAM
Dr. Gavin Bart is Director of the Division of Addiction Medicine at Hennepin County Medical Center and Associate Professor of Medicine at the University of Minnesota. He received his MD from the University of Minnesota and trained in internal medicine at the Hennepin County Medical Center. His PhD is in experimental and clinical pharmacology, also from the University of Minnesota. He trained in addiction medicine at The Rockefeller University where he continued as Director of Clinical Research until moving to Minnesota where is is co-PI of the NorthStar Node of the NIDA Clinical Trials Network. His areas of expertise include clinical pharmacology and the pharmacological management of opioid dependence.
His current research areas include the population pharmacokinetics of methadone, genetic influences of methadone pharmacology and treatment outcome, electronic health record privacy provisions of 42 CFR Part 2, and clinical decision support tool development for SUD.
He is Chair of the Life-Long Learning and Self-Assessment committee for the American Board of Addiction Medicine and is ASAM Region VI (IA, IL, IN, MI, MN, WI) director. Internationally, he is co-director of the SAMHSA-funded Vietnam HIV and Addiction Technology Transfer Center and provides ongoing technical assistance for the Substance Abuse and Mental Health Administration in South East and Central Asia.
Ryan Caldeiro obtained his medical degree from Case Western Reserve University School of Medicine in Cleveland, OH. He then completed residency training in Psychiatry and Addiction Psychiatry from the University of Washington in Seattle. During his education and training, he participated in research studies exploring pharmacotherapies for addictive disorders and treatment outcomes for patients with co-occurring chronic pain. Upon completing training, he joined Group Health Cooperative of Washington, where he serves as the Chief of Chemical Dependency Services and Consultative Psychiatry. Group Health is both the largest medical group in Washington State, providing integrated multispecialty care, as well as the largest HMO in Washington State. In his position, he oversees clinical delivery of services for substance use disorder care within the physical healthcare delivery system and provides medical leadership in directing health plan operations as it administers chemical dependency benefits for its members within a contracted network of providers. He also oversees consultative psychiatry services. Within the medical group, he works closely with Primary Care leadership and primary care providers in evaluating and managing patients with substance use disorders and developing capacity and support for delivery of office based buprenorphine in primary care settings developing integrated behavioral health services which includes screening, assessment and population management for patients with depression and substance use disorders. He continues with research activities through the Group Health Research Institute with investigations in collaborative care models for patients with substance use disorders.
ScD, RN, MA
Dr. Wu is a Professor in the Department of Psychiatry and Behavioral Sciences at Duke University Medical Center, Durham, North Carolina, USA. She received pre-doctoral and post-doctoral training in psychiatric and drug addiction epidemiology from the School of Public Health at the Johns Hopkins University, Baltimore, Maryland. She is one of the node Principal Investigators of the National Drug Abuse Treatment Clinical Trials Network.
Katharine Bradley, MD, MPH is a general internist and health services researcher who, for the past 25 years, has conducted research on how alcohol-related care can be practically integrated into medical settings. She is Senior Investigator at Group Health Research Institute, Affiliate Professor of Medicine and Health Services at University of Washington, and Associate Investigator at Veterans Affairs (VA) Puget Sound Health Care System in the U.S. Her research has included validation of the 3-item AUDIT-C and collaboration with VA clinical and quality leaders to implement alcohol screening and brief alcohol interventions in over 900 VA sites nationwide. Ongoing research includes the NIAAA-funded CHOICE trial of nurse-delivered collaborative care for alcohol use disorders (AUDs); an NIAAA-funded study developing a patient decision aid for AUDs; and a pragmatic trial of implementation of alcohol screening, brief alcohol interventions, and shared decision making for AUDs across 25 primary care clinics in a regional integrated health delivery system in the U.S. Dr. Bradley is currently supported by an NIAAA Mid-career Mentoring Award and is a multiple PI, along with Drs. Weisner and Campbell, on the new Health Systems Node of the NIDA Clinical Trials Network. Finally, NIDA CTN has funded pilot research on marijuana and drug screening in 3 primary care clinics which Dr. Bradley will be presenting at ASAM.
CNS Pharmacogenetics Determine Pain Perception, Opioid Risk, Addiction Treatment and Non-Opioid Alternatives (1 CME)Contains 3 Component(s), Medical Credits Offered
Earn 1 AMA PRA Category 1 credits while learning about CNS Pharmacogenetics (PGx) studies of pain, addiction risk and treatment. Our goal is determining which variants (single nucleotide polymorphisms: SNPs) affect patient's pain perception, require higher analgesic doses, increase opioid risk, and affect treatment outcome. While various SNPs predict pain sensitivity and opioid risk; their value is during the acute injury before chronic pain and opioid use. The discovery of COMT SNPs grouped into low, average and high pain sensitivity haplotypes has been reproduced in clinical studies showing prolonged morbidity in high pain sensitive patients with TMJ disorders, motor vehicle accidents and postherniotomy pain. Additional SNPs include voltage-gated sodium and calcium channel variants with new non-opioid treatment. Melanocortin-1, associated with red hair, and new research correlates eye color with pain tolerance. SNPs associated with addiction include Dopamine: DRD2, ANKK1, DRD4, DBH and DAT1. GABA α 2 correlates with adult addiction, yet in adolescents, rule-breaking behaviors. Additional SNPs with opioid risk include serotonin transporter 5HTTLPR and STin2, COMT and BDNF vs. the protective effects of Vasopressin/Oxytocin system. Finally the δ and κ opioid receptors are reviewed.
Pharmacogenetics (PGx) studies the treatment of pain management  addiction risk  and medication-assisted treatment . Precision medicine focuses on single nucleotide polymorphisms (SNPs) in the DNA that encode for receptors, transporters and other CNS enzyme variants. Our goal is determining which SNPs affect patient's exaggerated pain perception  require higher doses of analgesics  and be at increased risk of opioid or other addiction  along with response/treatment outcome. Despite isolating various SNPs, the end result depends upon multiple feedback pathways to up- or down-regulate the mRNA and production of proteins (GABA, glutamate, serotonin & dopamine receptors, transporters, etc.) within the mesocorticolimbic pathway stimulating the Ventral Tegmental Region [VTA] to Nucleus Accumbens [NAc] dopamine release, among other pathways . Similarly, the feedback loop of the Raphe Nucleus on afferent nociceptive pain fibers and the Locus Coeruleus on afferent neuropathic pain fibers are integral to new discoveries of non-opioid pain treatments . While various SNPs help predict pain sensitivity and risk of substance abuse; these analyses need to be done early during the acute phase of injury, or pain process. The longer a patient is on opioids stimulating NAc dopamine release, regulation feedback on RNA affects protein/receptor density. An early pain study found Catechol-o-methyltransferase (COMT) Val158Met variant having reduced activity and subsequent increased OPRM1 receptor density due to continuous dopamine bombardment down-regulating natural endorphin production . The original discovery of 4 COMT SNPs grouped into three haplotypes, low, average and high pain sensitivity  has continued to be reproduced from the bench to the bedside in clinical studies showing exaggerated and prolonged pain in high pain sensitive patients in TMJ disorders, minor motor vehicle accidents  and postherniotomy pain  adding GTP cyclohydrolase (GCH1) to the COMT. Additional SNPs include the calcium channel complex subunit CACNA2D2, which increased sensitivity to opioid treatment , and the importance of voltage-gated sodium channel variants in new non-opioid pain treatments . Several of these SNPs also have significant affects based upon gender . Melanocortin-1, closely associated with red hair color has some equivocal findings with pain sensitivity, and new research correlates eye color with pain tolerance. Several key SNPs associated with opioid abuse and addiction includes Dopamine: DRD2, ANKK1, DRD4, DBH and DAT1  but varies by the allele in regards to addiction risk vs. another allele in poor responders to buprenorphine  Other SNPs correlating with addiction include GABA α 2 (GABRA2) in adults, but race specific as some variants were addiction protective in African Americans . In adolescents it was associated with rule-breaking behaviors that may lead to addiction vulnerability . Additional SNPs with opioid risk include serotonin transporter, SLC6A4, specifically 5HTTLPR and STin2, COMT, BDNF  including stress-related reward affects on DA release in the NAc and protective effects of Vasopressin/Oxytocin system in reducing addiction and relapse . Finally the importance of the δ and κ opioid receptors will be reviewed.
Daniel A. Schwarz
MD, CMRO, FASAM
Dr. Schwarz obtained his M.D. from the University of Illinois at Chicago, and then completed his Surgery Residency at the University of Toledo, becoming Board Certified in 1994. He combined productive surgical research at the University of Michigan, while an active Level-1 Trauma Surgeon/Clinical Instructor of Surgery at the University of Toledo. After a business sabbatical, he returned to the University of Michigan where he expanded the Craniofacial Research Lab, was awarded several grants, research awards and co-authored an NIH RO1 funded grant, with Steven Buchman, MD. He mentored a dozen students, fellows and some residents.
Recognizing increased opioid abuse in surgical and pain management patients, he pursued a formal Addiction Medicine fellowship at St. John's Brighton Hospital under John Hopper, MD, becoming Board Certified in 2010. He initiated the first prospective study correlating addiction after gastric bypass, published 2010. He became MRO certified, is CLIA high-complexity certified in toxicology, and laboratory director for office EIA and reference LC-MS/MS laboratories. He practices pain management and addiction medicine, specializing in co-occurring disorders, primarily ADHD. He was Medical Director for Summit Diagnostics, LLC, overseeing both toxicology and Pharmacogenetics (PGx), and then became Chief Medical Advisor for Iverson Genetics, educating physicians before joining Proove Biosciences as Executive Director R&D;Medical Director Pain and Addiction. He authored and was P.I. for two large IRB approved, multi-center longitudinal studies on pain and PGx, and commercialized a reproducible pain perception PGx test, originally published in 2004. He went on to develop his own PGx algorithms in pain and addiction, as Principal of JAS Consulting, LLC, and interprets genetic tests for physicians, while speaking, educating, and consulting. He is currently authoring three manuscripts: Pain Management, Addiction Medicine and PGx in Toxicology for Elsevier's Clinics in Laboratory Medicine series.
Mark K. Greenwald
Mark Greenwald, Ph.D. (tenured Professor) is the Associate Chair for Research, and directs the Substance Abuse Research Division, its Human Pharmacology Laboratory and outpatient opioid treatment clinic in the Dept. of Psychiatry and Behavioral Neurosciences at Wayne State University (WSU) School of Medicine in Detroit, Michigan. He is jointly appointed in the WSU Dept. of Pharmacy Practice. Dr. Greenwald has published about 90 research papers and book chapters, and over 165 research abstracts. His research program focuses on (1) pharmacological, environmental and individual difference – including genetic – determinants of drug seeking/use as they relate to progression, persistence and relapse problems; (2) using brain-imaging techniques (e.g. PET to measure mu-opioid receptors, MRS to measure glutamate), pharmacokinetics, and behavioral phenotyping (laboratory models of drug motivation) to advance the clinical neurobiology of substance use disorders; and (3) developing novel medication and behavioral treatments for substance use disorders (e.g. opioid, cocaine and cannabis). The National Institutes on Health (NIH) has continuously funded his research since 1996. He has been principal investigator and co-investigator on many federally funded grants (especially related to opioids and buprenorphine treatment), has consulted for pharmaceutical companies related to emerging addiction medicine products, regularly reviews grant applications and has peer-reviewed manuscripts for more than 30 substance abuse and psychiatric journals. He is a past President of Division 28 (Psychopharmacology and Substance Abuse) of the American Psychological Association. Dr. Greenwald proudly mentors tenure-track junior faculty members, medical residents, postdoctoral fellows, graduate students, postbaccaulaureate, and undergraduate honors students.
Inna Belfer, MD PhD is a human geneticist with a primary interest in the relationship between genes and complex traits such as human pain, psychiatric diseases, and addictions. Her research focuses on identifying genetic and pharmacogenomic signatures predicting acute and chronic pain and analgesic response. Dr. Belfer is a nationally and internationally recognized expert in human pain phenotyping and genotyping as well as in modifiers of genetic effects on pain, analgesia and opioid addiction. Currently Dr. Belfer is a Clinical Analyst at the Division of Analgesic, Anesthetic and Addiction Products at the Food and Drug Administration. In addition she is an Adjunct Professor of Medicine and Human Genetics at the University of Pittsburgh, Pittsburgh, Pennsylvania and an Adjunct Professor of Neuroscience at McGill University, Montreal, Canada.
The Role of Screening, Brief Intervention and Referral to Treatment Everyone’s Business (1.5 CME)Contains 3 Component(s), Medical Credits Offered
Screening, Brief Intervention and Referral to Treatment (SBIRT) is a public health approach to identifying and addressing substance use in our patients. The SBIRT model will be examined via a panel presentation. Each presenter will provide examples of SBIRT implementation in a variety of settings (health and community health) and the utilization of technology-based SBIRT delivery systems. The panel will examine what role SBIRT can play with patient’s health and wellness.
Screening, Brief Intervention and Referral to Treatment (SBIRT) is a public health approach to identifying and addressing substance use in our patients. The SBIRT model will be examined via a panel presentation. Each presenter will provide examples of SBIRT implementation in a variety of settings (health and community health) and the utilization of technology-based SBIRT delivery systems. The panel will examine what role SBIRT can play with patient's health and wellness. At the end of the session participants will be able to: understand the Screening, Brief Intervention and Referral to Treatment (SBIRT) model and the role it can play with patient's health and wellness, describe technology-based interventions that deliver SBIRT in a variety of health care settings and apply SBIRT to their current work environment. The goal of this presentation is to create a community of providers who share a passion for reducing and/or eliminating substance use problems in society.
Before joining IRETA in 2011, Dr. Peter Luongo worked in the behavioral health field for over thirty years as a social worker and administrator. In Maryland, Dr. Luongo was the Single State Authority under three governors as the director of the Department of Health and Mental Hygiene Alcohol and Drug Abuse Administration. He also served within the Montgomery County, MD Department of Health and Human Services for over two decades in a variety of clinical and administrative leadership roles. He received his B.A. and M.A. in Psychology from The Catholic University of America and his Ph.D. in Social Work from the University of Maryland. Dr. Luongo has served as a faculty associate at Johns Hopkins University where he received the Johns Hopkins University Excellence in Teaching Award in 1996. In 2008, he received the Maryland Social Worker of the Year award from the National Association of Social Workers and in 2012, he was selected as one of “50 Heroes for Justice” by The University of Maryland School of Social Work. In 2015 Dr. Luongo was nominated and elected a Class A Trustee of the General Services Board of Alcoholics Anonymous.
Richard L. Brown
Dr. Brown is a family physician and a tenured full professor in the Department of Family Medicine and Community Health, School of Medicine and Public Health, University of Wisconsin. His academic focus has been the primary care management of alcohol and drug disorders and other behavioral risk factors and conditions. He has conducted NIH-funded research, published dozens of peer reviewed articles, made numerous presentations, and conducted workshops in these realms on four continents. He served as president of the Association for Medical Education and Research in Substance Abuse (AMERSA) from 1997 to 1999 and received AMERSA's McGovern award for excellence in medical education in 2002. From 1999 to 2004, he served as the founding director of Project MAINSTREAM (www.projectmainstream.net), a federally funded program that enhanced substance abuse education for twelve health professions and improved education for over 10,000 trainees. Since 2006, he has served as Director for the Wisconsin Initiative to Promote Healthy Lifestyles (www.wiphl.com). WIPHL has helped 40 general healthcare settings provide over 110,000 screens and 25,000 interventions, garner excellent patient satisfaction, and elicit substantial declines in risky and problem drinking. Dr. Brown is owner and CEO of Wellsys, LLC (www.wellsys.co), which provides software, consulting, training and clinical support to enable healthcare settings to provide systematic, evidence-based, cost-saving screening and intervention services for the behavioral risks and disorders responsible for over 40% of deaths, most chronic disease and disability and nearly $1 trillion in costs per year.
Thomas Freese, PhD
Principal Investigator and Co-Director, Pacific Southwest Addiction Technology Transfer Center (Pacific Southwest ATTC, HHS Region 9)
Thomas E. Freese, Ph.D., received his doctorate degree in clinical psychology from the California School of Professional Psychology in 1995. Dr. Freese is currently the Director of Training for UCLA ISAP, Principal Investigator and Director of the SAMHSA-funded Pacific Southwest Addiction Technology Transfer Center (PSATTC, HHS Region 9), and Principal Investigator and Co-Director of the SAMHSA-funded Center of Excellence on Racial and Ethnic Young Men Who Have Sex with Men and Other Lesbian, Gay, Bisexual, and Transgender Individuals (YMSM+LGBT CoE). Dr. Freese has served as Principal Investigator on projects funded by the California Department of Alcohol and Drug Programs and Department of Health Care Services to train providers to implement Screening, Brief Intervention, and Referral to Treatment (SBIRT). Dr. Freese has also led several large projects that assist providers in implementing integrated treatment for co-occurring mental health and substance use disorders. He has been a featured presenter at conferences and meetings nationally and internationally on the impact and treatment of methamphetamine and opioid dependence. In addition, Dr. Freese has served as the Project Director on a number of studies including research on methamphetamine use. He has worked in the addiction field since 1983, and has developed and conducted trainings in 45 states and internationally, providing training and workshops for clinicians-in-training at the all levels.
Brian Suffoletto, MD MS, is an Assistant Professor in the Dept. of Emergency Medicine at the University of Pittsburgh. As a clinical investigator, he has developed a specific focus on designing and evaluating mHealth interventions that use time-varying EMA data to understand contextual and time-varying contributors to substance use. He is currently a recipient of a K23 award from the NIAAA with a focus on advancing the science of adaptive mHealth alcohol interventions and a co-Investigator on an R34 from the NIAAA focused on testing a telemedicine and text message platforms aimed at reducing alcohol misuse among community college students. He is also a co-Investigator on a NIDA-Emergency Medicine Foundation grant to study the potential effectiveness of a text messaging program on substance use relapse rates and is conducting pilot studies that use mobile phone sensor data to predict alcohol use occasions. Based on these experiences, he has found that mobile communication devices can be powerful tools to understand substance use, but balancing design between data collection and usability is critical for success.
Overview of Addiction Medicine (1.5 CME)Contains 3 Component(s), Medical Credits Offered
Using The ASAM Principles of Addiction Medicine, fifth edition as a guide, presenters will review articles spanning neurobiology, pharmacology, intoxication and withdrawal, screening and diagnosis, treatment, mutual help, and special topics and populations.
This symposium will provide a rapid review of recent updates from the scientific literature from 2015 to 2016 in addiction medicine. We will begin with articles related to the neurobiology of addiction and progress to epidemiology, pharmacology, intoxication and withdrawal syndromes, screening and diagnosis, mutual help, special topics including harm reduction, special populations including the criminal justice population, and end with an overview of addiction treatments including pharmacologic and behavioral interventions. We will review key articles from the past twelve months, with a focus on those published in high impact factor journals and studies with particularly noteworthy findings. We will structure this as a "rapid-fire journal club" and will encourage audience participation. We will also discuss implications of research findings and possible relevance to clinical practice. The goal of this symposium is to provide the learner with a concise, structured, and evidence-based summary of the most recent scientific evidence in the field using The ASAM Principles of Addiction Medicine, fifth edition as a guide.
Sarah E. Wakeman, MD is the Medical Director for the Mass General Hospital Substance Use Disorder Initiative, program director of the Mass General Addiction Medicine fellowship, and an Assistant Professor of Medicine at Harvard Medical School. She is also the Medical Director of the Mass General Hospital Addiction Consult Team, co-chair of the Mass General Opioid Task Force, and clinical lead of the Partners Healthcare Substance Use Disorder Initiative. She is the Medical Director of RIZE Massachusetts, a state-wide, private sector initiative created to build a $50 million fund to implement and evaluate innovative interventions to address the opioid overdose crisis. She received her A.B. from Brown University and her M.D. from Brown Medical School. She completed residency training in internal medicine and served as Chief Medical Resident at Mass General Hospital. She is a diplomate and fellow of the American Board of Addiction Medicine. She is chair of the policy committee for the Massachusetts Society of Addiction Medicine. She served on Massachusetts' Governor Baker’s Opioid Addiction Working Group. Nationally, she is chair of the American Society of Addiction Medicine Drug Court Task Force and serves on their ethics committee.Clinically she provides specialty addiction and general medical care in the inpatient and outpatient setting at Mass General Hospital and the Mass General Charlestown Health Center. Her research interests include evaluating models for integrated substance use disorder treatment in medical settings, recovery coaching, physician attitudes and practice related to substance use disorder, and screening for substance use in primary care.
Joshua D. Lee
MD, MSc, FASAM
Joshua D. Lee MD, MSc is an Associate Professor in the Departments of Population Health and Medicine at the NYU School of Medicine. He is board-certified in Internal Medicine and Addiction Medicine and is a physician at Bellevue Hospital Center, NYU Langone Medical Center, and in the NYC jails. He directs the NYU ABAM Fellowship in Addiction Medicine. His research focuses on novel and medication treatments for addiction among criminal justice and primary care populations.
Reduction in Drug Use and Improved Health (1.5 CME)Contains 3 Component(s), Medical Credits Offered
For the first time a seminal finding shows that reduction in drug use is associated with improved health in general. Specifically we will show that reduction in cocaine use by chronic cocaine users improves their cardiac health and this can be diagnosed by measuring plasma levels of Endothelin-1, a biomarker of coronary endothelial function.
Reduction in Drug Use and Improved Health Jag H. Khalsa, MS, PhD, National Institute on Drug Abuse, NIH, USA Ivan Montoya, MD, National Institute on Drug Abuse, NIH, USA In 2014, an estimated 27 million people aged 12 or older were current users of an illicit drug in the United States. Although only an estimated 1.5 million were the cocaine users in the US, worldwide, an estimated 13-19 million people used cocaine in the past year. Drug use is associated with serious morbidity and mortality. Besides affecting the CNS, cocaine abuse is also associated with cardiovascular disease (CVD). It is projected that in 2030, an estimated 24 million people will die from CVD. In addition, not only HIV infection is associated with cardiovascular complications, but the highly active antiretroviral therapy (HAART) that has substantially reduced AIDS-related mortality and thus non-HIV-related mortality, is also increasingly associated with CVD. In this symposium, the clinician/researchers, Drs. Shenghan Lai (Johns Hopkins) and Alex Manini (Mount Sinai, NY) will present their latest research on cocaine and HIV-associated CV effects, and also show that reduction in cocaine use is associated with improved cardiac health. Further, they will also discuss the role of various biomarkers in diagnosing cardiovascular effects of stimulants including cocaine and amphetamines in HIV infected substance abusing populations. Dr. David Fiellin (Yale), By using the Veterans Aging Cohort Index (VACS), Dr. David Fiellin (Yale) will present his research on reduced drug use and improved health in a Veterans cohort of HIV-infected individuals on opioid agonist therapy. We will also discuss the latest funding opportunities available at NIDA/NIH.
Dr. Jag Khalsa, with about 50 years of experience in drug research, serves as the Chief of the Medical Consequences Branch, National Institute on Drug Abuse, NIH, DHHS; is responsible for developing/administering a national and international program of clinical research on medical and health consequences of drug abuse and co-occurring infections (HIV, HCV, and others). Prior to joining NIDA in 1987, he served for ~10 yrs as a pharmacologist/toxicologist assessing safety (carcinogenic/teratogenic) potential of chemicals [INDs/NDAs] and food additives) and clinical evaluator at FDA. He has published in pharmacology, toxicology, epidemiology and medical journals. He serves on editorial boards of Journals of Addiction Medicine, Research on HIV/AIDS and Palliative Care, Frontiers of Neuroscience, and Clinical Infectious Diseases. He also serves on numerous Federal and NIH level committees including the HHS Viral Hepatitis Implementation Group (VHIG), National Commission on Digestive Diseases and its two sub-committees (Liver Research, Diabetes Research), Federal Task Force on TB, NIH Steering Committee on Centers for AIDS Research. He has received distinguished service awards from the FDA Commissioner, NIDA and NIH Directors, Society of Neuro-Immune-Pharmacology (SNIP), Life Time Achievement Awards from SNIP and International Conference on Molecular Medicine (India) and MIT, India; a commendation from the US Congress, Awards of Merit from the International Society of Addiction Medicine (ISAM), the President of the American Society of Addiction Medicine (ASAM), and a Certificate of Appreciation from the Office of Assistant Secretary for Health (Drs. Howard Koh and Ron Valdiserri), DHHS. He has a Ph.D. in neuro-psycho-pharmacology, a Master's degree in herbal pharmacology/medicine, post-doctoral training in CNS/Cardiovascular pharmacology at SK&F, and Toxicology at SRI International. E-mail: firstname.lastname@example.org
Professor of Pathology, Radiology, Psychiatry, Medicine & Epidemiology
John Hopkins University School of Medicine
Dr. Manini is Associate Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai in New York City, where he is the Co-Director of the Medical Toxicology Division, and Associate Director of the Clinician Scientist Training Program (T32) in Emergency Care Research. He is an established, independent investigator with a track record in clinical investigation related to drug overdose, substance use, and emergency medicine, with over 60 peer-reviewed publications. He is currently PI on a NIDA R01 entitled "Predicting adverse cardiovascular events due to drug overdose emergencies". His completed funding includes a career development award from the National Institute on Drug Abuse, as well as grants from the City of New York, the New York State Department of Health, the Emergency Medicine Foundation, and the Medical Toxicology Foundation.
David A. Fiellin
Professor of Medicine, Investigative Medicine and Public Health
Yale University School of Medicine
Dr. Montoya is the Deputy Director of the Division of Therapeutics and Medical Consequences (DTMC) and Senior Medical Officer at the National Institute on Drug Abuse (NIDA). He received an M.D. from the University of Antioquia (Colombia), a Masters in Public Health from The Johns Hopkins School of Public Health, and completed residency training in Psychiatry at the University of Antioquia and the University of Maryland Hospital (Baltimore). He was a Fulbright-Hubert H. Humphrey Fellow at The Johns Hopkins School of Public Health, Visiting Foreign Fellow at the Intramural Research Program of NIDA, Director of the Practice Research Network of the American Psychiatric Association, and consultant for the World Health Organization's Pan American Health Organization. He has published extensively in the areas of etiology, prevention, treatment (pharmacological and non-pharmacological), and medical consequences of drug abuse.
Medication Assisted Treatment for Tobacco Addiction: Putting Evidence into Practice (1.5 CME)Contains 3 Component(s), Medical Credits Offered
Tobacco is the most common addiction for which medications are approved by the FDA to treat this deadly addiction. However, due to a variety of system, patient and practitioner level barriers, medication assisted treatment is rarely offered. Moreover, the presence of comorbidities such as other addictions or mental illnesses inhibit practitioners from assisting tobacco addicted individuals. This workshop will review the evidence base on the use of FDA approved smoking cessation medication in these populations. Learners will understand how to prescribe combination therapy safely. The session will be case based and interactive with a focus on safety while using medications to assist tobacco addicted individuals achieve and maintain a permanent remission.
Tobacco addiction is the leading cause of preventable death in North America, killing nearly half a million North Americans every year. Current smokers are more likely to be less educated, live in poverty and suffer from other addictions and or mental health disorders. The USPTF in September 2015 provided Grade A evidence to intervene with every smoker. Addiction treatment and primary care settings are optimal to provide combined evidence based behavioural and medication assisted treatment. , However, a lack of specialized knowledge in medication assisted treatment for tobacco addiction pose a challenge to adapting and tailoring treatment for patients with other mental illnesses and or addictions. Additionally, the challenge of variable motivation and firmly held beliefs regarding tobacco use pose a challenge for practitioners and patients.This workshop will assist practitioners adapt the latest evidence to their patients with comorbid addictions and or mental illnesses. This dynamic and interactive session will give attendees practical, relevant knowledge and skills to incorporate evidence-based approaches to tobacco dependence treatment in their practice, with particular emphasis on adapting and tailoring pharmacotherapy for patients with co-morbid conditions. Attendees will leave the session with a better understanding of how to recommend and prescribe pharmacotherapy for tobacco addicted individuals and explore evidence-based approaches for patients with mental health problems as well. This session emphasizes learner engagement, interaction and practice though large and small group discussions, case-based learning and reflective exercises. Workshop participants will receive links to clinical tools and resources to facilitate sharing with colleagues and community stakeholders.
MBBS, CCFP, FCFP, DFASAM
Peter Selby MD is the Director of Medical Education and a Clinician Scientist at the Centre for Addiction and Mental Health. He is a Professor in the Departments of Family and Community Medicine, Psychiatry, and the Dalla Lana School of Public Health at the University of Toronto. He is also a Clinician Scientist in the Department of Family and Community Medicine. Dr. Selby is the Executive Director and creator of the TEACH project; a continuing education certificate program in Applied Counselling for Health with a focus on smoking cessation, through the University of Toronto. Dr. Selbyâ€™s research, as a Principal Investigator at the Ontario Tobacco Research Unit, includes smoking cessation especially in smokers with co-morbid conditions. As the Principal Investigator of the STOP Study, he investigates the effectiveness of NRT and counselling in different types of intervention settings. He is also the PI of CANADAPTT- a unique Canadian Smoking Cessation Guideline development and dissemination project. Dr. Selby also continues his clinical research with pregnant women who use substances and is the PI of a knowledge translation program (PREGNETS) to increase the adoption of evidence-based interventions with pregnant smokers.
He has received grant funding totaling over 80 million dollars from CIHR, NIH, and Ministry of Health and has published 130 peer reviewed publications. He has published 5 books (including 4 edited), is the author of 30 book chapters, and 32 research reports prepared for the government. He is the Co-Chair for the Ministry of Health Cessation Task force and the Chair of the Canadian Centre on Substance Abuse National Task Force on Treatment for Prescription Drug Misuse. Dr. Selby mentors Fellows in Addiction Medicine and Addiction Psychiatry, junior investigators and medical students. Dr. Selby a sought after speaker for various topics including addictive disorders, motivational interviewing, and health behavior change.
President’s Symposium - Advances in Pain Management: Collaborative Solutions to a Complex Problem (1.5 CME)Contains 3 Component(s), Medical Credits Offered
ASAM’s President will lead an in-depth exploration into new developments in the field of pain management. This high-level symposium will not only explore the difficult overlap between chronic pain and addiction but also the complexities of inter-professional collaboration.
ASAM's President will lead an in-depth exploration into new developments in the field of pain management. This high-level symposium will not only explore the difficult overlap between chronic pain and addiction but also the complexities of inter-professional collaboration. Collaboration is ubiquitous and necessary for many of the healthcare innovations of the past few years. Presenters will discuss new changes in pain management that are being promoted by the AMA and how these changes will affect the medical culture surrounding pain treatment. Experts will also discuss inter-professional management issues and the patients who have chronic pain and a high risk of addiction. Doctors have found that some patients will feel abandoned if their pain medicine is stopped suddenly. Physicians and other members of the care team need to help their patients understand the risk of brain changes and how to use alternatives to addictive pain medicines to develop a new lifestyle. This session will provide a new viewpoint on the present and future of pain management
R. Jeffrey Goldsmith
MD, DLFAPA, DFASAM
Dr. Goldsmith began his addiction medicine career in 1974 as a medical student, learning about the disease of alcoholism as a counselor for one of the Department of Transportation's Alcohol Safety Action Projects. He received his medical training at the University of Cincinnati College of Medicine from 1973-1977 and finished his residency in Psychiatry at UC in 1981.
Recent Employment history
In 1994 Dr. Goldsmith joined the VA fulltime. From 1994-2009, he split his time between Dual Diagnosis Services and other duties including all of the psychiatric consultations for the hospital (1994-1997) and research with the Clinical Trials Network (1995-2009). He was an active member of Cincinnati's NIDA research group, and Cincinnati's principal investigator for its pivotal study of buprenorphine/naloxone for opiate addiction. Dr Goldsmith also created an integrated Primary Care Mental Health program with the director of Primary Care, initiated in 2007 and still active.
Currently Dr. Goldsmith works in the VA Buprenorphine Treatment Clinic.
In 1994, Dr. Goldsmith developed an ACGME accredited Addiction Psychiatry Fellowship and the following year was funded by the Dept. of Veterans Affairs for a two year Addiction Medicine Fellowship. He holds the title of Professor of Clinical Psychiatry in the Department of Psychiatry and Behavioral Neuroscience at the University of Cincinnati. He was addiction fellowship director from 1989 to 2007 and continues to teach in addiction fellowships: Psychiatry and ABAM.
Dr. Goldsmith joined ASAM in 1984, became ASAM certified in 1986 and got his CAQ in Addiction Psychiatry in 1994. He has been on the CME committee since then, and was its chair for nine years from 2000-2009. Dr Goldsmith is President of ASAM 2015-2017.
Mark A. Weiner
Dr. Weiner received his undergraduate degree (B.S. Psychology) at the University of Michigan, Ann Arbor. He earned his medical degree at Cornell University Medical College in New York City. He completed his internship and residency in Internal Medicine at Northwestern University McGaw Medical Campus in Chicago, Illinois. He is Board Certified in Internal Medicine and Addiction Medicine. Since 2008, Dr. Weiner has worked at Pain Recovery Solutions in Ann Arbor, Michigan practicing full time Addiction Medicine and Pain Medicine. He is the Section Head of Addiction Medicine at Saint Joseph Mercy Hospital - Ann Arbor. He has participated in planning the ASAM preconfernece, Common Threads: Pain and Addiction, since 2011 and is the current vice chair. He also is a member of the ASAM Annual Meeting planning committee since 2014 and is an editor on the up-and-coming ASAM Pain and Addiction Handbook.
Herbert L. Malinoff
MD, FACP, DFASAM
I am the president and founder of Pain Recovery Solutions and began this private practice in 1999. I am certified in Internal Medicine, Pain Management, Addiction Medicine, and Medical Oncology. I specializes in treating patients with chronic pain syndromes, addiction, and in detoxification as well as internal medicine needs. I have the understanding of the relationship between medical problems, pain, and addiction led to the establishment of a practice that provide services to patients that address multiple related problems using an integrated, comprehensive approach. I received my Medical Degree from the University of Michigan in 1978. I trained in Internal Medicine at Michael Reese Hospital in Chicago, and completed fellowships in Hematology/Oncology and Nuclear Medicine at the University of Michigan. I have an associate degree in Healthcare Risk Management and Quality Review. I present lectures internationally on Chronic Pain and Addiction and am an active member of the American Society of Addiction Medicine where I am co-chairman of the Pain and Addiction-Common Threads Course. I am a Fellow of both the American College of Physicians and the American Society of Addiction Medicine. I am the immediate past president of the Michigan Society of Addiction Medicine and on the faculty of the Department of Anesthesia at the University of Michigan Medical Center. No Disclosures