{"id":4853,"date":"2016-03-30T00:00:00","date_gmt":"2016-03-30T06:00:00","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/2016\/03\/30\/307\/"},"modified":"2022-07-13T11:58:06","modified_gmt":"2022-07-13T17:58:06","slug":"new-recognition-brings-addiction-medicine-into-the-light","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/new-recognition-brings-addiction-medicine-into-the-light\/","title":{"rendered":"New recognition brings addiction medicine into the light"},"content":{"rendered":"<div style=\"margin-top: 0px; margin-bottom: 0px;\" class=\"sharethis-inline-share-buttons\" ><\/div><p>The American Board of Medical Specialties this month took a major step toward bringing addiction medicine out of the shadows, <a href=\"https:\/\/www.abms.org\/news-events\/abms-officially-recognizes-addiction-medicine-as-a-subspecialty\/\" target=\"_blank\" rel=\"noopener noreferrer\">announcing<\/a> on March 14, 2016 the recognition of Addiction Medicine as a new subspecialty. The burst of light is a welcome sight at University of Colorado Hospital and the University of Colorado School of Medicine.<\/p>\n<p>The recognition, sponsored by the American Board of Preventive Medicine \u2013 a member of ABMS \u2013 opens the door to any ABMS board-certified physician to receive certification in Addiction Medicine.<\/p>\n<h3><strong>Addiction Medicine certification<\/strong><\/h3>\n<figure id=\"attachment_3004\" aria-describedby=\"caption-attachment-3004\" style=\"width: 300px\" class=\"wp-caption alignright\"><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-3004 size-medium\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144704\/EXT_033016_Millette20and20Pade-1.webp\" width=\"300\" height=\"200\" srcset=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144704\/EXT_033016_Millette20and20Pade-1.webp 600w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144704\/EXT_033016_Millette20and20Pade-1-300x200.webp 300w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144704\/EXT_033016_Millette20and20Pade-1-150x100.webp 150w, https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144704\/EXT_033016_Millette20and20Pade-1-200x133.webp 200w\" sizes=\"auto, (max-width: 300px) 100vw, 300px\" \/><figcaption id=\"caption-attachment-3004\" class=\"wp-caption-text\">For CeDAR Executive Director Steve Millette and CU Addiction Medicine Fellowship Program Director Patty Pade, MD, the American Board of Medical Specialties&#8217; recognition of Addiction Medicine as a new subspecialty is a positive step for a field that has long been overlooked.<\/figcaption><\/figure>\n<p>The certification process requires physicians to complete an education and training program based on the latest science and evidence-based medicine and pass a certification exam. Those who earn the certification will be required to maintain it through \u201ca lifelong learning program\u201d aimed at keeping them abreast of standards of practice in the specialty, ABMS officials said.<\/p>\n<p>\u201cThis landmark event recognizes addiction as a preventable and treatable disease, helping to shed the stigma of misunderstanding that has long plagued it,\u201d noted Robert J. Sokol, MD, and Patrick G. O\u2019Connor, MD, MPH, president and immediate past president, respectively, of the American Board of Addiction Medicine, in a separate letter to members. \u201cIt sends a loud and clear signal that patients can and should seek care from trained and certified physicians and be assured that the care they receive is grounded in research, science and evidence-based practice.\u201d<\/p>\n<h3><strong>Numbers game<\/strong><\/h3>\n<p>The ABMS recognition is a critical step in efforts to address the problem of addiction in the United States. The <a href=\"https:\/\/www.drugabuse.gov\/publications\/drugfacts\/treatment-approaches-drug-addiction\" target=\"_blank\" rel=\"noopener noreferrer\">National Institute on Drug Abuse<\/a> estimates that 22.5 million people age 12 and older need help for drug and alcohol use \u2013 a number that reflects a notable increase in those addicted to prescribed narcotic medications. The NIDA estimates that only about 4.2 million of those received care. Yet until now, the sole ABMS recognized addiction-related certification was available through the American Board of Psychiatry and Neurology \u2013 and only psychiatrists could obtain it.<\/p>\n<p>\u201cThat was unfortunate, given the number of people with addictions we have,\u201d said Patricia Pade, MD, director of the University of Colorado\u2019s Addiction Medicine Fellowship Program. Pade also practices at UCH\u2019s Center for Dependency, Addiction and Rehabilitation (CeDAR) and heads a <a href=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/02\/28144952\/chronic20pain20initiative20and20pcps-1.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">consult service<\/a> at A.F. Williams Family Medicine Clinic for chronic pain patients at moderate to high risk of addiction to prescribed opioid medications. The service is a resource for primary care physicians seeking alternatives to prescribing opioids for their chronic-pain patients. She also leads an addiction medicine consult service at UCH.<\/p>\n<p>The one-year Addiction Medicine Fellowship Program at CU, launched in 2014, is one of 40 in the country training physicians (the Addiction Medicine Foundation wants to triple the number over the next decade). At CU, the program gives fellows experience in residential, outpatient and adolescent treatment; Pade\u2019s chronic pain consult service; and methadone treatment offered through CU\u2019s <a href=\"https:\/\/www.artstreatment.com\/\" target=\"_blank\" rel=\"noopener noreferrer\">ARTS (Addiction Research and Treatment Services) program<\/a>. But those 40 programs, important as they are, can\u2019t do nearly enough alone to stem the tide of addiction, Pade said.<\/p>\n<p>\u201cEven with the programs we have today, we couldn\u2019t possibly train enough people to meet the needs. The Addiction Medicine certification will help to expand the provider source,\u201d Pade said.<\/p>\n<p>The expansion is on the docket at CU and UCH. Pade said her fellowship program will have two physicians \u2013 up from one \u2013 in fiscal year 2017, which begins July 1. In addition, CeDAR will bring on a new attending physician in July who will also provide some coverage for UCH\u2019s Boulder Clinic.<\/p>\n<h3><strong>An orphan no longer<\/strong><\/h3>\n<p>The ABMS decision reflects an emerging view among health care providers, administrators, and insurers that addiction, mental and behavioral health issues, and medical conditions cannot be easily compartmentalized, said Steve Millette, executive director of CeDAR, who <a href=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/2017\/02\/28144952\/cedar20executive20director.pdf\">successfully advocated for an accredited addiction medicine fellowship<\/a> after joining UCH in 2011.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" src=\"https:\/\/uchealth-wp-uploads.s3.amazonaws.com\/wp-content\/uploads\/sites\/6\/1970\/01\/28144952\/EXT_033016_ABMS20logo.webp\" alt=\"ABMS logo \" width=\"300\" height=\"81\" \/>\u201cFor a long time, the average medical person believed that addiction was the province of psychiatry,\u201d Millette said. \u201cThat created a problem because we now know that addiction is often not solely a symptom of an underlying psychological problem. It\u2019s frequently multifactorial.\u201d<\/p>\n<p>Yet for many years, managed care \u201ccarved out\u201d behavioral health and addiction treatment services from their medical benefit, essentially relegating prevention and early treatment to a poorly reimbursed and rationed health care backwater, Millette said. The result was millions of people engaging in risky use of drugs and alcohol with spotty access to services. Many struggled to cope, while residential treatment centers like CeDAR were left to care for the \u201csickest of the sick,\u201d as Millette puts it.<\/p>\n<p>That system will not yield solutions to the problem of addiction and the behaviors that contribute to it, he said. \u201cWe can build 1,000 CeDARs, but that won\u2019t address the issues of a fragmented system of care that fails to offer services where, when and how patients need them,\u201d he said. \u201cWe can\u2019t continue to exist in a parallel process that is outside the mainstream scope of health care. We have to redefine the continuum of care so we can get upstream and provide early-intervention and preventive services for patients.\u201d<\/p>\n<p>In Millette\u2019s view, that will require giving additional support to primary care physicians managing patients with chronic pain and behavioral health and social issues, as is the case at A.F. Williams and UCH\u2019s other primary care and internal medicine clinics. It also means training a new generation of health care providers in the complexities of addiction medicine. The ABMS noted that its recognition of Addiction Medicine as a board-certified specialty \u201copens the door\u201d for fellowship programs like CU\u2019s to seek recognition for residency training from the Accreditation Council on Graduate Medical Education (ACGME).<\/p>\n<p>Millette considers ACGME accreditation as another important step in bringing addiction medicine into the mainstream, <a href=\"https:\/\/www.capc.org\/about\/press-media\/press-releases\/2006-7-1\/acgme-approves-accreditation-process-hospice-and-palliatve-medicine-fellowship-training\/\" target=\"_blank\" rel=\"noopener noreferrer\">much as occurred with hospice and palliative medicine a decade ago<\/a>.<\/p>\n<p>\u201cMedical education has to change,\u201d he said. \u201cThe pressure is on to look at the problem of addiction and train enough physicians who understand it. The system also has to change to make primary care about providing holistic care to people before they have problems.\u201d<\/p>\n<p>Pade sees progress in that regard. \u201cWe\u2019ve gotten more requests from residents for information about addiction medicine. That\u2019s exciting,\u201d she said. \u201cIt\u2019s about an attitude change as much as a knowledge change.\u201d<\/p>\n<p>For Millette, the complexities of addiction medicine ultimately boil down to a simple calculus. \u201cWhen we get people the treatment they need, more get well than die,\u201d he said.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>The American Board of Medical Specialties this month took a major step toward bringing addiction medicine out of the shadows, announcing on March 14, 2016 the recognition of Addiction Medicine as a new subspecialty. The burst of light is a welcome sight at University of Colorado Hospital and the University of Colorado School of Medicine. [&hellip;]<\/p>\n","protected":false},"author":2143,"featured_media":3004,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[8],"tags":[4750,159,17,207,154],"class_list":["post-4853","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","tag-access-to-care","tag-addiction-and-rehabilitation","tag-addiction-treatment","tag-cedar","tag-palliative-care"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - 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