Newswise — In a new JAMA Internal Medicine “Viewpoint” article, three leading addiction experts document the need for an addiction medicine specialty, trace the history of physicians specializing in addiction treatment, and discuss current efforts by the American Board of Addiction Medicine (ABAM) and The ABAM Foundation to train and certify physicians, and to become recognized and accredited within the larger medical community. The paper is published online September 8, and will be in the journal’s November 2014 print issue.
The article’s authors are all uncompensated officers of ABAM and The ABAM Foundation: Patrick G. O’Connor, M.D., M.P.H., FACP (President); Robert J. Sokol, M.D., FACOG, (President-Elect); and Gail D’Onofrio, M.D., M.S. (Secretary). Dr. O’Connor serves as Professor of Medicine and Chief of the Section of Internal Medicine, Yale University School of Medicine and Yale-New Haven Hospital; Dr. Sokol is The John M. Malone, Jr., MD, Endowed Chair & Director, C.S. Mott Center for Human Growth and Development and Distinguished Professor of Obstetrics and Gynecology, Wayne State University School of Medicine; and Dr. D’Onofrio is Professor and Chair, Department of Emergency Medicine, Yale University School of Medicine and Chief, Emergency Medicine Department, Yale-New Haven Hospital.
“The need for addiction medicine specialists has never been greater,” says Dr. O’Connor, the paper’s lead author. “The path our organization has chosen will help meet this urgent need.”
Despite the devastation caused by substance abuse and addiction, the 2012 National Survey on Drug Use and Health found that 23.1 million Americans needed specialized addiction treatment, while only 2.5 million (11%) received it. This illustrates what the authors call a “treatment gap” – one that might be filled by increasing the number of trained addiction medicine specialists across multiple disciplines.
Addiction specialization in medicine was first initiated by the field of psychiatry. However, the number of addiction psychiatrists has not met the overwhelming need for physicians specializing in addiction treatment and prevention. To meet this need, many in the addiction field saw the necessity of extending the addiction specialist designation to other specialties through the creation of the new discipline of addiction medicine.
ABAM was incorporated as an independent board in 2007, and assumed the certification examination created by the American Society of Addiction Medicine in conjunction with the National Board of Medical Examiners in the 1980s. A physician must meet a number of criteria in order to take the ABAM certification exam. To date, 3,094 physicians have been certified by ABAM.
Because addiction medicine is multidisciplinary, the ABAM board of directors consists of representatives of eight specialties: emergency medicine, family medicine, internal medicine, obstetrics and gynecology, pediatrics, preventive medicine, psychiatry and surgery. Candidates for ABAM certification must have certification from an American Board of Medical Specialties (ABMS) recognized board in one of these – or other -- specialties. To train physicians in addiction medicine, The ABAM Foundation has established 23 addiction medicine fellowship programs at leading medical institutions across the U.S. and Canada. These programs are modeled on the standards of the Accreditation Council on Graduate Medical Education (ACGME), the primary accreditation body for American medical residency programs.
Major goals of ABAM and the Foundation are to have these programs accredited by the ACGME, and to have addiction medicine recognized by the ABMS. A number of steps have already been taken to meet the respective requirements of the two organizations.
According to the authors, “Addiction specialty leaders and clinicians are committed to a vision that the addiction treatment gap will be closed and that the health of the public will be improved by ready access to high-quality care. Addiction medicine offers the opportunity to promote a vision for prevention and treatment by greatly expanding addiction physician specialists to include physicians from internal medicine and other specialties, who can bring their unique perspectives and skills to bear in treating patients in need of their expertise.”
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JAMA Internal Medicine, Nov. 2014