Eighth Slice of Cheese: Addiction Medicine Specialist

Memo to Self: “Get a doc, Doc" 

Dr. Elizabeth Howell, previous president of the American Society of Addiction Medicine, describes the specialty of Addiction Medicine, and why doctors choose this specialty.

 

What is an Addiction Medicine Specialist? (from the website of the American Society of Addiction Medicine)

 

American Board of Addiction Medicine (website)

 

American Academy of Addiction Psychiatry (website)

 

A Major Step Forward for Addiction Medicine by Dr. Nora Volkow, Director, National Institute on Drug Abuse (2016)

 

Howard Wetsman, MD is the most brilliant Addiction Psychiatrist that I have ever met. His book Questions and Answers on Addiction is a simple, excellent summary on addiction neuroscience.  

Dr. Howell explains why it is important for people in recovery to choose an Addiction Medicine Specialist as a physician and why this level of expertise is of benefit to one’s recovery.

What we did at Le Mont with regard to Addiction Medicine Specialists: We asked our residents to choose and develop a relationship with a local Addiction Medicine physician - to have an initial visit with that doctor, and preferably follow up with them at least every other month. For those residents on medication, it is optimal for that person to see their Addiction Medicine physician on a monthly basis. If any medical problems came up during their stay at Le Mont, that resident had a physician who was familiar with their history and could meet their primary care needs in the context of their sobriety.

 

Many people in recovery are wary of doctors because of past mistreatment. They often avoid doctors out of fear that they will be prescribed controlled substances without regard for their recovery, putting their sobriety at risk. This is unfortunate because recovering people can miss out on important preventive health measures and evaluation of other medical problems that often accompany substance use disorder. Addiction Medicine Specialists know how to meet the needs of patients in recovery. They also LIKE taking care of people in recovery, and can manage problems common to early sobriety with compassion and skill. Developing a trusting relationship with a knowledgeable, empathic physician can be a strong resilience factor in establishing and maintaining sobriety.

Dr. Howell explains the approach of the high-risk procedure or using or not using pain medications in a recovering person.

Pain and Addiction

from the website of the American Society of Addiction Medicine

 

Pain Management and Addiction

Addiction Technology Transfer Center

 

Pain-free Living for Drug-free People: A Guide for Pain Management in Recovery

Marvin D. Seppala, MD and David P. Martin, MD, Hazelden Publishing

 

A Day Without Pain

Mel Pohl, MD

 

Dr. Howell explains that, in some patients, opioids often cause a subjective response different from most peoples’ experience. The reasons for this phenomenon are still unclear.

 

Are Opioids the Next Antidepressant?

Anna Fels, MD (New York Times - June 4, 2016)

 

Molecular Mechanisms of Opioid Receptor-Dependent Signaling and Behavior

Ream Al-Hasani, Micheal R. Bruchas (2011) Anesthesiology

 

The Kappa opioid receptor: from addiction to depression, and back.

Lalanne, Ayranci, Kieffer, Lutz (2014) Frontiers in Psychiatry

 

The Therapeutic Potential of Kappa-opioids for Treatment of Pain and Addiction.

Charles Chavkin (2011) Neuropsychopharmacology

 

 

 

I ask Dr. Milner about the emotional sensitivity often common to opioid addicts (which may pre-exist a person’s addiction).