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April 19, 2011
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    ASAM News

    Renew Your Membership Today
    ASAM    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Reminder — If you have not already renewed your ASAM membership for 2011, please do so now in order to continue to receive your membership benefits and services. Renewing is easy. You can renew online with your credit card by using your membership credentials, or you can contact the national office at 301.656.3920 or 800.844.8948. For an extensive list of membership benefits and services, visit ASAM's website at

    ASAM Career Center
    ASAM    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    The ASAM Career Center is designed to meet the needs of both job seekers and employers in the field of addiction medicine. It offers employers targeted access to quality addiction medicine professionals, along with quick and easy job posting and online job activity reports. In addition, employers have access to the National Healthcare Network — a growing network of over 200 top health care associations and professional organizations, including the American Hospital Association, American Academy of Pediatrics, and the Association of American Medical Colleges. Job seeking professionals can make sure their resumes are being seen by those in the field who matter most to them. The ASAM Career Center offers job seekers free and confidential resume posting, automated weekly email notification of new job listings, and the ability to save jobs for later review. More

    Doctors Choose Different Paths for Themselves, Patients
    MedPage Today    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    When asked for their recommendations about treatment, doctors were more likely to recommend that their patients go with the less risky procedure but would choose the riskier one for themselves, researchers said. Among primary care physicians given a hypothetical colon cancer scenario, for example, 37.8 percent said they'd choose the treatment with the higher death rate for themselves, Peter Ubel, M.D., of Duke University, and colleagues reported in the April 11 issue of Archives of Internal Medicine. But only 24.5 percent recommended it for a patient.

    » MedPage Today    » Archives of Internal Medicine - Abstract

    Depression and Suicide Among Physicians
    Current Psychiatry    Share    Share on FacebookTwitterShare on LinkedinE-mail
    Although the rate of depression among physicians is comparable to that of the general population, physicians' risk of suicide is markedly higher. Depression and other mood disorders may be under-recognized and inadequately treated in physicians because physicians might be reluctant to seek treatment, attempt to diagnose and treat themselves, and seek and receive "VIP treatment" from other health care providers.

    An evidence-based review in Current Psychiatry, examines physicians' risk for depression and suicide, licensing concerns, and other barriers to effective treatment, and what can be done to overcome such obstacles.

    Daily Alcohol Drinking May Increase Risk for Certain Cancers
    British Medical Journal (Abstract)    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Cancer risk "increases with every extra daily drink," according to research in the British Medical Journal. The analysis of "364,000 people in eight countries," found that "44 percent of cancers of the upper aerodigestive tract" in men and 25 percent in women "might be linked to alcohol"; liver cancer "(33percent in men, 18 percent in women)"; colorectal cancer "(17 percent in men, 4 percent in women)"; and about 5 percent of "breast cancers in women." The American Cancer Society agrees that alcohol "raises the risk of cancer in the mouth, throat, voice box, and esophagus." Alcohol may act as a "solvent," to tissue lining, "allowing harmful chemicals through (especially tobacco from smoking)," ACS explained. Alcohol may also raise drinkers' cirrhosis risk by "further damaging liver cells"; and it may "change estrogen levels," increasing breast cancer risk. More

    Preliminary Evidence of Hippocampal Damage in Chronic Users of Ecstasy
    WedMD and Medscape    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Researchers used MRI scans to measure the "volume of the hippocampus" in 10 men who were long-term ecstasy (3,4-methylenedioxymethamphetamine) users and seven men "who had never used the drug." On average, the users had taken an "average of 281 ecstasy tablets" over the previous six years. The scans revealed that, compared to non-users, ecstasy users had an average 10.5 percent "less hippocampal volume" and an average "4.6 percent lower overall proportion of grey matter in the brain, which suggests that the effects of ecstasy may not be limited to the hippocampus."

    According to WebMD, the study authors said their findings "mirror previous research that has indicated acute swelling and later atrophy of hippocampal tissue in long-term ecstasy users." Notably, the scientists pointed out that hippocampus atrophy "is a hallmark" for progressive cognitive-impairment diseases, such as Alzheimer's.

    Medscape noted that the ecstasy users had also "used more amphetamine and cocaine," but there were "no significant differences between the two groups in recreational drug exposure, other than ecstasy. Both groups also drank alcohol regularly." Meanwhile, Jean M. Bidlack, Ph.D., professor at the University of Rochester School of Medicine and Dentistry in New York, who was not involved in the study, said the preliminary trial "needs to be followed up with a larger study that enrolls a greater number of former ecstasy users."

    » WebMD    » Medscape   » Journal of Neurology Neurosurgery and Psychiatry

    Untreated HCV May Be Boosting Nation's Health care System Cost Increases
    Medscape    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Patients with hepatitis C virus (HCV) infection continue to take an increasingly larger bite out of the American health care system, according to research presented at the International Conference on Viral Hepatitis. Researchers analyzed data from the National Inpatient Sample, found that between 1994 and 2007, hospitalizations for "HCV and HIV/HCV-coinfected patients rose 10.3-fold and 9.2-fold," respectively; and total health care spending increased from "$627 million to $6.9 billion in HCV monoinfected patients and from $63 million to $655 million in HIV/HCV coinfected patients." In contrast, spending and hospitalizations decreased for HIV-infected patients. The study authors noted that HIV infection "rates continue to decline because of improved antiretroviral therapy. .. 'We need to increase identification of HCV-infected patients and offer them therapies,'" said study author Susanna Naggie, M.D. More

    Asymptomatic HSV-2 Carriers Can Transmit Genital Herpes
    The Journal of the American Medical Association    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Researchers at the University of Washington have found just how easily people infected with herpes simplex type 2 virus, which causes genital herpes, can unknowingly pass it on to other people. According to a study published in The Journal of the American Medical Association, participants who tested positive for herpes simplex virus type 2 used a swab to collect 'genital secretions' each day for 30 consecutive days and kept symptom diaries. The researchers found that "410 people with symptomatic genital herpes and 88 participants who tested positive for infection," showed no symptoms.

    The researchers found those "who had had past herpes outbreaks were infectious 20.1 percent of the time, while the asymptomatic group was found to be able to transmit the virus 10.2 percent of the time. The study is one of the largest to date, of people tested positive for herpes simplex virus type 2, also found that virus presence was detected "at least once in 83.4 percent of the people with symptomatic infection and in 68.2 percent of people with asymptomatic herpes."

    Richard D. Whitley, M.D., the University of Alabama and a past president of the Infectious Disease Society of America, has said everyone should determine whether they have HSV-2. In addition to the risk of "unwittingly infecting sexual partners," Dr. Whitley emphasized that "pregnant women with no symptoms can pass on the virus to their babies with devastating consequences for the newborn, including death." Moreover, HSV-2 infection can cause "complications in people who have weakened immune systems due to chronic disease, and it can increase a person's likelihood of contracting HIV."

    The study authors "said condom use, drug therapy and disclosure of the disease to partners can help curb the spread of herpes," and pointed out that blood tests to "detect HSV-2 became widely available in 1999, making it easier for people to find out if they have genital herpes even if the infection isn't active."

    Synthetic Drugs Sent Thousands to ER
    The Associated Press via    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Synthetic substances that mimic marijuana, cocaine and other illegal drugs are making users across the nation seriously ill, causing seizures and hallucinations and even killing some people. The products are often packaged as incense or bath salts and can be obtained for as little as $10 at many head shops. As more people experiment with them, the results are becoming evident at hospitals: a sharp spike in the number of users who show up with problems ranging from labored breathing and rapid heartbeats to extreme paranoia and delusions. The symptoms can persist for days.

    At the request of The Associated Press, the American Association of Poison Control Centers analyzed nationwide figures on calls related to synthetic drugs. At least 2,700 people have fallen ill since January, compared with fewer than 3,200 cases in all of 2010. At that pace, medical emergencies related to synthetic drugs could go up nearly fivefold by the end of the year.

    Increasing Number of US Infants Born Prescription Opiate Dependent
    The New York Times    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    As prescription drug abuse ravages communities across the country, physicians are confronting an emerging challenge: newborns dependent on opiod medications. Infants born dependent on prescription opiates are entering a world in which little is known about the long-term effects on their development. Few physicians are even willing to treat pregnant opiate addicts, and there is no universally accepted standard of care for their babies, partly because of the difficulty of conducting research on pregnant women and newborns.

    ASAM fellow, Dr. Mark Publicker is quoted in the article, as well as ASAM Women's Work Group member, Dr. Hendree Jones.

    Some Docs Ask Patients To Sign 'Pain Contracts' To Get Scripts
    Kaiser Health News via Physician News Digest    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    To help monitor use of opiod medications, some doctors ask patients to sign "pain contracts" or "opioid treatment agreements" that spell out the rules patients must follow to take these drugs safely. The contracts aim to discourage people from taking too much medication, mixing medications, or sharing or selling them, among other things. The agreements may require patients to submit to blood or urine drug tests, fill their prescriptions at a single pharmacy, or refuse to accept pain medication from any other doctor. If patients don't follow the rules, the agreements often state that doctors may drop them from their practice. Some patient advocates and policy experts say that rather than ensuring safety, the agreements invade patients' privacy and damage the trust that's essential to the doctor-patient relationship. More

    Companies Attempt Abuse-Proof Opioids
    MedPage Today    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    When the oxycodone was introduced in the late 1990s, its maker claimed that the drug's controlled-release mechanism would make it less likely to be abused. But it didn't take long for drug seekers to devise a workaround that foiled that plan.

    Since that failed attempt at making a "safe" opioid, researchers have been experimenting with ways to make all prescription painkillers "abuse-resistant." Although OxyContin maker Purdue had its "tamper-proof" version approved last year, few other attempts to abuse-proof these drugs have made it on the market. In June, however, the FDA is expected to issue a decision about another oxycodone product — Acurox. And a handful of other companies are pursuing a pharmacological solution to help mitigate what the federal government has described as an epidemic of prescription painkiller abuse. Some are attempting to prevent abusers not only from inhaling and injecting the drug, but also from taking multiple pills all at once.

    Montana Governor Vetoes Repeal of Medical Marijuana Law
    Reuters    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Montana Gov. Brian Schweitzer vetoed a bill that would have repealed the state's 7-year-old, voter-approved law legalizing marijuana for medical purposes. Schweitzer's veto came as state lawmakers continued work on an alternative bill to tighten regulation of medical marijuana in the state, where 30,000 residents carry cards allowing them to lawfully use marijuana for medical ailments. Critics of the law, approved as a ballot measure by voters in 2004, say the statute has been abused by some as a pretext for recreational pot smoking and even for illegal drug trade. More

    Indiana panel OKs criminal checks on medical workers
    The Associated Press via Bloomberg    Share    Share on FacebookTwitterShare on LinkedinE-mail
    Physicians, dentists, nurses, veterinarians, pharmacists and other medical workers would have to undergo a criminal background check when applying for a new state license under a bill approved by an Indiana House committee. The House Public Health Committee voted 7-1 in favor of the bill, which would permit state boards to suspend, deny or revoke the licenses of people with criminal offenses determined to affect the person's ability to perform their duties. The bill allows action against a person's license if they've been convicted of various offenses, including illegal drug possession, fraudulently obtaining a controlled substance and sex crimes. More

    Teen Substance Abuse on Rise Over Past 3 Years
    Reuters    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Substance abuse has trended upward among American teens over the past three years after a decade of declines, according to a report issued by the Partnership at It said marijuana and ecstasy use among teens shows marked increases while attitudes toward alcohol use have become more relaxed. Between 2008 and 2010, teens who said they had used the "party" drug ecstasy in the past year increased to 10 percent from six percent.

    The Partnership Attitude Tracking Study, which based its findings on a survey of around 2,500 high school students, found that 45 percent said they do not see a "great risk" in heavy daily drinking, while 31 percent strongly disapprove of their peers getting drunk. A total of 68 percent of those surveyed said they had had at least one drink in their lifetimes. Among them, the average age for that drink was 14.

    Maryland Seeks to Tackle Prescription Drug Problem
    The Baltimore Sun    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    The number of people abusing prescription medications in Maryland has risen sharply in recent years, and officials are looking to a new monitoring system, as well as increased awareness, to stem the tide. "Abuse is a serious problem in Maryland, and it's one of the only states without one of the best tools to deal with the problem," said Dr. Joshua M. Sharfstein, secretary of the state's Department of Health and Mental Hygiene. That tool is a monitoring system that would require pharmacies to log each filled prescription in a database, allowing prescribers in doctors' offices, emergency rooms or urgent care facilities to check before writing prescriptions for the same medications. More

    Senate President Haridopolos Welcomes Start of Prescription Drug Database
    The Florida Senate    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Florida Senate President Mike Haridopolos thanked the Florida Department of Health for the decision to begin operation of Florida's prescription drug monitoring program. Created by the Legislature in 2009, the drug database will target prescriptions in an effort to track criminal activity. "The database will provide 'shock and awe' in Florida's efforts to end the criminal abuse of legal prescription drugs," said Haridopolos. "In addition to the Senate's commitment to the database, pending legislation will strengthen the prescription drug monitoring program and provide even stronger privacy protections for individual Floridians." More

    Ohio Governor Announces $36 Million for Prescription Drug Abuse
    The Plain Dealer    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Gov. John Kasich said his administration had directed $36 million in additional funds to combat prescription drug abuse and mental illness. The Republican governor said Ohio's county Alcohol, Drug Addiction and Mental Health service boards were able to come up with $9 million that the state in turn leveraged to draw down $27 million in federal matching funds for a drug treatment and work readiness program. More

    AMA Statement on Vote to Repeal IRS 1099 Reporting Requirement
    American Medical Association    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    "The American Medical Association applauds the passage of bi-partisan legislation to repeal the IRS 1099 reporting requirement for businesses, including physician practices," said J. James Rohack, M.D., immediate past president of the American Medical Association. "Existing administrative burdens already weigh heavily on physicians, taking up time that is better spent caring for patients. The AMA urges President Barack Obama to sign the bi-partisan legislation repealing this unnecessary and burdensome requirement." More

    AMA Advocacy Secures Win on Lab Test Physician Signature Requirement
    American Medical Association    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    The American Medical Association has been urging the Centers for Medicare & Medicaid Services to rescind a provision in the 2011 Medicare Physician Fee Schedule Final Rule that requires physicians to sign every requisition for clinical diagnostic laboratory tests. This policy departs significantly from current practice and would require major changes in work flow. It was scheduled to take effect on Jan. 1, but the AMA persuaded CMS to announce a short delay to Apr. 1, while continuing efforts to have the policy rescinded.

    In response to this aggressive advocacy, CMS has informed the AMA that it is placing a moratorium on enforcement of this new policy while it provides an opportunity for public comment on a proposal to rescind the requirement altogether. It is not yet clear what regulatory vehicle CMS will use to propose this policy rescission. There will be no formal announcement of the moratorium on enforcement prior to the new rulemaking process.

    New Substance Abuse Treatment Advisory: 'Treating Clients with Traumatic Brain Injury'
    SAMHSA    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    SAMHSA's "Treating Clients with Traumatic Brain Injury," Substance Abuse Treatment Advisory, Volume 9, Issue 2, will help substance abuse treatment and behavioral health professionals whose clients are affected by a traumatic brain injury. TBI frequently co-occurs with a behavioral health disorder. It can cause a wide range of cognitive and behavioral effects that interfere with a client's ability to adhere to substance abuse treatment. This Substance Abuse Treatment Advisory provides guidance to substance abuse treatment and behavioral health professionals on working with their clients affected by TBI to promote their successful recovery from both conditions.

    Download or order your free copy today.

    ASAM Online Membership Director/DoctorFinder Feature
    ASAM    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Please take a few minutes to review and update the information in your ASAM member profile. This information appears in ASAM's expanded Membership Directory/DoctorFinder Feature on ASAM's website at At any time you can make edits, change your preferred address, or remove your name from the Membership Directory/DoctorFinder. A complete and accurate member profile helps you get the most out of your membership. To update your complete profile log into the Members' Only section of ASAM's website at using your member credentials and click on the submit button to save your changes. Please remember to update your member profile throughout the year. If you change positions, leave your organization, or your employment status changes this will ensure the continuance of member benefits including your copies of the Journal of Addiction Medicine, ASAM Weekly, and other communications related to your ASAM membership. For more information about updating your profile, contact the National Office at, or call us at 800.844-8948 or 301.656.3920 between 9 a.m. and 5 p.m. EST, Monday through Friday. Thank you for being a member of ASAM! More

    Mental Health and Addiction Parity Law Toolkit
    Mental Health Parity Watch    Share    Share on FacebookTwitterShare on LinkedinE-mail article
    Do you know what your rights and benefits are under the new federal parity law? Do you have a grievance to report? Visit Mental Health Parity Watch,, an online toolkit provided by the Parity Implementation Coalition and the American Psychiatric Association, to find out what the law covers, how to file a complaint and other useful resources. More

    Upcoming Events

    Date Event Location More Information
    April 21 Motivational Interviewing: An Introduction to an Evidence-Based Program and Implementation Process Webinar ATTC
    April 26-29 Federation of State Physicians Health Programs 2011 Annual Meeting & Conference Seattle ASAM
    May 2-3 Advancing Public Health and Safety - It's All About Behavior Baltimore Institutes for Behavior Resources
    June 3-5 Comprehensive MRO: Toxicology Testing and the Physician's Role in the Prevention and Treatment of Substance Abuse Chicago ASAM
    June 14 PCSS-B: Minimizing the Risks of Buprenorphine Diversion and Misuse from Office-Based Treatment Webinar Webinar Registration
    Additional PCSS-B training and resources
    June 17 Drug Use, Abuse and Dependence in Women: Promising Interventions and Treatments Hollywood, FL Women's and Children's International Group
    Oct. 27-29 State of the Art in Addiction Medicine Washington, DC ASAM
    Ongoing Making a Difference: Improving Blood Pressure Control in Your Black Patients Online New Jersey Academy of Family Physicians

    Upcoming Chapter Events

    Date Chapter Location More Information
    April 29-30 North Carolina Asheville, NC Addiction Medicine 2011: Meeting Tomorrow's Challenges Today & NCSAM's Annual Business Meeting
    Aug. 26-27 Georgia Atlanta 2011 Summer Conference
    Oct. 12-15 California Long Beach, CA 2011 Addiction Medicine State of the Art Conference
    ASAM Weekly
    Richard G. Soper, M.D., J.D., M.S., FASAM, Editor-In-Chief, ASAM Weekly
    Dawn Howell, ASAM Publishing Program Coordinator, 301.656.3920 ext. 119
    Colby Horton, Vice President of Publishing, MultiBriefs, 469.420.2601   Download media kit
    Meghan Day, Content Editor, MultiBriefs, 469.420.2650   Contribute news

    ASAM reviews the content of each article included in ASAM Weekly to ensure that it is reflective of the mission of ASAM, aligned with the core principles of addiction medicine and of interest to our members. The articles cited in in ASAM Weekly are offered for information only and ASAM is not responsible for the content of the articles.

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